Monday mourning quarterbacking

Monday morning quarterbacking refers to the treasured pastime of critically reviewing a competitive activity, be it an athletic contest or an election, to see how different decisions might have changed the outcome. Usually it is a harmless, even enjoyable activity. But when Monday morning quarterbacking be­comes Monday mourning quarter backing ­that is, when we obsess over the choices we made before a death, it can deeply compli­cate our grief. We can often wonder about a decision that we made. Did we do everything that we could? Did we pursue treatment for too long, causing unnecessary discomfort and pain when the treatment was futile?

All of these choices are difficult. They can be even more complicated when there was no communication about what the dy­ing person wanted, when family members disagree, or when professionals offer little counsel or conflicting advice. We can feel alone as we literally make choices about life or death. Yet, these choices are not just about the patient. They may influence relationships with family after the death. And, these choices affect our grief. ­ There are a few things to remember as we struggle with our choices. The first is that the struggle is, in itself, normal. Grief, after all, involves many emotions. It is natu­ral that we would re-examine our decisions.

However, it is important to remember where we were when we made those decisions in the first place. We made the decisions that we did under difficult cir­cumstances-often under deep emotional strain and personal distress, and perhaps with the pressures of time and incomplete information. Our health and decision ­making capabilities may have been compro­mised by the stresses we experienced, by lack of sleep, and even by our own conflicting feelings. It is important to remember that we made the best decisions we could at that time.

We may wish to talk with others. It may help to review these decisions with our physician, to ask any questions that still trouble us. Sharing our feelings with a counselor may help us explore these thoughts with an empathic listener. Support groups also can be helpful. As we recount our stories, others may not only relate but communicate the ways that they were best able to cope.

Sometimes we may need to do more. Lesley’s husband Arun struggled with cancer for years. He insisted that he would beat it. But after a few years, he succumbed to the disease. There never seemed to be a good time to address his wishes as death approached. In fact, he resisted all such conversations. In the end, Lesley faced choices that Arun had refused to consider. She wondered if she made the right choices and sought counseling.

Seeking counseling, Lesley’s counselor used a therapy technique that involved an empty chair. Imagining her late husband was sitting in the chair, she explained her decisions. She expressed the wish that they had had such conversations when Arun was alive. Lesley expressed how difficult these decisions were and how she felt so alone in making them. As a result of this therapy, Lesley came to feel that her husband had under­stood that she did her best and did everything he would have wanted.


Kenneth J. Doka, PhD, MDiv, is Sr. Vice President, Grief Programs, HFA and recipient of the 2019 Lifetime Achievement Award from the Association for Death Education and Counseling. 

April 2023 Issue: Journeys, A newsletter to help in bereavement

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