Physical presence means so much. Phone calls are good. Video connections can be better. But there is nothing like experiencing physical presence with the potential or reality of a hand on the shoulder, a hand in another’s hand, and a body-to-body hug.

But now we live in a strange and stressful time of necessary physical distancing with the COVID-19 pandemic. In these days and weeks (and months?) when we feel frightened and worried, the gifts and resources of presence are limited and restricted. We connect by phone, text, social media, and video—and thank goodness for these options—but we know they are not the same. They certainly help, but there is just no way they can be as powerful and comforting as physical, whole-body, whole-self presence.

In training healthcare professionals, the importance of presence is often emphasized. The goal is to be, no matter what one’s role, a “non-anxious, caring presence.” “Non-anxious” because those who are suffering—physically, emotionally, mentally, or spiritually—have enough anxiety on their own. They don’t need the burden of our anxiety, too. “Caring” because it’s not enough to be a neutral presence. We need to communicate connection and compassion in our presence. Effectively communicating caring is not a simple thing. It takes intentionality, awareness, sensitivity, and openness to another’s pain. While we often focus most on the words we say, people experience our caring more often through our body language, the expressions in our faces—especially our eyes—and the way we say our words. Two people can say the same words but leave a very different impression of caring and compassion.

Earlier in my career, I worked in pediatric oncology and was often on-call for my patients if they were in the hospital at what could be, or looked to be, the end of their lives. For most patients and families, I had been with them for the twisting and turning path from diagnosis through treatment to this time where treatment was no longer helpful. If I got a call in the middle of the night that death was near or had just occurred, I came. Entering the patient’s room, few words, if any, were needed. We knew each other as I had had the privilege of being there in good times and bad. My physical presence in the middle of the night did the speaking. It said, “I care about you. I grieve with you. I will help and support you any way that I can.”

In those pediatric cancer years, about once a month I would also be on-call for the whole hospital from midnight to 8 am. Sometimes I would be called because a patient who I did not know had died. In some ways, these were more difficult. For the families I knew, my presence carried layers of meaning because of our shared experiences. For these unfamiliar families, my presence was a question mark of meaning. I would enter the room as a stranger, and the family’s understandable thoughts were “who are you and why are you here?” It was still possible to be a “non-anxious, caring presence,” but it was much more of a challenge to connect and for the family to experience compassion.

We have all been there when the presence of family and friends made a difference. During times of crisis, when we’ve been in the hospital, and for funerals, it’s mostly presence that speaks to us. People often fumble for words, stand speechless, or say unhelpful things. But what matters most, what says the most, is that they came. There is no eloquence like presence.

Our experienced grieving selves know about the challenge of living in the absence of physical presence. We have lived with the deaths of family and friends. We have yearned for their touch and the experience of their bodies and their whole-self presence. But the comfort of their touch and physical presence was not to be found, and that loss brought deep, human grief. Our grieving selves learned, however, that we are not left without all presence. We have rich and layered memories. We carry an ever-increasing community of friends and family in our hearts—those we could never leave behind. Looking at our bodies and at our homes, there are pieces of presence everywhere. Clothes, jewelry, tattoos, pictures, mementos, and more. And stories, so many stories. There are times, too, when we experience presence in ways that we don’t always share with others for fear of skepticism or judgment. A red bird lights just outside our window or lands in our path. We hear a sound of a voice, feel a brush of something pass, catch a glimpse. We have dreams. In times of trial, we sometimes hear their voices in our heads and in our hearts.

Despite all these ways that presence manifests when physical presence is absent, we are left disappointed. These other expressions of presence are significant, but we understandably want more. Our grieving selves work to make a truce with this reality. We grieve the presence that is lost to us while we seek and cherish the evidences of presence left to us. What presence is left does not feel like enough, but our wiser selves understand that we can live as if it is enough. And for that presence left and possible, we are grateful.

Our grieving selves have much to teach us and others who may not have lived as long or as deeply in times of physical distance. It is possible to live, and even live well, in these circumstances, although it is not easy and we need not pretend otherwise. Sometimes we even grow in such times, but we should never burden ourselves or others with this obligation. Our best grieving selves have learned that there are seeds of presence to be found planted deep within us by our past experiences with those we love. Not as good as a hug, but a comfort nonetheless.


Greg Adams

Program Coordinator

Center for Good Mourning


Greg Adams

Greg Adams is a social worker at Arkansas Children's Hospital (ACH) where he coordinates the Center for Good Mourning, a grief support and outreach program, and works with bereavement support for staff who are exposed to suffering and loss. His past experience at ACH includes ten years in pediatric oncology and 9 years in pediatric palliative care. He has written for and edited The Mourning News, an electronic grief/loss newsletter, since its beginning in 2004. Greg is also an adjunct professor in the University of Arkansas-Little Rock Graduate School of Social Work where he teaches a grief/loss elective and students are told that while the class is elective, grief and loss are not. In 1985, Greg graduated from Baylor University majoring in social work and religion, and he earned a Masters in Social Work from the University of Missouri in 1986. One answer to the question of how he got into the work of grief and death education is that his father was an educator and his mother grew up in the residence part of a funeral home where her father was a funeral director. After growing up in a couple small towns in Missouri south of St. Louis, Greg has lived in Little Rock since 1987. He married a Little Rock native in 1986 and his wife is an early childhood special educator and consultant. Together they have two adult children. Along with his experience in the hospital with death and dying and with working with grieving people of all ages, personal experiences with death and loss have been very impacting and influential. In 1988, Greg’s father-in-law died of an unexpected suicide. In 1996, Greg and his wife lost a child in mid-pregnancy to anencephaly (no brain developed). Greg’s mother died on hospice with cancer in 2008 and his father died after the family decided to stop the ventilator after a devastating episode of sepsis and pneumonia in 2015. Greg has a variety of interests and activities—including slow running, reading, sports, public education, religion, politics, and diversity issues—and is active in his church and community. He is honored to have the opportunity to be a contributor for Open to Hope.

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