Note: Initials, names, and some identifying details have been changed to protect patient identity.

“CM passed away this morning,” the brief, curt email read. The words made no sense. I re-read the initials, thinking maybe I confused residents with this alphabet-soup method of protecting patient identities and information. No, CM was Cliff. There was no other patient with those initials. At first, I felt nothing but disbelief. The hospital had to be misinformed. Cliff had to be fine; he was scheduled to return to the long-term-care unit in two weeks. His bed was made up for him; the Christmas lights were still twirled across the walls of his room.

I was a recent college graduate, working on the long-term-care unit in this small hospital 3,000 miles away from home. I was tasked with providing activities and social support for the 12 residents on the unit floor. I was basically there to be a friend, learning each resident’s likes and dislikes, creating tailor-made games or outings that could improve their quality of life and maintain their current levels of cognition and sensory perception. Besides being nervous about meeting such high expectations, I was anxious about whether I would even be accepted by the residents. On my first day, I was relieved when I met Cliff.

Cliff was an elderly man with patchy white hair and cloudy, blue eyes. Although he was a wheelchair user, he went nowhere without his neon orange Nike sneakers. An inquisitive world adventurer, Cliff had traveled everywhere, even to Sri Lanka where my family was from. We had long conversations about Buddhism, philosophy, and Eastern cultures. We met halfway in our interests: we explored his love of Buster Keaton and silent movies by delving down YouTube rabbit holes, noting how Buster’s physical comedy of twirls and leaps were forever immortalized in a digital realm for future generations. I was able to coax him out of bed and out into town to visit local museums, and to sit and watch the ocean at the harbor. He worked at teaching me a few phrases from the different languages he had picked up during his travels. We shared a fear of the dentist and I promised Cliff I would stay with him when he was scheduled a mandatory visit. I helped him out of his wheelchair and into the exam chair, held his hand while the dentist drilled, and winced along with him when it seemed like the drill hit a nerve.

I had worked with Cliff everyday for five months. On a Friday, the last day I saw him – though I had no idea it would be the last – he suddenly said, “You know, I had a dream last night and we were in it together.”

“Really? What happened?” I asked.

Before he could answer, a nurse walked in. “Cliff, your daughter is here to see you.”

This was relatively momentous. His daughter lived out of the state normally and, in my five months of knowing Cliff, he had never had a visitor. I hurried out so his daughter could come in. I continued on with my shift and towards the end of the day, I checked to see where Cliff was. He was still with his daughter. No matter, I thought. I’ll catch up with him on Monday.

On Monday morning, I walked into his room but he was gone and the bed was made. I checked some communal spaces, but Cliff was nowhere. During our morning staff meeting, we were told that Cliff had fallen from his wheelchair during the weekend. He was stabilized, but the staff had transported him out of the state by helicopter to receive more extensive care than what could be provided in our small, rural hospital. He was expected to make a full recovery after some physical therapy and would return to the facility soon.

I was sad this had happened to Cliff, but I was not overly concerned. Quite a few residents had been emergency airlifted out before for more basic issues, simply because of our more rural location and limited resources. Almost all patients returned, and if not, it was because they had decided to live in the new hospital to which they had been relocated.

However, a week later, the email popped up in our inbox. The hospital informed us “CM passed away.” No explanation. No context. I was still in shock for the rest of the day. The rest of the residents did not know and we were not to tell them yet. I was surprised how easy it was to smile, joke, and carry on as if nothing was out of the ordinary.

That night in bed, however, I tossed and turned for a few hours. I sat up, frustrated with this newfound insomnia, and, suddenly and inexplicably, started sobbing. I wondered why I was hit so hard. I felt silly, almost overdramatic. I had known Cliff for less than a year. While I had worked with him everyday, it did not span the entire day or focus solely on him, since there were 11 other residents to consider. I wasn’t his family. I was a caregiver, a trained worker, who should have realized death was always a natural stage in this kind of work. Did I have any real right to mourn like this? If I felt this way, I could only imagine what his family was going through. I probably didn’t know his life story beyond his recent travels and interests. There were so many things I didn’t and wouldn’t know about him. Then I was reminded: his dream of us. I would never know what it was. I sobbed harder.

A few weeks later, for the first time, the hospital began offering grief counseling to employees. I had not improved: I still missed Cliff but felt guilt for feeling the loss so acutely. But it felt like a sign. Cliff himself had espoused the benefits of therapy and the importance of excavating the complexities of the mind. He had seemed to think it was a good strategy for establishing well-being. I laced up some Nike sneakers, and walked in for a counseling appointment.

The counselor’s office felt like the architectural embodiment of a hug. Cushy pillows lined every chair in the room. The scent of vanilla candles wafted from the windowsill. Lamps with delicate shades cast warm, orange light across the framed photographs of ocean waves. The counselor was sweet, caring, and listened more than she spoke. I unplugged the mental dam I had been hiding behind since the email, verbally pouring out every pang of sorrow followed by a chaser of qualms and doubt. I ended, asking her if I even had the right to be there: surely five months of knowing someone could not necessitate grief counseling. I stopped. She was smiling.

The counselor paused, and pushed a bowl of wrapped chocolates towards me.

“There are two lessons here. One: chocolate helps.” I took a candy. “Two: being in someone’s life, no matter how briefly, means just that. Caregivers work by being in others’ lives. The work they do is tied to the lives they touch, and in return, their lives are touched and influenced by the people with whom they work. Caregivers, with however much training, are not immune to grief, an emotion that cannot be ranked, summed, or compared to others.”

I unwrapped the chocolate while she talked and savored both her words and the candy.

Eventually, after a few weeks of counseling, I was able to take down the Christmas decorations in Cliff’s room with a clear head. The room was being prepared for the next and newest resident, for the next and newest life that would intermingle and connect with those on the unit. I was ready. I felt prepared. I had chocolate in my pocket. I had come to reconcile that I would never know the details of Cliff’s dream. I had also come to know what grief was and I had staked my claim to it.

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