Sometimes I come upon a passage in a book that on its own feels worth the price of the book. Here is that passage in That Good Night: Life and Medicine in the Eleventh Hour by palliative care physician, Sunita Puri:

“There is no freeway between the mind and the heart; a statement of medical facts didn’t lead easily to acceptance. Acceptance is a small, quiet room, Cheryl Strayed wrote in an essay that I read and reread somewhere around the start of fellowship.”

No freeway between the mind and the heart. That feels so true.

The mind takes in information and organizes spreadsheets of facts and soundbites. It makes lists of pros and cons and fills in the paint-by-number scenes of our lives with colors to outline discernible images. It advocates for a reality-based approach, interrogating the circumstances like Sgt. Joe Friday on the old TV series, Dragnet: “Just the facts, ma’am.” The mind knows because the mind was there, witnessed what happened, heard the words spoken.

Oh, but then there is the heart. The mind may know, but the heart believes. And the heart doesn’t believe everything that the mind tells it. Some facts are too much to take in, too terrible to consider, too heart-breaking to accept. At least in the beginning. So the heart tells the mind to “slow down.” Or, “Say that again, slower and with kindness and more explanation.” Or, “Back off, we’re not going there.”

Denial may be the mediator in these situations. The mind sees and the mind may know—that the situation is bad, that our person is dying, that there may not be any reasonable options—but denial knows that this is too much for the heart to take in all at once. So denial takes the phone and passes on the mind’s message to the heart in small pieces. Kindly, slowly, bit by bit as the reality of the situation becomes more and more clear to the heart. And even though denial is slowing down the message and cushioning its landing, it can still feel like a bomb to the heart. Too much to believe and too painful to accept.

Denial gets a bad rap, but it has an important role to play. We need it to help us not be blown away from the reality-bombs of our lives and to dull the realization and pain of our losses. Denial holds our hands, face to face with us and its back to source of our pain. It says, “Don’t look, look at me.”

But in time, it moves. Still holding our hands, it moves a little so we get glimpses of the bombed-out wreckage of our lives, of our dreams. A little at a time, and still it feels too much, hurts so much. Denial keeps moving out of our line of sight for longer and longer periods as we take in more and more of the facts our minds have to show our hearts. Eventually, denial is standing and hand in hand at our side as we stare at what we have lost. And there comes a time when we realize that our hand is empty and denial is gone. Our mind and our heart sit weeping together.

Together, mind and heart compose the story and make as much sense as possible of what feels inconceivable in the beginning. The story is a blend of facts and beliefs. Sgt. Joe Friday actually never said, “Just the facts, ma’am,” but he said something close enough to be true in spirit. Sometimes our stories are like the Native American storyteller who began his tribe’s story of creation by saying, “Now I don’t know if it happened this way or not, but I know this story is true.”

There is no highway between the mind and the heart. Maybe life would be simpler, make more sense, if there were, but for whatever reasons, we’ve just not made that way. So much of the time it’s a long road with many twists, turns, and obstacles until we come to that small room called acceptance. We come to it arm in arm with mind and heart. Denial now stands at a distance, if seen at all, as we grasp the door and take our first, tentative step inside.

Sometimes we stand with one foot in and one foot out. Even when we go inside, we may not sit at first, and it may take time until we decide it’s right to stay. With a heavy heart and a solemn mind, we eventually adjust. If we are fortunate to live longer, we will take this trip over and over again. The path will become worn, and while we may become wiser and more seasoned travelers, it will never be a painless journey. Fortunately, mind, heart, and denial will keep us from ever walking alone.


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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