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Wednesday, January 22, 2014 at 3:17 PM
The art of presence
Do be there. Some people think that those who experience trauma need space to sort things through. Assume the opposite. Most people need presence.
Don't compare, ever. Don't say, "I understand what it's like to lose a child. My dog died, and that was hard, too." Even if the comparison seems more germane, don't make it. Each trauma should be respected in its uniqueness. Each story should be heard attentively as its own thing.
Do bring soup. The non-verbal expressions of love are as healing as eloquence. When Mary was living with Catherine during her recovery, some young friend noticed she didn't have a bathmat. He went to Target and got a bathmat. Mary says she will never forget that.
Do not say "you'll get over it." "There is no such thing as 'getting over it,' " Catherine writes, "A major disruption leaves a new normal in its wake. There is no 'back to the old me.' "
Do be a builder. The Woodiwisses distinguish between firefighters and builders. Firefighters drop everything and arrive at the moment of crisis. Builders are there for years and years, walking alongside as the victims live out in the world. Very few people are capable of performing both roles.
Read the full column here. It's so enlightening. Have you lost a loved one or been through a trauma? What did people say or do that brought you comfort? My mom once told me that when her mother died, people would seem scared of bringing it up, as if they didn't want to remind her, but of course she was thinking of her mother all the time.
P.S. Encouragement.
(Photo by Nicole Franzen)
108 comments:
- Trish said...
Yes, yes, yes! I lost a young son and I second what your mother said and what the article said. I was also told, "You're young, you can have more children." WTF??? I want THAT child!! Don't. Ever. Say. That. DO talk about the child and call him by name. He is very much still a part of the parents' lives and always will be.
- The Bebebirds said...
These could not be more true. I especially love the comparison one. That can be really painful to hear...the last thing you want to do when grieving is to feel like you need to suddenly be the shoulder someone cries on! Thanks for sharing these :)
- Daryl Lindsey Schmidt said...
What a thoughtful post about caring for others - such an important message!
<3 Daryl
Unlost - 3:29 PM
- benrho98 said...
I lost my brother when he was 33, I was 27. It was the darkest and loneliest time of my life. My roommate would just sit with me, and not force me to talk, but would listen and encourage me when I wanted to. She would even sleep in my bed next to me when I couldn't bear the stillness of night. Another thing I will never forget is on his birthday one year, my friend played his favorite music and asked me about good times we had spent together. We went out for dessert and had the staff put a birthday candle in it. They wrote his name on the plate with chocolate sauce and I blew out the candle and made a wish for him- a tradition I still do ten years later. Those friends still call me on the anniversary of his passing and it ALWAYS touches my heart.
- opposing feet said...
I have lost people very dear to me including both parents and also been witness to the loss of both children and partners of dear friends, I will say that stories help more than you know, share your memories of the person, their life gets relived for a moment in your story and use their name, as time passes the person grieving craves the sound of that name.speak, pick up the phone or send a letter presence is always better than absence, there is no hierarchy to grief but there is a hierarchy of time, it is their moment of loss you can share yours with them much later down the road and understand it is a long long process. Shrug off the anger stage it is just that,a stage in the process, it's not personal and they will need you so much more 6 months, 1 year maybe several years after the funeral, there are no time limits on grief, it is different to depression you can't treat it chemically but you can help with love, patience and practicality.listen and let them talk.
- Kath said...
I thought this article really captured what is wanted or needed in times of grief. After my daughter was stillborn this year, my husband and I most appreciated the little things- the friends who just randomly called or texted to stay in touch; and the folks who weren't afraid to acknowledge that we were hurting. The loveliest gesture I remember was the friend who came over during the hardest days, put on the kettle, did our dishes, pulled out the scrabble board and didn't get freaked out by my tears. The hardest has been the people who haven't called, the folks who seem to pretend that nothing has happened or changed; and some friends who I've had to track down. I'm learning that people who have experienced some sort of grief/tragedy are a little more in tune with what is helpful.
- Bex said...
I wrote about this (http://olivedragonfly.blogspot.co.uk/2013/08/what-do-you-say.html) when I was struggling with certain things people were saying to me as we are going through IVF and hitting all sorts of hurdles with multiple 'rare' issues (another thing I'm fed up hearing!) meaning none of our cycles have even resulted in an embryo transfer.
I also included examples of the things people said that were just what I DID want or need to hear and have been particularly lucky when it comes to having understanding friends who know just how to be there. - 3:38 PM
- jamie said...
My father passed away last March and I wish certain people who visited my family knew these things. I especially hated when a family "friend" came over and started making jokes about my dad's ghost mere hours after we found out the news. It was really hard, but through this experience, I found out who the "builders" in my life are and it's comforting knowing that they're always there.
- janis said...
Yes! When my dad was sick with cancer, it drove me crazy when people said, "I know how you feel. My grandma died last year." NO! Totally different.
I also remember being really annoyed by a friend who tried to put a positive spin on everything I said. It grated me so much. Sometimes you just want someone to say, "That sucks so much. I'm so sorry!" - 3:45 PM
- Brooklynbee said...
When I lost my dad, a friend of his who is a scientist (a geneticist) came over to me at his funeral, hugged me, and just said "You have his DNA. You have his eyes. You have his laugh. You have his personality. You have him. You have him. You are him. You have him, always."
- Catherine said...
I lost my dad five years ago when I was 25, and now, when friends go through similar traumas, I'm always so quick to offer up my own story for comparison. But there's a fine line between wanting to show empathy and failing to listen. This is a good reminder to step back, be present and listen to THEIR story. The one that is happening now. There will be plenty of time for commiseration later.
- Carrie Hamilton said...
This post is so profound, thank you for sharing Jo. It really hit me reading about "the new normal". My husband's Mom passed away (suddenly & unexpectedly) 2 1/2 years ago. My husband has changed so much since. I keep thinking it will get back to normal, but I've been terribly wrong in assuming that; we are living the NEW NORMAL. Time does heal, but it doesn't snap it back to what it was. Wow, I just had a "light bulb" moment & in doing so, I think it will allow me to change my perspective. Thank you.
- Jenny Attwater said...
Lovely article. Although I do agree with the general rule of not meeting someone's sadness with a story you believe to be equal, I think that this can be variable depending on the person. Of course, it can be incredibly unhelpful to share something of your own story, and risks detracting from the value of the plight (for want of a better word) of the person in need, but I feel that some people *do* find self-disclosure helpful, and it can help them to open up. I also think that firefighters and builders are both incredibly important in their own right, but totally agree that it is rare to find someone that is both. Great advice though! :)
- Lana said...
My grandmother had 12 brothers and sisters. When she was 16 years old, her youngest brother drowned in a fishing accident. She said that she always remembered hearing people attempt to comfort her mother by saying, "But you have so many children! It will be okay!" The lesson it taught her was one she passed down to all of us: Hug tight, let the other person be the first to let go and then look them in the eyes and say, "I'm so sorry. How can I help?" You would be surprised how often people will respond by telling you exactly what they really need.
- Jessi said...
When I was 22 I lost my mom, a nurse who was taking care of me during the shock of the moment gave me the best advise: Do not be alone, try to stay
accompanied all the time... At the time I didn't have much more family, but now that I'm married, when this past year I lost my dear grandpa, I understood the meaning of those words...
Thank you for sharing these, it is a beautiful post Joanna. - 3:53 PM
- molyem said...
My dad passed away last fall and I cherish being able to talk about him with the people around me. I like when people ask about him and how I'm doing without him. Talking about him is how I'll keep his memory alive, so it's nice to read this article and know that sentiment is shared because we tend to avoid hard topics but here's one instance where talking it out can do wonders for the grieving person who doesn't want a loved one to be forgotten.
- Melissa Blake said...
What a wonderful article. So many good tips.
I lost my father to suicide when I was 21, and I wholeheartedly agree with not being afraid to bring up the lost loved one. Sometimes I felt like people were forgetting my dad by not talking about him, which made me mad, sad and everything in between. Looking back now, I can see that they were probably scared to bring him up for fear that it would make me feel worse. - 3:55 PM
- katie said...
My husband & I have been struggling with infertility & the loss of 3 pregnancies (2 of the 3 were late 1st trimester losses) & we've learned firsthand all the stupid things people say to you. One of the most touching things was just an email from one of my best friends - she said when she heard about my latest loss, she shut the door in her office & cried for us. It was so helpful to hear that someone cared so much & knew how deeply we were hurting.
- sarah acheson said...
I found this interesting - similarly helpful information about a time you don't want to think about and probably won't be functioning well in. - 4:09 PM
- sarah acheson said...
I found this interesting - similarly helpful information about a time you don't want to think about and probably won't be functioning well in. - 4:11 PM
- jenny said...
My Dad's death was very sudden and traumatic for my family and I bristled every time someone said, "He's in a better place," or anything to that effect. It was always said with good intentions but I felt like it assumed too much about his beliefs and mine and it didn't apply the same way it would have after the passing of someone who had, for example, been sick for any length of time. "A better place," to me always suggests a bit of relief and, in his particular case, was just slightly off base. When anyone I know is in a similar circumstance I'm very careful to only say, "I'm sorry. When would be a good time to come over? Tuesday? I'll bake you some muffins." The best thing really is just to be there and sometimes something as frivolous as muffins really hits the spot in such a serious time.
- más allá said...
Thank you so much for sharing this. Someone in my family just lost their 25 year old son to a terrible accident and we are all trying to sort out how to help and be there for them. Thank you, Joanna.
- Unknown said...
We just recently lost my father to depression. I found stories about him from his friends to be so very healing and helpful. From those who did not know him, but know me, I found simple, sincere thoughts to be the best. Since our loss, two other friends have lost a parent, and I try to pass on the comfort I felt though simple, sincere thoughts of my own
- sixtet said...
How is this original content? You are reposting excerpts from a NYT journalist's work. I realize you gave him credit, but it seems like sloppy work.
- Grace Kretschmer said...
About a month ago my boyfriend lost his mother and brother in a car accident. As I am struggling to help him through his grief, this post/article is incredibly helpful for me. Thank you so much.
- Giulia said...
Yes, I am on disability for PTSD/TBI following violence & tremendous loss (in another country). Let me tell you what: you find out really fast what people are made of. Seriously.
I have huge problems with David B. on other things but he is right on in the piece.
Ppl say the most horrible things & so I hope this makes some difference but honestly? Quite often you find yourself saying (silently) WTF?! All. The. Time.
Thanks for this...
Susan - 4:27 PM
- Laurie Hoffman said...
I was only 13 when my father was murdered... it shattered the beautiful emerging bud of who I was to become. Now I am more of a resilient weed, more survival instinct and less wonder. Sometimes I look longingly at the luxuriously-fragile beautiful buds thriving around me. People nearest to me couldn't understand this sorrow but some found ways to cushion or bear witness to it. I will be forever thankful for a friend who begged her older brother with a driver's license to drive her 26 miles to my home so that she could hug me and bring a cassette tape that she had recorded especially for me. We weren't close friends at the time and I have long since last track of her but that expression of compassion, I will never forget. Every time one of those songs plays on the radio, I think of her and the good that exists in the face of tragedy.
- J and H from Beyond The Stoop said...
the "don't compare" tip is great... i was recently in a conversation with a local store owner about business, he mentioned it was tough with his father recently passing away. my boyfriend's father also recently passed away, but didn't say anything during conversation with the store owner. on the walk home he mentioned that he wanted to comfort the store owner by saying "i feel your pain, my father passed away" but held it back for respect for the store owner and his father.... i didn't get it right away, but i thought about it a lot aafter he told me he held back his words of comparison.... it makes a big difference to say "i'm sorry for your loss" instead of comparing...
- glenda said...
Thanks for sharing this. Yes...yes...yes! My dad passed when I was 13 and my mom in 2004. I think of them daily. The fact that people don't bring them up hurts, but I get it...they don't know what to say and are freaked out when the tears start flowing.
- Jess L. said...
I took a death and dying sociology class in my undergraduate degree, and I think it was the most valuable course of my four years there. 1. Jo you are completely right, people are already thinking about , so don't be afraid of being present as if it would suddenly remind them. 2. Check in with the griever 1 month after the tragedy. By that time the immediate responders have left, the griever is left alone and could use the support.
I have used this advice time and time again in the many years since I learned these valuable skills. It gives me confidence to go ahead and be there for my friend without feeling awkward, and not second guess myself. - 4:46 PM
- Kiana said...
I lost my sister very suddenly eight years ago and I still remember to this day the people who called and came over. Those actions are so different than sending a card or flowers. I think it makes friendships stronger or can break them and it can make you feel close to someone who you barely knew who for some reason chose to show up for you. My advice is to show up. It does matter.
- Emily said...
I lost my husband when I was 26 (and with two small boys). My best memory was my sister who flew from across the country and decided to stay at my house - whereas almost everyone else wanted to let me have my space. It's so true. She told me if I'd rather she stayed somewhere else she would, but that she figured I would rather not be alone. I also had another sister who would IM chat me into the late hours of the night until I was too tired to stay up anymore. It kept my mind on (possibly useless) other topics and gave me a way to forget my crazy life if only for a little bit.
I also think the biggest thing I've dealt with is that no one seems to understand everyone grieves differently. My inlaws seem to have had a harder time losing their son - but just because they express it more than I do doesn't mean I've gotten over it before them. I've also heard a number of times that losing a child is much harder than losing a spouse - meaning they are going through something worse that I am. Unless you've lost a child and a spouse you can never know which is harder. And even then, it's not up to you to judge someone else's pain.
Just be nice.
- Susan Moorhead said...
Such good advice and so true. Love the soup. People usually say "call me if you need anything" which is kind and well meant but someone grieving is not about to do that. Show up instead, preferably with muffins or a casserole or whatever. A neighbor showed up several times over a month with various soups and nothing was as healing, the soup and the action of just showing up.
- Beauty Sparkle said...
yep i lost my father last year and its so so hard i am still grieveing but friends stayed away like it was just one of those things. I still struggle alone today.
- Sarah said...
I think "comparison" can be done in a very caring way that actually helped me deal with grief. My brother died in a car accident, and I only wanted to be around other people who had actually been through a major grief. I felt like their survival helped me realize that I am not alone in grief and I too can survive this.
However, never say "I know exactly how you feel" because you don't. Something like "when I lost my son it was the darkest time of my life" tells me that you know what real grief is and I can turn to you for help. - 5:08 PM
- Tamsin Jessica said...
My half sister died suddenly last year age 21. I didn't grow up with her but saw her 3 or 4 times a year. I remember a colleague at work saying "I'm sorry to hear that. But you weren't that close to her were you?". Horrible :(
- Joy said...
This is very touching. I lost my Mum four years ago and I really like when people talk about her. It's very comforting that people remember her.
Hugs. - 5:21 PM
- brooklynash said...
I lost my father, with whom I was very close, suddenly when I was 29. I find that most people in my world were the firefighter type. They came immediately after they found out. There's not a day that goes by I don't miss him and need his advice. However, once I came back from the funeral, it was as if it never happened. Nobody asked anymore or wanted to bring it up.
Given that my close friends have not lost a parent, I've struggled to find people to listen and understand. Meeting people at my age (31), people just assume you still have both parents. When they find out otherwise, it's this completely awkward "Oh I'm sorry." I struggle with what to say to that. Why sorry? It wasn't your fault. It is what it is.
Also, there does come a point when you want and need to pepper that missed person into conversation in a positive way. Unfortunately, I find that people who haven't lost anyone significant in their lives are incredibly uncomfortable with you discussing this person in a positive light.
All in all, I feel like there's an inevitable divide between those of us who've experienced full on grief and those who have not. Once you've lost and are across the divide, we're all on the same team of empathy. But I'm unsure there are many people who can empathize without having experienced it themselves. - 5:22 PM
- Christina Quinn said...
Thank you for sharing this. I lost my father about a year and a half ago when I was a senior in college, and something that consistently makes me feel a lot better is when friends or family share when they're missing my dad. I know I think of my Dad every day, but don't like bringing up the topic with others because I don't want to be responsible for making someone else think of something "sad". When someone voluntarily brings it up, it's such a relief because I know they're in the mood to talk about him. It means so much when someone is willing to have that kind of conversation.
- Kerry said...
I agree with the earlier comment from Jenny. When my brother died, it angered my mother so much when people said he was in a better place. She understood that they were trying to be comforting but as she said then, "the better place is here and now".
And do check in with folks weeks and months later, not just immediately following a loss. I didn't really process my grief until about six months later and until that point, I was a nightmare to be around. People tend to forget but I was still raw and the friends who put up with me helped immensely. - 6:18 PM
- Mrs. Sho Nuff said...
My husband's aunt was giving us a house tour when we came to visit and she had the most beautiful historic old house in NY. We came to her office and there were many very cool older political activist banners and pictures of when our aunt and uncle were young. I was really enjoying looking at all of them when I came across a bulletin board of their daughter who died suddenly at the ago of 11 (same age as my husband at the time) and there were the most beautiful momentos of her life and writings from her in school at that age. It brought tears to my eyes and as we were leaving later that day, our aunt pulled me aside and said she wanted to thank me. Thank me because she said nobody ever wants to talk about her daughter or acknowledge that she was alive and she could tell that I really took the time to see and appreciate the things on the board related to her. It was such a powerful moment. I had never thought of that before but will never ever forget it.
- Missy said...
So true. Especially resonating is the idea that you dont want to mention the elephant in the room for fear of hurting the person further; but when my grandpa died all I wanted to do was talk about him, and remember all of the things he'd said and done. Like the article mentioned, the grieving are going to be thinking about it, so might as well provide a comforting environment to talk freely about the good memories and then be a shoulder to cry on.
- MelanieKPrice said...
What a beautiful article and such an important reminder. Thanks for posting!
- Jamila St. Julien said...
This is a lovely post. My hubby (who is a Chaplain) wrote about a similar topic today: http://goo.gl/1nlnRs
- Jamila St. Julien said...
- This comment has been removed by the author.
- josashimi said...
Thank you for this post. I really appreciate it because it gives us insight into a way we can care for others, which is something we too easily forget in our busy lives.
Also - living here in Australia, I don't always read the New York Times. I'm so glad you shared this article. And. It is not sloppy at all, by any means. - 7:14 PM
- Joanna Goddard said...
sixtet, it's not original content, actually; some of my posts are original and some are reposts. this is the latter. totally fine blog etiquette to repost an excerpt and credit and link to the original source for the full read. (see blogs like kottke, swissmiss, etc.) in fact, if you take a look, david brooks's new york times column actually was reposting another blog post by a woman about her family's grief. so no worries there, thank you!
- Joanna Goddard said...
these comments are so enlightening. it's so fascinating and moving to hear your stories.
- Joanna Goddard said...
benrho98: "She would even sleep in my bed next to me when I couldn't bear the stillness of night." that is so, so sweet.
- Massiel said...
I lost my mom suddenly, five years ago when I was 20. It was completely devastating to me and really taught me who was there for me. Most people 'forgot' within that first month. But I didn't. I think of her daily and am now in a better place where I can mention and talk of her in regular conversations, and hear others talk about her as well, without breaking down all over the place. I still can't handle talk of her actual death or suffering -- just too sad.
- HDemaray said...
Ashley Woodiwiss was a professor of mine in undergrad--a truly thoughtful, gentle man, and though I had heard about his first daughter, I was unaware of their family's most recent tragedy. Thanks for posting this, Jo. I had a late-term miscarriage a couple of years ago, and can relate to the line in the article about how they were disoriented by those who weren't there. Equally so, we were also blown away by the kindness of those we didn't expect. I have vowed to always be the latter. This is a great reminder.
- donzwebb said...
Hi Joanna...thanks sooo much for sharing this article. My mom died when I was 12 and my brother committed suicide 8 years ago. With my mom, it was so sudden and I was pretty young so for years I didn't really open up about it until I was in university.
When my brother died, one of my friends took the Greyhound bus and traveled two and a half hours to spend the weekend with me. She sat with me and hugged me while I cried. I was in a daze for weeks after and my emotions switched back and forth between anger to sadness. I've finally come to terms with it and blogging has helped.
A lot of my friends haven't lost a parent or sibling so it can be difficult to talk about it with them. But I do have one close friend who lost his mom so we're able to talk to each other about it whenever we're having a down moment. It makes all the difference to be able to talk to someone who understands what you're going through.
After my brother died, a lot of friends would bring tons and tons of food by the house. This was really appreciated because when you're trying to get over the shock of it all, eating/cooking is the last thing on your mind.
Thanks again for sharing this, Jo! - Donna - 8:59 PM
- Aja Lake said...
I love that reflection your mom made. Very sweet.
- ABBY LOW said...
I read this, too. It is so well written. I try to be more like he suggests. Having grieved unbearable loss, I know that sometimes just having a warm body nearby is all that is needed to lighten some of the pain.
- spunthoughts said...
I always try to learn something from these articles. I think it's safe to say that until I myself lost someone special in my life, I wasn't the best or most understanding friend to knowing how to deal with these moments. I'm sure many here would agree. I think it's easy to judge others and their responses when you're the one that's hurt (and I have judged others for their responses when I lost someone special), but harder to remember that we might be able to improve ourselves. So I love these articles because I think I have learned how to be better myself. Not just from my own experience but the collective experience of others.
I think that grief is so very personal that it's hard to come up with hard and fast "rules." I think most of the general rules here are good but even so, they still don't fit everyone. I don't think that you should never mention that you have had grief yourself and therefore you do understand a *little* (though not, of course, *exactly*) of how someone feels - because that's true, you do know how gut-wrenching it can be and you feel terribly for the other person that they would suffer so; and sometimes it is not wrong to say that perhaps they are in a better place, if they were suffering very much on Earth (as my loved one was). Of course we should be sensitive to others' cultural and spiritual beliefs, but that doesn't mean it's *always* wrong to say.
One lovely thing I learned from an article such as this is that some might appreciate a thoughtful card or gesture on the 1 year anniversary of their loved one's death (such as mentioned by one of the previous posters). So I put it in my Google calendar to remember these dates now, for those that might appreciate such a gesture that you're thinking of them and that you haven't forgotten. - 9:18 PM
- bisbee said...
I appreciate this post...and I thank you for it. I think it is a positive thing when you repost articles such as this...it's similar to your posting links on Friday, which is a favorite of mine...other bloggers I read do the same.
I was moved, and I will be reaching out to a college friend who lost her son to suicide a little over a year ago. We hadn't been close in recent years, but I found out during the summer, and I will email her just to ask how she is doing...that's all.
I lost both of my parents when I was in my 40s...and my daughter-in-law has unfortunately lost both of her parents by her early 30s. I am so unsettled when I hear people saying they don't know what they would do "if" they lost a parent, when they are lucky enough to still have parents who are in their 80s or 90s. Perhaps I am intolerant, and I of course don't say anything, but I always think, don't they know that we are supposed to lose our parents, and that to have them around to a ripe old age is a privilege? I just can't get up too much sympathy when someone loses their 93 year old mother. - 9:21 PM
- Meaghan Delmonico said...
My husband, Mike, died on his commute home from NYC last August. And to be honest, our friends and family have been loving and kind to our wee little son and me; mostly we have been spared the insensitive comments. They helped turn the worst experience of my life into a time of profound gratitude. They even made this...
- Michele said...
- This comment has been removed by the author.
- Sydney said...
I lost my mother and it was the hardest thing I've gone through so far in my life. What a well-written article. I find talking about the loss of my best friend and caring mother helps me most. I cry and laugh and get all of my emotion out and then I feel better. No one will replace her and I miss her every single day but the deep pain I felt when I first lost her is slowly getting better as time goes by.
- Paola Albergate said...
Joanna, This post is one of the many examples why I love your blog so much. Always such thoughtful things that really come from the heart. When my grandfather passed away, my two best friends asked if I wanted them to come to his service. I told them no and that it was nice of them to ask, but that I would be ok. They both came. I will never forget that. Having them there meant the world to me. Showing up whenever possible to be there for the ones you love is so important.
- Hannah said...
When my family was going through a tragedy many people asked what they could do to help and I found that exhausting. When you're just trying to survive the hour, the day, it's hard to figure out what you need. If people you love are experiencing tragedy, don't ask just do. I guarentee it will be appreciated.
- Dorothy Lin said...
Thank you so much for find this wonderful article! I love the empathetic message and feel that it can be applied to a broad range of situations, not only in times of comfort.
- Stasha said...
This is a great post! So many people say NOTHING for fear of saying the wrong thing. It's really helpful to give folks pointers of how to help the grieving. Thank you!
- SKC said...
In May I was admitted to the hospital with gut-wrenching, screaming-in-agony pain and four days later I awoke to a jagged incision running from just under my rib cage to the top of my pubic bone. To learn that I had nearly died, had emergency surgery, and was missing a piece of my insides was the most traumatic thing I have ever had to go through. For the next five months I recovered at home - both physically and emotionally. People I had thought were close friends disappeared from my life and others made comments like "Wow, you're taking a long time to recover - what's wrong with you?" to "Cheer up! My husband's co-worker tried to commit suicide." Only my immediate family and a handful of friends stayed in touch, monitoring my progress, visiting me, and helping me through the dark times. Now, as I start living in the "new" normal, I can identify the people who are worth having in my life. And I know that I will never, ever, ever compare - I will just be there. Thank you Joanna for posting this article and creating a community where your readers can share their stories. It helps to know I am not alone.
- Ramsey said...
Sixtet's comment is heartless and insensitive, but hopefully you know that. There are so many beautiful and insightful comments here. I am reminded of a passage in a book I read years ago about the experience of infertility. The author had just had a miscarriage and was in the hospital, alone in her room, crying, when an LPN came in to take her vital signs. Seeing that her patient was in tears, and knowing what had happened, she sat down on the bed, put her arm around her grieving patient, and said "Ain't nothing no one can say to you now gonna make you feel any better, so you just go on and cry." And she sat there with her, holding her, letting her cry. Can there possibly be any better way to comfort a grieving friend?
- Darcy said...
We just lost our little girl 3 weeks ago and I wish that everyone we knew would read this article. Thank you for sharing.
- atalldrinkofwater said...
Thank you for this post. My husband and I recently lost a pregnancy at 21 weeks, a baby boy which we had prayed for and prepared for. I find that friends, family, acquaintances often don't know what to say, or don't want to bring it up out of fear of upsetting me. Which is okay, sometimes there isn't anything to say. But the comment I appreciated the most was from a friend at work, who stopped me at a time when we were alone, and said to me, "I heard what happened, I know that you had planned for this baby and had wanted to meet him so badly. I don't want to upset you, and we don't have to talk about it, but I wanted to acknowledge it and let you know that I'm so sorry." I felt thankful that she was brave enough to bring it up and acknowledge what had happened - I had been internalizing my grief at work, hesitant to burden someone else with it. But she lifted some of the weight off of my shoulders. Simple words, but incredibly meaningful. - 11:07 PM
- Krista said...
When my father died, my husband called my friends and family to let them know. He knew that it was hard for me to even say the words out loud. Because of his efforts everyone knew about his memorial service- which was standing room only.
- shawn said...
Thanks so much for posting this! What great advice. My fiance's grandmother recently passed away and it was amazing the different reactions he (we) got from friends/family. I especially love "Do be a builder". It's too easy to be flighty and get recognition. I think most people notice those who put in the work.
- Jay said...
I'm not sure I can add much to all the comments already. But- I did find when I went through my losses that people started sharing with me their own. Not in a comparative way but to let me know they truly understood. That was really helpful. Sometimes I knew about their experiences before my own but boy, I did not understand. Not really. The comments today remind me again that I, and we, are not alone.
- Carolyn said...
I lost my mom in April. I don't remember much from the wake but I do remember a family friend who had also lost her mom came up to me and said "There's nothing I can say right now. This sucks and I'm sorry and I love you." And then she hugged me. I'll never forget that.
- Colombatto Family said...
Thank you. I unexpectedly and suddenly lost my Mom a week ago today. As I read this I know we will be forever changed and I hope you don't mind that I re-post this lovely sentiment. Thank you.
- Colombatto Family said...
Thank you. I unexpectedly and suddenly lost my Mom a week ago today. As I read this I know we will be forever changed and I hope you don't mind that I re-post this lovely sentiment. Thank you.
- Kate at M is for make said...
When my dad died suddenly a year back, a good friend at the time could barely speak to me or look me in the eye, I was so hurt. I had great respect for other friends and acquaintances who came straight out asked about it, about me, the family, however hard it was, I really appreciated it.
- Joanne Lee said...
I don't know how to react when someone trivializes something important to me. I put it like this:
Say you have a little sweet daughter that loves her goldfish. One day the goldfish passes away and your small daughter is heartbroken. What do you do?
1) Do you tell her that it is not a big deal, stop crying, they cost 10 cents?
2) Or do you realize that she did not just lose her goldfish, she actually lost her friend, so you hold a funeral for the goldfish?
Sometimes, the most loving thing you can do is to put a hold on your opinions and just hold a funeral for the goldfish. - 3:02 AM
- Beautifulosophy said...
Great advices on a never easy topic. Caroline
- Rose said...
very interesting, especially don't compare as I think I have done that, but trying to make someone feel like you have been there and it sounds like it isn't a good way of empathising
- goodnightstars said...
I couldn't agree more with these. My roommate is an extreme introvert and spends much of her time at home in her bedroom with the door closed. When I experienced a great loss, she asked me what I needed and at that moment, all I needed was for her to sit with me and not close her bedroom door when she was in there. It's amazing how much simple presence can comfort.
- Liz said...
I read this, went back and read the NYTimes article and then over to Sojourners and read the original piece. Thanks for sharing.
- collette said...
Thanks for this link. I lost my mom at age 18 and can't stand it when people say their moms are overbearing, or when they suffer a loss, "Is this like when your mom died?" NO! Also helping my dad since he was diagnosed with early onsite dementia (but doesn't believe that he has it!) and I just cannot imagine what it must be like for some of these 30 something people whose parents do everything for them. [End rant] Anyway, thanks!
- Tristen said...
My Grandmother died the day before a 5k that I had signed up for. Because I didn't want to be alone and because I knew my grandmother would want me to show up and finish, I ran the entire thing. After the race my friends surrounded and hugged me, but one particular friend asked me to described to them the things that my grandmother loved- what she enjoyed most in life. That has always stood out in my mind, because it brought my attention not to how I felt or the sadness of it, but instead the joys of her life. I will always remember that.
- Chelsea said...
My fiance died when I was 23. This article expresses exactly how I felt about the way people responded (both good and bad). There were two very kind and practical gifts I was given that I will always remember.
One friend gave me a gift card to a local salon and spa. It was a large enough amount that I could get multiple massages and hair cuts. It was so nice to have a way to relax during that time. Plus, I was super poor, so it was quite a treat!
Another incredible gift was someone paying my rent the month he died. I was out of town for the funeral and spending time with family for about a month, so I didn't even think of paying my rent. This was such an amazing way to show love and support! I still to this day do not know who did it, but I am forever grateful for it! - 12:28 PM
- embarcando said...
I read this earlier this week (a Henry James quote) and it really touched me:
"We all live together, and those of us who love and know, live so most. We help each other—even unconsciously, each in our own effort, we lighten the effort of others, we contribute to the sum of success, make it possible for others to live. Sorrow comes in great waves [...] but it rolls over us, and though it may almost smother us it leaves us on the spot and we know that if it is strong we are stronger, inasmuch as it passes and we remain. It wears us, uses us, but we wear it and use it in return; and it is blind, whereas we after a manner see." - 12:41 PM
- l&h said...
My mom died suddenly when I was 17. I had a few friends who were so uncomfortable they didn't know what to say or do (we're all babies at 17 so of course they didn't know what to do!). But I had one friend who just showed up and listened and sat with me - no expectations, no need for words. She was just there & let me be - and most of the time that being was just really really sad. She got me through the worst of it, by simply being there with me.
- Sibéal said...
- This comment has been removed by the author.
- Cathi said...
I have lost several people in my life - my dad to a murder and a lot of friends to cancer. The one thing that I encourage is to continue to talk about them. When my dad died we all would tell stories (as he was quite the character) and it never failed to cheer us up and make us laugh. A few people I know didn't even acknowledge when my dad was killed as it made them uncomfortable...please don't do that either...acknowledge the loss and give your love and support...Great post! xxoo
- The Plath Diaries said...
Thanks for this post, Jo. I am currently trying to be there for the friend I hold dearest and it's so important to read articles like this. Sometimes I think the world is such a dark place, the awful grief and trauma people go through. We can only try our best to be there.
- Amanda said...
This was so timely. I'm a law student and we've been working on a case representing a man on death row.
He was executed yesterday and the entire team is now struggling with loss, grief and injustice. I'm sharing this post with all of them and doing my best to live it by being there for all of them.
- Lisa C. said...
When we lost our first born son when he was only two days old some people were terrible....but two of the most helpful things immediately was someone who would call/email and tell other people what happened so we could avoid folks seeing my small belly and thinking we had a healthy baby (and saying congratulations unfortunately it still happened). It was also helpful immediately to have someone who would pick up and bring over family coming over from the airport or out of town. In the long term, my "builders" are my friends who remember my child's birthday, ask what I remember about him or my pregnancy and include him in my kid count now that I have had more children. Those mean more to me now because it is like they acknowledge that how ever short he lived and I am his mother who will remember him every single day or hour forever...he is STILL part of our family and I need to talk about him all the time even though it just didn't happen this instant.
- jill cavanaugh said...
Acknowledging the loss even if you think it's too late to say something. It's never too late.
- Victoria said...
This article is so beautiful and insightful. I lost my mom 2 years ago and was also struck by how often people seemed afraid to bring her up. I often wanted to scream "I am not fragile! Stop being so scared!" it's very isolating. What I found to be most therapeutic and loving were the moments when friends cried with me. It's so comforting.
- jill cavanaugh said...
Also I meant to write that when I lost my first child (stillborn) - the only stories that helped me were from those that also had the same kind of loss. I think it was because i had no idea how many people i knew also had stillborns (neighbors, aunts, great aunts) - no one wants to ever talk about it - it's practically taboo. Anyway, it made me feel less alone - more connected and hopeful for the future.
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- Erika said...
This is beautiful. A perfect way to describe how to act towards someone going through something traumatizing.
- Jennifer S. said...
I'm so grateful for articles like this. It seems to me that people have gotten much more tactful and respectful in dealing with tough situations because there is this kind of information out there about how to respond. I recently went through a really rough breakup, which cannot even compare to a death, but is still losing someone in a way. I had several friends who gave really amazing advice and let me be sad in my own way, while also being there for me and encouraging me to do good things for myself when I can. Thanks for posting!
yourstrulyjen.com - 6:42 PM
- KatH said...
I needed this article today. Another's grief/trauma is one of the easiest things to judge but surely one of the hardest things to humble yourself to, and in turn, be of help.
When I was 14, I had an ear infection that turned into a brain infection inexplicably. For seven weeks, I was given at-home IV antibiotics to continue suffocating the infection. To make a long story short, I was given too much of the medication, and it severed all the vestibular (balance) nerves in my brain. For the past 11 years, I have seen the world through a bouncing lens. The world moves even when I am standing still. I lost so much of myself then. But I also liked to think that I gained so much too.
Trauma never leaves you. It is with you from the moment you wake up to the moment you fall asleep. And it haunts the dreams in between.
Presence is what gets you through. Presence brushes your teeth when you can't get out of bed. And presence holds your hand in the grocery store, when you hands can't stop shaking from fear.
Thank you so much for this, Joanna.
- Timemimi 當代迷你倉 said...
- Allison said...
- This comment has been removed by the author.
- Allison said...
Love that you dealt with grief on your blog -- you're helping to overcome the stigma of talking about it! I lost my brother 5 years ago when I was 26 and he was about to turn 32. I often think of an adage someone told my parents..."Don't tell me I'll turn the corner; the building is round." It's so true -- loss doesn't go away, it ebbs, flows, evolves over time.
- Katie said...
My grandfather died suddenly right before New Year's, and I think the most healing thing was that all of my extended family was able to come together and support my grandmother for that week.
We spent so much time eating, sitting around 'remembering,' and going through dozens of old family photo albums. Laughing at the silly photos was a wonderful form of catharsis.
It was also really heartwarming to see so many of my grandparents' friends and neighbors bringing food (for all 26 of us!).
I want to keep in better touch with my grandmother now, so hopefully she will feel less lonely. But it's true that I also struggle with how to mention the dead, because often I'll get sad and teary, and I don't like that all the time. - 10:08 AM
- Marta Valente said...
My parents lost a baby before I was born. He was 3 when he was hit by a car.
My sister and I never felt that my parents were sad or traumatised, they never let us feel we were living in a sad home. We were very happy and still are. My parents were brave enough to be happy after they lost their son.
My mother always sais that: you will be happy again.
I am very grateful for my parents! - 10:34 AM
- Belinda said...
Yes, I lost my Mom just a few months after having my first child and it was the darkest period of my life.
The only true thing anyone ever said to me was "this shall pass". I wrote about some other helpful things you can do: http://makingmountains.co.za/2014/01/23/losing-a-parent-how-to-cope/ - 12:21 AM
- Amy Reams said...
I read this in 2 minutes and I think I'm a better person now. So valuable. Thanks so much for this thoughtful post.
- Karstileigh said...
Yes please! My first is 3 months old and I love reading your blog as a 'what to expect' and 'what to cherish' advisory
- Amy Neal Larkin said...
This is a great post. I think it's important for everyone to be reminded to be kinder and more understanding, even if they're already kind and understanding.
Also: your blog is beautiful! I'm excited to be a new follower!
xoxo - Amy
glitterinmytea.blogspot.com - 12:22 AM
- Sunshine on my window. said...
I just lost my dad 2 weeks ago. And the pain is tremendous, numbing to a certain extent. I wished I could give this article to 80% of the people.
They keep waiting for me to go back to normal. I keep waiting for me to go back to normal. But there's no going back. The gap in my heart is huge. Just so raw. So much pain. - 2:32 AM
- Ann'sLife said...
I remember one woman took my hand when our 2 year old son died and said, 'look on the bright side, you have one less mouth to feed'! It felt like someone slapped me. I have started a blog about death at www.deathiswhat.com and would love to have your comments.
- Martini said...
After many, many years, when our daughter died, I still remember reading on a condolence card from a friend, the sweet, simple words "I'm so sorry". It's been a very long time ago and those three words still bring me comfort.
Speak the truth.
Even if it's "I don't know what to say", it will be the truth.


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Review: Khortytsa Platinum Vodka
Posted by Arctic Wolf on August 14, 2012
The Khortytsa Distillery is located in the City of Zaporizhzhia, in the south of Ukraine. The facility is relatively new, its first distilled products were rolled out in December of 2003. According to the company website, the distillery uses only high quality grain spirits produced by Ukraine's best factories for vodka manufacturing. Although the facility and the brand are relatively new, they have made a significant impact in the global market where today, Khortytsa is found in 85 countries worldwide.
The Khortytsa Brand was recently introduced into Canada, and I was recently asked by the local importer, Ukrainian Drinks Ltd. to provide a few reviews of some of their selected products. The first of these products which I sampled is the Khortytsa Platinum Vodka whose formulation was apparently developed using a special silver and platinum filtration technology.
Here is an excerpt from my review:
You may read my full review here:
Review: Khortytsa Platinum Vodka
I have included a very nice cocktail which I call, the Minted Vodka Daiquiri.
Please enjoy the review and the great cocktail provided!
Sorry, the comment form is closed at this time.


text:
Prevalence of violence against women should be measured based on questions listing different acts of violence for each type of violence. Detailed, behaviourally-specific questions are needed to ensure that respondents consider a wide range of acts in their responses that they might otherwise omit if they are left to speculate about the meaning of a more general term. For example, physical violence encompasses all acts of intentional force that have the potential to cause injury or death (not including forced sexual contact). Questions measuring the prevalence of physical violence should lists acts such as hitting with a fist, open hand or hard object; kicking; biting; pushing; squeezing; pulling hair; repeated hits that result in beating; choking; burning; holding the person down; threatening to use a gun, knife or other object used as a weapon; and actually using a weapon. This list and other suggested lists of behaviours needed to measure each other type of violence (sexual, psychological and economic) as well as the definitions of all concepts used are presented in the United Nations Guidelines for Producing Statistics on Violence against Women: Statistical Surveys (Forthcoming).
Severity of violence should not be assumed based on specific acts of violence. Similar acts of physical violence can have very different consequences due to a number of circumstances (prolonged violence as opposed to a single incident, for example). Severity should be assessed separately according to the consequences suffered by the victim, including frequency, injury and other impacts that make it difficult for the woman to carry out usual daily activities. Emotional consequences, such as fear of the perpetrator, for example, could also be incorporated as indicators of the severity of intimate partner violence.
Broad concepts of marital status and intimate partners should be used in order to adequately estimate the prevalence of violence by intimate partner. Recording of marital status should extend beyond relationships that are socially or legally sanctioned and cover forms of informal unions specific to each country. Also, the definition of intimate partner should not be limited to legally married partners, but kept as broad as possible and include, for example, boyfriends and dating partners. Testing of the questions and training of interviewers is essential to ensure that responses are recorded accurately. Probing questions should be used if necessary.
The presentation of the survey in the initial approach to a selected household and subsequently to a selected respondent should not put the respondent's safety in jeopardy. It is common practice to introduce the survey to the household not as a survey on violence against women but as a study on women's health, safety, or other issues of particular relevance to women, without specifically mentioning violence. This is done to avoid raising suspicion from other family or community members and to encourage participation in the survey. Interviewers will not know in advance if the woman has experienced violence or is currently living in an unsafe situation; therefore precautions must be taken at all stages not to disclose the specific objectives of the survey to anyone in the household or community.
Introductions to various sections of the questionnaire are essential for building rapport and trust, ensuring disclosure, and setting the context. At the beginning of the questionnaire, the respondent should be provided with information about measures that have been put in place to ensure her safety while she responds to sensitive questions, such as re-scheduling to another time or switching to a neutral questionnaire if a family member comes on the scene. Careful introductions should be designed for the sensitive sections. For example, sensitive questions on intimate partner violence should be introduced by first assuring respondents that relationships have both good and bad moments to avoid the risk that only socially desirable responses are given. At the same time the respondent should be reassured that their answers will remain confidential and the participation in the survey remains voluntary. Introductions are also important for setting the context of a particular section in the questionnaire. For example, an introduction to questions about violence involving individuals other than intimate partners should help the respondent consider a wide range of actors, including violence by male or female relatives, friends and acquaintances, or strangers.
The flow of the questionnaire should be from topics and questions that are non-threatening and less sensitive to topics and questions that are more personal and sensitive. This gradual transition is critical for disclosure of experiences of violence; reducing the risk of participants to terminate prematurely the interview; and reducing the risk of emotional trauma. Questions about family composition, health, social networks, personal characteristics and partner characteristics can be situated prior to modules about experiences of violence. Situating questions about psychological and economic abuse by partners prior to questions about physical and sexual violence is important for providing a gradual lead-up to these more sensitive questions. It is good practice to place questions about forced sexual acts after questions about physical assaults because of the difficulty many women will have disclosing these very personal experiences to an interviewer. Questions concerning childhood experiences of violence may also be placed toward the end of the questionnaire. Within each section covering a type of violence, the behaviourally-specific questions should also range from less serious to more serious acts of violence.
Careful wording is essential in reducing underreporting of experiences of violence. As a general principle, value-laden and stigmatizing terms such as "rape" and "violence" must be avoided in the questions or introductions as they lead to under-reporting of experiences of violence. Instead, detailed behaviourally-specific terms, which yield much higher disclosures of identical experiences, should be used. Survey questions and introductions to various sections of the questionnaire should cue respondents to consider a variety of different settings (eg., home, work, school, outside locations, etc.) and specific categories of perpetrators (eg., current partners, former partners, other male relatives, males in positions of authority, etc.). Drafting of the introductory sections of the questionnaire and development of the right wording of the questions can greatly benefit from focus group discussions engaging local women. Preferably, focus groups should include women identified as experiencing partner violence and sexual violence. These women can be recruited from shelters and counselling groups, for example. It is also important that women participants in the focus group represent various social groups, including immigrants and other minority groups.
All significant subgroups of population should be represented in the sample in number large enough to allow analysis at their levels. The expected prevalence of types of violence in the sample population and the requirement to conduct analysis for subgroups of population, such as different age groups, geographic areas, or ethnic minority groups, are important factor in deciding the sample size and sample design. In order to produce prevalence estimates of specified precision for subgroups, the sample size will have to be increased considerably or higher sampling fractions may need to be applied to the smaller subgroups.
Method of data collection should not prevent the possibility of covering specific groups of women. Women living in violent situations may be prevented from using the telephone or may not take the risk of undergoing detailed questioning over the telephone if their movements are monitored by a violent partner. As another example, web-based and disk-by-mail surveys require wide ranging computer ownership, Internet access, and literacy.
It is recommended that only one woman is interviewed in each household For safety reasons, it is recommended that only one woman is interviewed in each household. Violence against women surveys that interview all women in the household should take extra precautions to ensure the safety and privacy of all respondents.
All interviewers for a survey on violence against women must be female. Utilizing female interviewers increases disclosure of sensitive information, particularly experiences involving sexual victimization and violence perpetrated by male partners. Field supervisors must be female in face-to-face interviewing situations since they must travel with interviewers periodically to oversee their work. However, in forming teams of field workers, project managers must take into account local norms prohibiting women from working in public spaces, and other barriers female interviewers may face when approaching households to obtain an interview. In these situations, teams of male and female interviewers working in tandem have been shown to improve household contact, lower refusal rates, and be beneficial in ensuring the safety of female interviewers. In telephone situations, it is possible to have male supervisors if they do not have contact with respondents and if they have the required skills and training to further train interviewers and support them through regular debriefings.
Age is an important factor to consider when selecting interviewers. Interviewers that are seen as too young may experience distrust from respondents, which can lead to outright refusal to participate in the survey or reluctance to disclose personal information. In some locations, it would be considered inappropriate for a young woman to pose questions related to violence to an older woman. While there is no recommended specific age limit or range applicable across all settings, many respondents perceive older female interviewers to instil more warmth and reassurance compared to younger women. Other characteristics of interviewers that may affect participation and disclosure rates should be taken into account when selecting interviewers and during training. Particularly important in obtaining accurate information from the respondents are non-judgemental and empathetic attitudes, good interpersonal skills, and sensitivity and knowledge of gender issues and issues related to violence against women. These skills should be further developed through extensive training.
Training of interviewers is a crucial step in reducing bias in data collection. Training is essential to ensure that interviewers understand the purpose of the survey and know the structure of the data collection instrument well; are skilled in conducting the interview and developing a rapport with the respondent; understand the ethical requirements of the survey, including confidentiality, safety and support for respondents; are aware of the possible dangers women face when responding to questions concerning their experiences of violence; are able to ensure the safety and emotional wellbeing of respondents; and guard the confidentiality of the information collected. All interview training should be in accordance with the guidelines for addressing ethical and safety issues in violence against women research established by the World Health Organization.
Sensitivity training is an important component of interviewers' training. Sensitivity refers to interviewers' ability to pose very delicate questions about experiences of violence in a respectful manner, accurately assess the feelings or reactions of respondents in a variety of situations, and respond appropriately. Sensitivity training must facilitate the understanding of gender issues related to violence, the dynamics and causes of male violence against women, and the impacts of violence on women's health and wellbeing. Training techniques can be used to reduce the chances that interviewers will respond with judgmental or blaming comments when interacting with respondents. Such techniques are: listening to and discussing in-depth testimonies of abused women and advocates for abused women; discussion of general or local stereotypes, prejudices and myths regarding female victims of violence; discussion of interviewers' own biases and stereotypes concerning women who have experienced violence; and role plays. Role play scenarios are particularly important in preparing the interviewers for situations where women refuse to participate in the survey; or situations that may compromise the safety and wellbeing of respondents and the confidentiality of information (such as interruptions of the interview by other household members, including threatening husbands; or emotional reactions of respondents to the disclosure of experiences of violence).
Training in controlling the interviewing environment to ensure the safety and privacy of respondents and the confidentiality of the information disclosed The potential that women may be put at risk of violence for participating in a survey cannot be underestimated. It is essential that respondents are in a position to answer freely and without fear of repercussions. As mentioned before, selecting only one female member of the household to be a respondent is one of the mechanisms used to ensure that women who have experienced violence from intimate partners or other family members are able to respond in a manner that will not jeopardize their safety. Other strategies oriented toward the safety and privacy of respondents should be developed by survey designers and covered in interviewers' training. It is recommended that interviews should take place at a time when other household members, particularly male partners, are not present. Interviewers should be prepared to switch to a neutral questionnaire if a household member comes on the scene. In some contexts, it may be advisable for escorts accompanying the main interviewer to conduct interviews with other family members to distract them from the main focus of the survey. When the privacy of the respondent cannot be ensured, the interview should be re-scheduled. In telephone surveys, respondents should be offered a toll-free telephone number they can use if they have to hang up suddenly or want to continue the interview at another time. Interviewers can establish a safety plan with respondents so that respondents can stop an interview at any time they feel unsafe. Interviewers should also check in with respondents periodically during the interview to confirm that they are able to proceed.
Interviewers should be trained to identify and respond properly to respondents' emotional trauma. Given the personal and delicate nature of the information requested in surveys on violence against women, respondents can be expected to react in a wide range of ways. Some respondents may be open to disclosing their experiences and may view the survey as an opportunity to allow them to make their experiences known. Others, however, may be fearful that a violent partner might learn of their participation in the survey; feel disturbed by the content of the interview; be traumatized by recent experiences of violence; or feel embarrassed or stigmatized when disclosing their experiences. Interviewers should be trained how to react to this multitude of possible reactions. It is important that the reaction to emotional distress is in a warm, empathetic but neutral manner. Interviewers must be instructed not to counsel respondents themselves. They should be able to refer respondents to a list prepared in advance consisting of agencies in the local community who can provide assistance. Where few resources exist locally, the survey design may need to take into account the development of short-term support mechanisms.
Interviewers should be trained to identify their own emotional reactions and reduce their own stress. In violence against women surveys, interviewers will be engaged in emotionally draining work. Interviewers should be trained to identify their own emotional reactions to the numerous disclosures about violence and helped to develop skills that manage and reduce their stress. Supervisors should also be trained to recognize emotional trauma among interviewers during fieldwork. Strategies to prevent burn-out should be considered, such as regular de-briefings by supervisors or counsellors specially engaged as part of the project team, or offering interviewers the chance to participate in less taxing administrative tasks between interviews.
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View thousands of cars, trucks, and SUVs for sale online from Miley Mercury dealers. Browse current and past-production vehicles for sale by manufacturer date, cost, gas mileage, or distance from your home. Find Mercury dealers in Miley with ease. Buying an automobile can be a big decision. Do some legwork by studying all the various options to get the most out of your investment. Browse the inventory of cars for sale at Miley Mercury dealers.
With the resources available on the web; the majority of consumers begin their search online. To go out and visit a Mercury dealer Miley represents quite an investment in time. Rather; see the entire vehicle inventories of Mercury dealers in Miley from the comfort of your own home at the Autobytel.com website. We are a top resource for all things automotive. Consider a couple of cars at the same time with our vehicle competitor tool. Also find the starting cost of almost any recently produced automobile. This is just the tip of the iceberg. The Autobytel website is packed with additional information. Find the technical specs of a car, crash test results, entertainment options, and engine details just to name a few. Pinpoint Miley Mercury dealers that are near to your location in no time.
A Mercury dealer Miley can do more than just sell you a car. Most reputable Miley Mercury dealerships have a complete financing department that offers leases. Or if you need a stock part, a Miley Mercury dealer will have a dedicated parts and accessories department. If you buy a new vehicle then most often Mercury dealers in Miley will offer the first few service appointments for free since service is covered under the new car warranty. Miley Mercury dealers have certified mechanics that can fix any automobile even if the car is out-of-production. There are other assets offered by a Mercury dealer Miley including a body shop and a certified pre-owned sales department.
There is an area to rate Miley Mercury dealerships based on your experience. Is the dealership reliable and trustworthy or do people have a bad experience there? You can find this information by reading consumer reviews. Because in the end, it is these consumer reviews that can make or break a Miley Mercury dealer. Since you have a few different choices of Mercury dealers in Miley, it is important to arm yourself with as much information as possible so you do not make the wrong decision.


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Created in this Craftsy class
Thread Art
taught by Lola Jenkins
Color and texture dominate this art quilting class. Learn stitches and shading to make colors and patterns pop in your collage or portrait quilts.
Other projects made as part of this class:
View all class projects »Offer some kudos...
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Category | Quilting |
Type | Wall Hanging |
Style | Art |


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At the 2010 Subregatta seminar, we had a discussion about where to have the 2011 Subregatta. Everyone there (I believe) wants to have it in Carmel, again. Since those that couldn't make it this year weren't in the discussion, could you please give us your opinions so we can get the location picked soon and then a date can be set? Then we can start planning all of the events that are on the topic started by Matt Thor.
If anyone else is thinking about having is somewhere else, please speak up so we can review what you would like to present.
Thank you,
Chris Campbell


text:
Pet supplies retailer Zooplus grows web sales 35.5% in Q1
Total sales in 2015 are expected to reach $811 million.
Even with helpful new mobile wallet developments, consumers and retailers stay on the sidelines.
A friend of mine intends to keep his gasoline-powered car until he can buy one that uses some form of renewable fuel. Sometimes I have the same attitude about my wallet. My current one, which I picked up in Paris some years ago, does the job well enough. It holds my driver's license, some family photos, my cash and credit cards. I'll keep it until the next wallet incarnation, which may be a digital one stored on a smartphone, can replicate all those functions.
That day may be drawing nearer. Isis, a smartphone-based digital wallet backed by AT&T Mobility, T-Mobile USA and Verizon Wireless, this week said four point-of-sale terminal makers will support the Isis digital wallet in its devices. And, Google Inc. says Sprint, which currently is the only U.S. wireless carrier offering a smartphone-based digital wallet to consumers, will add support for Google Wallet to at least 10 smartphones. Currently, only the Nexus S 4G phone from Sprint has Google Wallet. Consumers can use a digital wallet to buy items inside stores.
Near field communication is integral to Google Wallet and is expected to be part of Isis. NFC is a two-way wireless connection that enables devices to send data back and forth. For example, a tap of an NFC smartphone against an NFC payment reader not only could send the user's payment data to the device, but deliver a coupon to the digital wallet. NFC requires that payment terminals, such as those offered by the four terminal vendors above, have compatible hardware and software built in.
Some digital wallets, like Square Inc.'s Card Case, do not use NFC. Instead, the retailer signs up to accept Square and the consumer pays by giving the salesperson her name. The consumer's photo, registered through Square, appears on the point-of-sale system to verify the consumer's identity. The consumer controls the payment method via the Card Case app on her smartphone.
Both methods are appealing, but they're just not enough to persuade me they can replace my wallet. I suspect retailers, too, will keep using what works, the venerable magnetic-stripe payment card. The technology has become so good that I'm still putting away my card when the receipt begins to print. And, with the advent a few years ago of no-signature-required for transactions of less than $25, the checkout process when paying with a card even became quicker.
For the retailer, the speed translates into a better ability to move more consumers through the checkout process. More consumers means more money.
And for me, that's where digital wallets really have to excel. There has to be some tangible reward for using them. It can't just be a "wow" factor. Digital wallets have to offer more convenience for consumers and retailers to have any chance of widespread adoption. Until that is figured out, I'll keep my trusty wallet.
The potential for wearable fashion is endless and exciting. But brands promoting these web-connected wearables ...
An Adobe executive offers five key tips to create mobile shopping experiences that boost mobile ...
A visit to Starbucks turned me on to a new app thanks to a stack ...
Responsive design is the best way for retailers to serve mobile shoppers, argues the CEO ...
If there's something you've bought offline that you weren't able to buy online, we're probably thinking about that.


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Paul Aridgides MSIV, Upstate Medical University and Neha Vapiwala, MD
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: October 31, 2007
Leukemia is defined as a malignant, marrow-based neoplasm of hematopoietic or lymphoid cells. The key feature of leukemia is the presence of tumor cells circulating in the blood. Acute leukemia involves aberrant differentiation and proliferation of malignantly transformed progenitor cells, and can be rapidly fatal if untreated. The two main types of acute leukemia are named for the stem cell of origin: acute lymphoblastic leukemia (ALL)if it involves lymphocytes, and acute myeloid leukemia (AML) if it involves myelocytes. Of note, both lymphocytes and myelocytes are subtypes of white blood cells. While ALL and AML are clinically similar in that they both typically present with symptoms secondary to cytopenias (lowered cell counts), there are significant laboratory features and prognostic factors that can be used to distinguish ALL from AML and to dictate therapy, as discussed below.
Metabolic |
14% |
5% |
Hemorrhagic |
2% |
20% |
Chemotherapy induction deaths |
1% |
10% |
Nuclear/cytoplasmic Ratio |
high |
low |
Nuclear chromatin |
clumped |
spongy |
Nucleoli, number of |
0-2 |
2-5 |
Granules |
absent |
often present |
Cytoplasm staining |
blue |
blue-gray |
Sudan black |
(-) |
(+) |
Peroxidase |
(-) |
(+) |
Acid phosphatase |
(+) |
(-) |
FAB Type |
Blast characteristics |
L1 (more common pediatric) |
Blast size <2RBC, scant nucleoli, round or oval nucleus |
L2 (more common in adults) |
Blast size >2RBC, prominent nucleoli, >20% cytoplasm, folded nucleus |
Blast big, blue, and vacuolated, called "Burkitt's" cell, most have characteristic c-myc translocation t[8;14] |
Immunophenotype |
Expressed antigens |
Precursor B-cell ALL (85% of childhood ALL) |
B-cell associated antigens including CD19, HLA-DR, cytoplasmic CD79a. Subtypes include: Pro-B ALL, Common precursor B-cell ALL, and PreB ALL |
Precursor T-cell ALL |
T-cell associated antigens including CD7, CD2, cytoplasmic CD3, CD5 |
M0 - AML undifferentiated
M1 - AML without maturation
M2 - AML with maturation
M3 - Acute promyelocytic leukemia (APL)
M4 - Acute myelomonocytic leukemia (AMML)
M4eo -AMML with abnormal eosinophils
M5 - Acute monoblastic leukemia
M6 - Acute erythroleukemia
M7 - Acute megakaryoblastic leukemia
AML with recurrent genetic abnormalities
t(8;21) FAB M2, inv(16)/t(16;16), t(15;17) FAB M3, 11q23
AML with multilineage dysplasia (MPD)
following MDS/MPD, dysplasia in 2 or more cell lines
AML and myleodysplastic syndromes (MDS), therapy related
alkylating agents/radiation-related, topoisomerase II inhibitor-related
AML, not otherwise categorized
with subtypes identical to FAB classification
Favorable prognosis with [12]:
1. Catovsky D, Matukis E, Buccheri V, et al: A classification of acute leukemia for the 1990's. Ann Hematol 62:16-21, 1991
2. Matutes E, Morilla R, Farahat N, et al: Definition of acute biphenotypic leukemia. Haematologia 82:64-66, 1997
3. Harris NL, Jaffe ES, Diebold J, et al: The World Health Organization classification of neoplastic diseases of the hematopoeitic and lymphoid tissues. Ann Oncol 10:1419-1432, 1999
4. Gurney JG, Severson RK, Davis S et al: Incidence of cancer in children in the United States. Sex -, race-, and 1-year age-specific rates by histologic type. Cancer75:2186-2195, 1995
5. Smith MA, Ries LA, Gurney JG, et al.: Leukemia. In: Ries LA, Smith MA, Gurney JG, et al., eds.: Cancer incidence and survival among children and adolescents: United States SEER Program 1975-1995. Bethesda, Md: National Cancer Institute, SEER Program Leukemia, 1999.
6. Preston DI, Kusumi S, Tomonaga M, et al: Cancer incidence in atomic bomb survivors: part III. Radiat Res 137:S68-S97, 1994 (suppl)
7. Pui C and Evans WE: Treatment of Acute Lymphoblastic Leukemia. NEJM 354:166-178, 2006
8. Faderl S, Kantarjian HM, Talpaz M, et al: Clinical significance of cytogenetic abnormalities in adult acute lymphoblastic leukemia. Blood 91:3995-4019, 1998
9. Laport GF, Larson RA: Treatment of adult acute lymphoblastic leukemia. Semin Oncol 24:70-82, 1997
10. Vardiman JW, Harris NL, Brunning RD: The World Health Organization (WHO) classification of the myeloid neoplasms. Blood 100:2292-2302, 2002
11. Jemal A, Siegel R, Ward E et al: Cancer Statistics, 2007. CA Cancer J Clin57:43-66, 2007
12. Byrd JC, Mrozek K, Dodge RK et al: Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461). Blood 100:4325-4336, 2002
13. Estey EH: Prognostic factors in acute myelogenous leukemia. Leukemia 15:670-672, 2001.
14. Bishop JF: The treatment of adult acute myeloid leukemia. Semin Oncol 24:57-69, 1997
15. Zittoun RA, Mandelli F, Willemze R, et al: Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia. N Engl J Med 332:217-223, 1995
16. Ohno R, Asou N, and Ohnishi K: treatment of acute promyelocytic leukemia: strategy toward further increase of cure. Leukemia 17:1454-1463, 2003
17. Micallef IN, Rohatiner AZ, Carter M et al: Long-term outcome of patients surviving for more than ten years following treatment for acute leukaemia. Br J Haem 113:443-445, 2001


text:
Gynecologic Pathology
A Volume in the Series: Foundations in Diagnostic Pathology
In Stock
Available Formats | Price | |
PDF eBook | $204.00 | |
(With Adobe DRM, readable with Adobe Digital Editions for PCs and Macs, and on most mobile devices except Kindle) |
This new title in the Foundations in Diagnostic Pathology series offers today's most essential gynecologic pathology know-how in a compact, high-yield format! For each pathologic entity examined, you'll find discussions of clinical features, pathologic features (gross and microscopic), as well as ancillary studies, differential diagnosis, and prognostic and therapeutic considerations. The text's pragmatic, well-organized approach—complemented by abundant full-color, high-quality illustrations and at-a-glance tables—makes it easy for you to access the information you need to quickly and accurately identify pathology specimens. The result is a practical, affordable resource for study and review as well as for everyday clinical reference.
Key Features
- Covers both neoplastic and non-neoplastic conditions of the female reproductive tract to equip you to meet a wide range of diagnostic challenges.
- Uses a consistent, user-friendly format to explore each entity's clinical features • pathologic features (gross and microscopic) • ancillary studies • differential diagnoses • and prognostic and therapeutic considerations, making it easy to locate specific information on a particular entity.
- Features abundant boxes and tables throughout, enhancing the presentation and accessibility of the material.
- Offers hundreds of full-color, high-quality illustrations that demonstrate the key features of a wide variety of pathologic lesions to facilitate greater accuracy in identification of specimens.
Published Reviews
"I like this book and I can see myself using it frequently in my routine diagnostic work, multidisciplinary team meetings and teaching. I am confident that this book would be a very useful companion for its targeted readership i.e. pathology trainees, general pathologists and general pathologists with an interest in gynaecologic pathology."
ACP News, December 2009
Author Information
By Marisa R. Nucci, MD, Assistant Professor, Department of Pathology, Harvard Medical School; Staff Pathologist, Brigham and Women's Hospital, Boston, MA; and Esther Oliva, MD, Pathology Service, Massachuetts General Hospital, Boston, MA
Customer Reviews
- Hardcover
- Reference
- 592 Pages
- Trim Size: 11 11/16 X 8 1/4 in
- Imprint: Churchill Livingstone
- Copyright: 2009