Face to Face
Loss Leader
Ben Wolfe has made a life out of helping the people of Duluth come to terms with death and the grief that goes with it.
By Carmen Peota
Grief expert Ben Wolfe makes his way from the stage to the back five rows of the auditorium at Duluth’s Miller-Dwan Medical Center, where a group of nurses and therapists from the hospital’s rehabilitation department are sitting, eating their lunches, waiting for him to start an inservice workshop. If they had planned to distance themselves from the presenter or the subject this August day, their plan is foiled.
Wolfe stops, smiles, then says with a grin, “This is like church. You guys have put your butts in the back rows.”
With this slightly irreverent quip, Wolfe has established that although he’s going to be talking about grief, he’s not going to bring his audience down. He goes on to tell the rehab staff members that as a grief counselor he has seen many of the same patients and family members they have worked with. So when he says, “My sense is that it’s usually crazy for you guys,” heads nod. “All of us know you can’t do this stuff without knowing your own stuff,” he adds.
That “stuff,” Wolfe explains as he clicks through the slides in his PowerPoint presentation, is the set of emotions triggered by caring for patients who are grieving a loss, whether it’s the death of a spouse or, in the case of rehab patients, loss of ability. Wolfe’s agenda today is to get these nurses and therapists to think and then talk openly about how they are affected by their patients’ grief.
Actually, getting people to talk about grief is his goal most days. Whether working one on one with a patient on a cancer ward or speaking before a convention center full of thanatologists (specialists in death and dying), Wolfe is on a mission to let people know that grief is normal and something that needs to be talked about—and then to help them see they have choices in how they’re going to deal with it.
Soul and Science
A thin man with a beard and a long gray ponytail, who this day is dressed in a lavender shirt and white pants, Wolfe, 59, is obviously an old hand at putting people at ease around the subject of death and loss. And if he seems comfortable talking about subjects most people avoid, it’s probably because he’s been doing so almost nonstop for more than two decades as head of St. Mary’s Grief Support Center, a resource available to the 17 clinics and four hospitals—Miller-Dwan Medical Center and St. Mary’s Medical Center in Duluth, St. Mary’s Hospital in Superior, Wisconsin, and Pine Medical Center in Sandstone, Minnesota—that make up the SMDC Health System.
The seed for the center was actually planted in the 1970s by a nun at St. Mary’s Medical Center who saw a need to support families who had lost children in the hospital’s brand new neonatal intensive care unit. Wolfe was teaching a graduate course on death education at the University of Minnesota and doing volunteer grief counseling in the 1980s when hospital administrators asked if he’d help create a grief program for children. By 1984, Wolfe and Kathy Noble, head of social services for the hospital, pitched the idea of expanding the grief support services back to the administration. In 1985, Wolfe was given a one-year contract, no staff, and the charge to see what he could do. Near the end of that first year, hospital administrators changed his status to full-time employee. Wolfe’s career and the Grief Support Center were officially launched.
Now the center has four grief counselors who follow up on every death that occurs in the hospital and work with inpatients with life-threatening diagnoses, trauma, or end-of-life issues; about a dozen adjunct staff who facilitate support groups for bereaved family members and former patients; and approximately 50 volunteers, all of whom have undergone training so that they can mentor people who are grieving. It has become a multifaceted entity that offers programs for youth and adults for as long as they need it. It has also become an educational hub on all issues related to death and dying, sponsoring conferences and classes for professionals, special events for grieving kids, and workshops and seminars for anyone in the region. Wolfe says the center was the first of its kind in the country and is seen as a model of bereavement care. Although many organizations offer grief support, few are hospital-based and even fewer have dedicated as many staff members and resources solely to the needs of the bereaved.
One reason why the center receives such support is because it fits the hospital’s Benedictine mission of bringing together the “soul and science” of healing, says Susan McClernon, COO/administrator of St. Mary’s Medical Center. “This is the soul part.”
McClernon notes that because St. Mary’s is a tertiary care hospital, it sees the “sickest of sick”—from trauma victims who’ve lost a leg to people with end-stage cancer. Many patients and families are facing life-threatening situations. “We see grief as a health and a healing issue,” McClernon says.
That is why Wolfe has been allowed, if not encouraged, to run with his ideas about grief support, even take them out of the hospital and into the community. Wolfe has become, in the words of one colleague, an “evangelist” for grief support. In addition to heading the center, Wolfe teaches a course on the psychosocial and spiritual aspects of life-threatening illness at the University of Minnesota Medical School, Duluth campus. He’s chair of the Minnesota Coalition for Death Education and Support and a past-president of the National Association for Death Education and Counseling. He’s served on the Minnesota end-of-life commission and other state task forces, and he has presented more than 1,700 workshops, training programs, and speeches at local, state, national, and international events.
Wolfe also has become the go-to guy when there’s a tragedy in the north woods. After Sen. Paul Wellstone’s plane went down in the woods near Eveleth, Minnesota, four years ago, for example, Wolfe was asked to work with the individuals who recovered the bodies. When a freak fog settled on the bridge linking Duluth with neighboring Superior, Wisconsin, and car after car plowed into one another, injuring many and killing one, Wolfe was called in to debrief emergency workers. When a teacher from an area school killed himself last summer, Wolfe was contacted soon after by the school principal.
In such cases, Wolfe goes in without a fixed game plan but with a knack for figuring out what needs to be done to help people cope with death. He found that what the responders to the Wellstone crash needed first was a chance to piece together the details of the story. The school principal needed to figure out how to help the students and staff deal with their grief.
“He knows how to zero in and help people look at issues,” says Linda Senta, a fellow grief counselor at St. Mary’s. It’s a skill he uses regularly in the hospital, where he and the other grief counselors are often called on by physicians to meet with cancer patients or others confronted with a terminal illness or trauma.
These are patients who are dealing with issues that are “more than medical,” says Jonathan Sande, M.D., an oncologist at the Duluth Clinic Cancer Center and director of the St. Mary’s Medical Center ethics program. “It’s often very obvious what you can and can’t do for the patient from a medical standpoint,” he says, adding, “if you define medicine as the science and the therapeutic options. But when there’s a conflict around goals and values, that’s when things get very challenging for patients and their families.”
Sande cites the example of a patient with incurable cancer and other medical problems who wanted every possible treatment to be done. “The patient is basically lying in bed sleeping 24 hours a day, and we’re still doing everything,” he says, clearly frustrated that these issues weren’t resolved differently ahead of time. “I find that very challenging personally. Should I keep doing this? Am I doing the patient any favors?”
Sande says he’s more than willing to talk about end-of-life issues with patients and their families. But he thinks his role as a physician often prevents him from being effective even when he does. “As unauthoritarian as you try to be, you come across as the authority figure,” he says. “Ben and his colleagues are indispensable at clarifying conflicts, goals, and values during end-of-life care, and they help us add soul to our science.”
The Normalizer
Sande says Wolfe gives people the idea that he’s not going to judge them, regardless of what they may say or feel about the loss of their loved one or their own health.
That impression is no accident. Wolfe makes it a practice to let those who are grieving know that they are normal people going through normal reactions to an abnormal event. He recalls one heart-broken woman telling him between sobs that she almost wished her other child had been the one to die. “You need to know that I’ve heard it before,” he told her, honestly.
And he’s not afraid to encourage people to articulate thoughts that might scare them or make them uncomfortable. He’ll encourage a child to wonder what it might have been like if their father had died instead of their mother or a parent what it felt like when that $250,000 insurance check arrived in the mail after the death of the child.
Pediatric intensivist Liz Kelley, M.D., says Wolfe, in addition to being nonjudgmental, is sensitive to the spiritual and cultural needs of others. She recalls asking Wolfe to help the family of a toddler who had died. Wolfe met with the family, who had Native American spiritual beliefs, then found a medicine man willing to do a special service for the child with singing, drums, and smoke, all within 24 hours.
Kelley says Wolfe is also simply practical; he knows what to do after a death. In a situation in which all but one member of a family were killed accidentally, Wolfe not only consoled the child who survived but also helped relatives prepare to assume the child’s care, assisted with decisions about organ donation, coordinated a visit from worried school friends, and helped hospital staff come to terms with their feelings about the deaths.
She believes such work—both the counseling and the attention to the nitty gritty details—is therapeutic for the children and families she deals with. “I think a lot of healing has to do with how emotionally you’re feeling about yourself,” she says. “Being able to say goodbye and think about what’s going on and have someone who’s there for you months and months down the road … makes a significant difference for them,” she says of the people Wolfe helps.
Making Meaning
Spending his career dealing with death has made Wolfe reflect about life. Raised in an Orthodox Jewish family, he says that his Jewish traditions are still meaningful to him but don’t provide answers that apply to everyone. “What it’s done, if anything, is help me to ask more questions,” he says. If people ask him about his religious beliefs, he’s happy to share them. But rather than ask them what religion they are, he’s more likely to phrase the question as “What gives you hope?”
Dealing with the deaths of others also has made Wolfe acutely aware of his own mortality. “I take a shower every morning, thinking I have a brain tumor or my ovaries hurt,” he jokes, then adds, “You listen to these stories … It scares the heck out of me.”
Yet Wolfe seems less afraid of dying than of losing out on the chance to continue doing what he loves. “I just enjoy it,” he says of counseling and teaching people about grief. All the same, to stay healthy—both physically and emotionally, he runs, rides his bicycle, or escapes from the city to kayak or camp as often as possible.
And to make sense of the many hardships he has witnessed, Wolfe continues to talk and write. A lover of metaphors, he muses about the symbolism of a window shade, a truck stop, or a train ride in his column in the grief center’s newsletter or his talks to groups such as the rehab staff. It’s as if his daily brushes with mortality have sharpened his awareness of the poignancy of ordinary things and moments.
Wolfe knows his work has affected him. For one thing, it’s changed his own ideas about death. “I used to think that a good death would be a quick, sudden, and painless one,” he says. Now, he’d like time at the end, “so there’s no unfinished business, so those around me will feel supported, loved, so that my story at the end of my life will be helpful to others.” MM
Carmen Peota is managing editor of Minnesota Medicine.