Sometimes I think I must still be in the “denial” phase. Happens every morning when I wake up and I expect her to be there. Or when, half-asleep, I reach over to touch someone who isn’t there. I used to do this sometimes to reassure myself that she was still breathing — she would be so still when she slept, it would scare me sometimes. I was that paranoid she’d die. But not paranoid enough, or at the right time, apparently.

I’ll think: she’ll be there when I come home.

I’ll think: she’s away on a trip. She’ll be back.

Only two things seem able to push her out of my head. Maybe three. Patient care does it; I think I knew that instinctively, which is why I went back to work so quickly. If I get caught up in a book or movie, that helps. And thinking about other women, that surprisingly is the most effective trick. This is something I never would have predicted. I would have thought it impossible to think about other women when you’re grieving for someone so dear. Turns out it’s easy. It feels like a physical force, like magnetism or gravity. I want to fill that huge sucking hole. They say you shouldn’t make any important decisions (like marriage) in the first year. I can see the sense of that. And it’s not an irrational urge; I mean, I don’t feel like I want to fill the gap with just anyone. Naturally, I want what I had with Karen, and that is no easy thing to come by.

Just glum right now because I’m working on bills. Procrastinating RIGHT now, obviously, but the bills are there at my left side, waiting to be paid. This is something Karen did for years, and then as she declined, we did it together, but now it never fails to upset me.

I’ve taken to lying to my patients when they ask about my family. Oh, we’re fine, I say. Just fine.


The memorial service . . .

is set for March 15. I mentioned it on Facebook, but I imagine some folks only visit me here. Query me if you’re interested . . . hoffmandscott at gmail dot com.

I guess I am doing as well as can be expected. I took myself off the antidepressants and I’m only tearing up in the mornings, usually. Not sure why mornings should be so bad. Last week, I had a few days of “she’s really not coming back, I’m really never going to see her again.” Amazing, how something like that could take so long to manifest.

I still feel like she left me. Rather angry about that. Not you died, but you left me. There’s plenty of anger to go around, by the way — for myself, for Karen, for the medical community (and Medicine, capital M) that failed her, for friends who could have kept in touch, could have given her more than just me and Jake to live for. Anger, like guilt (plenty of that, too, believe me) — not constructive, and I do try to let go.

It would be easier if she’d make an appearance. In my head, in my dreams, I don’t care. Jake thinks that I don’t dream about her because I think so much about her during the daytime. I don’t think I’m THAT obsessed during the daytime.

I’m tired of reaching over (in bed) and not finding her there. I’m tired of remembering how, towards the end of our relationship, when I’d reach over she would be there. But she wouldn’t be there, not really. She left me before she left me.

Which isn’t fair to Karen. It’s not entirely true. But it was sometimes true.



I want to cook for more people, apparently. I can’t seem to prepare food just for two; I come up with three, four servings. I think about converting the library to a bedroom (which is what it’s supposed to be). Get a roommate. Someone who appreciates my food.

This afternoon, I showed Jake how to make crock pot beef stew, and also Marcella Hazan’s meatballs recipe. Some of the meat, we set aside as hamburger patties. Dinner for the next two days! That meatball recipe is pretty awesome if you use equal parts ground turkey and mild Italian sausage.

Today is a good day, inasmuch as nothing horrible happened. Yesterday was a comically bad day. Felt like Karen was stage-managing things from beyond the grave to give me a last few kicks to the gut. Trying to get back to normal? That’ll show you. But she overdid it. She went too far. I just started laughing after a while because it was all I could do.

I feel like I’m a visitor in an alternate universe. I’m an actor here. This isn’t my life. I’ll wear one of Karen’s shirts and think, “Oh, she’s not gonna like it if I stretch this out,” but then I’ll remember that in this universe, she’s not here to complain. I can fuck up all of her shirts now. This sort of thing happens a lot.

No bad dreams. Jake gets the bad dreams. I only get glimpses, if I see her at all. She’s waiting for something and I don’t know what. Only once . . . I woke up in the dream and I had been sleeping in a different bed because I have a cold (in real life, too). So I was in one bed, Karen was in the next bed over. Like the Brady Bunch, got it? Back when, thanks to the censors, even married couples weren’t supposed to be sleeping in the same bed (let alone having sex!) Anyway. I went over to her bed, we started making out — it was like college again. And it was one of those dreams where I was blissfully ignorant of this world. I woke up before it got interesting. Wasn’t even sad when I woke up.

So she’s waiting. She’s waiting for the big talk, the big sit-down. Or maybe, this last year, we talked our hearts out so much that there’s no talking left to do. But I doubt that.

I don’t know what she’s waiting for. I’m ready.



Someone told me that after a while, all you remember are the good things. I’ll remember Karen as she was when we met, when we married, when she gave birth to Jake . . . all those good years we had together (although I suspect she would have a problem calling them “good” years; but they were good, given the hand that we were dealt). And I won’t be so focused on the last year, the last few months, the last hour. I’ll stop beating myself up.

Because there’s a special horror in this for a doctor, this second-guessing, this wondering — why didn’t I notice that? Why didn’t I take that into account?

Part of me wants to run into a room full of {insert ethnic group here} and yell, “{insert situationally appropriate ethnic slur here},” get the shit kicked out of me, and feel like I’ve paid some tiny percentage of penance for not being a better husband. A better doctor. But then I would be a piss poor father, and I know I owe far more of a duty to the living than to the dead.

So we made it to Asilomar, which is one of my favorite places to be. We drove first to San Jose, to meet up with Karen’s mom, sister, and her sister’s family. Also wanted to pick up a nice vase for some of Karen’s ashes (we’ll be scattering most at sea) but the store was closed today. We’ll have to go back. It was Karen’s favorite store for Japanese ceramics.

It was a hard day for me. I don’t know if Jake noticed. The drive on the 152, Casa de Fruta, the drive up to San Jose — it took me back to my first year with Karen. We made that trip just before she got sick. Back when we thought we had our whole amazing lives ahead of us. These should be great memories. Instead, I’m just depressed and angry.

But it’s good to be in Asilomar. The grounds smell like wood smoke, pine trees, and the sea. I can breathe a little easier here.



I’ve been watching those old videos. Not sure if it’s a good idea or a bad idea, but it jibes with a conversation that ran through my head the other day. I imagined myself saying to Karen, “I want you back,” but then I thought: no. I want her back. That Karen. Before these last few years.

She hears those thoughts, of course, since after all she’s just a construct in my mind. And she says, “You want the impossible.”

“Yeah,” I say. “I want the impossible.”


To sleep, or not to sleep

So I have a choice. I can feel what I’m supposed to be feeling, or I can take this antidepressant (at what is supposedly way below the typical antidepressant dosage) and get some sleep. SOME sleep. Lately, I’ve been getting four hours a night. Last night I tried to do it on 25 mg benadryl alone, and lay awake for 2.5 hours before giving up and taking one of the antidepressant pills. Then I managed four hours. I find I can function quite well on four hours, but I know that seven would be a lot healthier. But when I’m on the antidepressant — even at a measly 50 mg — the grieving gets muted. It’s still there, as I discovered in the last couple days as I tried to wean down off the stuff. But I guess I have to sleep.

I have to do a lot of things. I have a very long checklist and it doesn’t seem to be getting any shorter.

I signed up for a years’ worth of personal training this last week, and had my first session yesterday. She kicked my ass. Going back to her tomorrow, and I’m going to try to go to the gym today, too. But first, I have to get into the office and clear out some of the “do this before the end of the year” stuff I’ve been putting off.

But Jake and I seem to be doing okay. No one’s doing anything self destructive, and we’re still more a comfort to each other than the other way around. Honestly, I’ve been more worried that I’m a burden to him with all of my blithering. But thanks to the antidepressant, there’s been a whole lot less blithering.

Off to the office!


Day 12

I picked up her ashes today. They weighed more than I thought they would, but then, they put her in a box first and then burned her. I had to sign something acknowledging that some of the ashes would be cardboard ash or plywood ash or whatever the hell they used. I asked if they would at least be my wife’s ashes and not Random Kern County Residents’ ashes, but of course I asked it more politely than that. They assured me that they are a strictly regulated industry.

We’ll scatter 99% of the ashes off the North Coast, and keep a small amount in an urn. Going to make a trek up to San Jose (as part of a bigger vacation with Jake at the end of the year) to Kogura, a Japanese ceramic store. Karen and I were very fond of that store. We bought at least one of our friend’s a wedding present there. And I still have a vase that I think we bought for ourselves at Kogura — I’m not sure, actually. It just sort of showed up on the shelf. I didn’t even remember that we had it. It’s dark gray with herons on it. I want something nice.

Had this moment of dissonance when the Funeral Home called to let me know the ashes were ready for pickup but they’d store them for me, if I preferred, until I brought the vase. On the one hand, I thought, “What difference does it make? She isn’t her ashes.” But on the other hand, we’ll scatter the ashes. So the ashes must have some significance to me. So I brought her ashes home.

When I was interviewing for med school — this was at a time when Karen was still healthy and my biggest care in the world was whether I’d get into med school or have to settle for grad school — no cares about Karen, really, because we were supremely confident in one another and knew without ever saying it that we’d be together regardless — I met a prof, I think it was at UCSF, a young guy in his early forties, whose wife was bedridden due to some sort of back pain issue. I’m not sure why he volunteered this information to me. People have a bad habit of opening up to me, and I realize this must be my fault somehow, but for the life of me I don’t know what I do. Anyway, I remember he seemed stunned by the way his life had turned out. I even thought I could understand it. Clearly he loved his wife; I’m not sure how that was clear, it just was. He was powerless to do anything about it. Prof at UCSF, an academic success by almost anyone’s standard of academic success. They had undoubtedly had all kinds of hopes and dreams for themselves, and now he was in this inescapable situation and she was in pain.

Assholes bale out. I’ve heard stories like that. Maybe they aren’t even assholes; I don’t know. If the love isn’t there, are you an asshole to bale out? (Or is it bail out? Too lazy to search right now.) Love narrows your options. I almost wrote “trapped by love” but that’s unfair. I imagine he was still able to have some good times with her, even with her limitations. Karen and I managed to live a good life. A hard life for both of us, a hard life for my son, too, although I’m not sure he realizes this. So “trapped” is unfair. We had some joy. We raised a family together. We both did the best we could, and we both fucked up at times, and this whole thing is just so hard.

I’m not sure about these Kubler Ross stages. Right now it feels like they’re all mushed up together, like when you’d do watercolors as a kid and mix everything together and wind up with a nameless color. Purple brown mud.


What helps

For me, anyway.

First few days: talking to people, anyone who would listen, but I tried (mostly) to pick on close friends and family.

After that: getting back to work right away, staying busy, filling the hours with chores or movies or whatever just to make sure the time passed. Sitting in my bedroom doing nothing (or next to nothing, like watching TV) was pretty awful. I didn’t do much of that. (And even as I’m writing this, I’m looking forward to getting the hell out of here.)

Last night, I think, was the first time I worried about the medication. I’m on something to help me sleep, but it’s an antidepressant, too. Is it numbing me up? Will there be an emotional price to pay once I get off the stuff? Before this all happened, I had mastered my insomnia and could get to sleep, stay asleep, and manage about six hours a night without any medication. I’d like to get back to that, eventually, but I’m afraid of that overwhelming grief I felt in those first few days.

We had our building’s Christmas party last night. During the White Elephant gift exchange, I had too hard a time hearing the ticket numbers (I’d explain, but it’s probably not worth it). So I volunteered to call them out, since I can project my voice fairly well. And while I’m up there calling numbers I’m flashing on Camus’s The Stranger, and how the jury convicted the narrator not because he shot the man on the beach, but because he did not grieve properly after his mother’s death. Yeah, yeah, more guilt. I’ve lost track . . . but the worst thing (which varies from day to day — what I consider “the worst thing”) is that a few days before she died, Karen asked me about vacation time, and couldn’t we go back to our house in Oregon and stay there for a week? I squashed the idea, and it seemed like her feelings were hurt. She didn’t get angry. She just seemed so sad for a minute or two, but then she seemed to get over it. I thought she was sad because my tone of voice was annoyed-verging-on-angry, but I’m wondering if maybe she was looking for something to live for. Did she know this was coming, somehow?

Okay, not feeling numb any longer. Not sure writing all of THAT helped. (Folks keep saying that it helps to write these things out. Hmm.)

I think I’m experiencing those Kubler-Ross stages simultaneously. There’s denial and depression and acceptance all rolled up inside of me. Yeah, I know it’s contradictory — how can you be in denial and acceptance at the same time? But it all varies so much from moment to moment.

As for Karen knowing: I’m sure she would scoff at this. She was not one to believe in the paranormal, and I don’t think she did anything to contribute to this. So how could she have known? No. She, like I, didn’t realize how serious this was. By the time I realized, it was too late.

Okay, I need to get out of here and start doing my chores for the day. You don’t want to know how long my to-do list is.


Santa Barbara

I’m here with the rest of the leadership team on a two-day retreat: The Speed of Trust, which is genetically related to the whole Seven Habits thing. Not kidding. I’m imagining dynasties in which fathers tell their sons, “You shall author a book about . . . Hmmm. Decisiveness. Yes, decisiveness. That sounds about right. And there shall be twelve aspects of decisiveness, and the number of aspects of decisiveness shall be twelve. And you shall sell this book far and wide, and yea, you shall hold great meetings at expensive resort hotels where the tables are festooned with little minty candies. And the book, and the meetings, and the assorted shwag shall make you a gajillionaire, and you shall wallow in caviar and champagne for all the days of your–”

“But Dad, can’t these twelve aspects be neatly summarized into these three statements, two of which are self-evident?”

“NO! You are no son of mine!”

Yeah, I have a bad attitude.

I’m doing better today. Choked up a few times but no crying. Had seven hours of sleep last night, and that helped. (Hell, I used to get teary after a bad night’s sleep even before Karen passed.) Being away from home helps; let’s see how I do back home.

Day seven.


Day Five

. . . and I’m still having to do the math. 9 – 4 = 5. The time dilation of grief is easing; it seemed like those first two days took a lifetime. By comparison, yesterday and today went by like lightning. I went back to work yesterday, and that has helped. Still crying my eyes out and telling too many people my business, and Karen would be turning in her grave (she was very private and would NOT have approved), except we’re going to scatter her ashes, so no turning in the grave for Karen.

Honestly, I do not understand how anyone would want a grave. Or would want to be embalmed. Or want an open casket funeral. Think of the people you leave behind: they’re left thinking of your body stuck in that one place, forever (the grave, I mean) not even decomposing naturally (the embalming, that is), and they have to have one last look at someone else’s conception of what the deceased looked like in life (talking about the open casket funeral, now). I don’t want to see Karen’s dead body or face. I want to look at the pictures of her alive, thriving as best she could thrive, and I want to think of her voice.

Which is another thing. The only recordings I have of her (that I can think of at the moment) are a youtube video, and a voice mail message in which, in an irritated voice, she’s saying, “DOUG. WHERE ARE YOU. CALL ME BACK.” I find that one strangely soothing, even if she does sound pissed off. She sounds pissed off in such a strong, healthy way.

As for the YouTube video, you can hear her at the beginning of this one saying, “I. Disavow. ANY responsibility.”

Don’t let her fool you — she loaned me her camisole, after all.

Oh, and here’s a third. Watched it just now and it made me very, very happy. (With special bonus of Jake’s pre-pubertal voice!)

Now, that’s the girl I married. I love you, Karen.