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'What Looks Like Bravery' explains how achievement can't protect us from grief

SACHA PFEIFFER, HOST:

Laurel Braitman was still in high school when she experienced one of the most devastating things that can happen to a child - her father died. That affected the rest of her young adult life. Nearly three decades later, she's written a memoir about that experience. It's called "What Looks Like Bravery." Braitman says she had a happy childhood growing up on an idyllic ranch in California with donkeys and peacocks and avocado trees. But she had to keep a brave face as she watched her father get sick. She told me her parents never tried to hide his illness from her.

LAUREL BRAITMAN: Well, my dad was diagnosed with osteosarcoma, which is a rare and aggressive form of bone cancer. My parents absolutely did not try to protect us from it, and I think that was mostly a blessing. But it was also hard. So my dad was given an initial prognosis of about six months and prepared us for his death. You know, he said goodbye. He started to get his affairs in order. And then he didn't die.

He went on his own journey for the next - oof, probably 14 years to find treatments, oftentimes experimental. But the thing was, we would never know how much time we were going to get. So we would get time with him in tiny chunks, like four months here, a year there, six weeks there, and then we'd say goodbye again. So we really lived with the ticking clock of mortality for years and years. And we were never quite able to take a day for granted.

PFEIFFER: Part of the reason that your father lived so much longer than his doctors thought he would is that he was very good at advocating for himself in the health care system, maybe because he was a doctor himself. You wrote he even got one surgery against the advice of his oncologist, but that bought him time. What lessons do you think his experience offer the rest of us about health advocacy, if anything at all?

BRAITMAN: No one cares as much about your outcomes as you do. I learned that at a very, very early age. And that isn't to say that your health care team doesn't care about you - absolutely they do. But such is the way with modern health care. People aren't talking to each other. You need to be your own advocate. And against all odds, you need to fight for the kind of care that you deserve. And I wish that wasn't true in this country, but it absolutely is.

PFEIFFER: And for him, it paid off, at least in terms of extra time with his family.

BRAITMAN: It did. It did. He also taught me that you shouldn't be scared to ask questions of your physicians and nurses and other folks who are helping you. If a doctor is annoyed or frustrated by you asking questions, he told me to run, not walk out of their office, that a really good physician is just going to appreciate that you're asking questions and that you're curious and won't be threatened by the need to answer you. No one cares as much about your outcomes as you do.

PFEIFFER: Your dad lived till a few months before your high school graduation. In your book, you jump all the way from his death to when you were 36 years old. You skip what happened in between. How would you sum up your life from high school till mid-30s?

BRAITMAN: I was on an epic hamster wheel of achievement. You know, I would do anything for a brass ring of success. And the blessing of what my dad did when my brother and I were growing up was lay out all these beautiful things that we could become and things we could do as adults. But I overinterpreted that as a to-do list. And there was all kinds of things on there, you know, from writing a New York Times bestselling book to getting a PhD at MIT. And I spent 20 years, one by one, checking every single thing off that list he wanted for me. So by the time the book picks up again, when I'm in my mid-30s, I was exhausted.

PFEIFFER: Do you think at some conscious or unconscious level you were doing that because you thought your dad wanted it?

BRAITMAN: Oh, absolutely. You know, what I learned later - I became a grief counselor for bereaved kids who were in my situation, trying to learn from them. And one thing that I learned was that achievement or overachievement can be a trauma response. And really what it is, is an effort to control the uncontrollable, that subconsciously you believe that if I only do X, then Y will hurt a little less, and that's what I was doing. I was trying to exert control over a world where we can lose people we love for no reason at all.

PFEIFFER: I think you described it as overachieving to contradict feelings of helplessness.

BRAITMAN: Absolutely.

PFEIFFER: Do you think that's what it did for you - it helped you overcome grief or a feeling of helplessness at some level?

BRAITMAN: I would say it distracted me on pretty much every level. And you get positive reinforcement from the world. You know, so the better you do at school, the better you do in sports, and then eventually the better you do in your career, you get accolades. You get praise. And so even though for me, in the end, it was a form of a unhealthy coping mechanism, I was getting rewarded for it. The only problem comes when enough losses catch up to you and when new losses happen, that coping mechanism stopped working for me.

PFEIFFER: You mentioned that you volunteered at a center for grieving children, and you got some great advice from an 8-year-old girl. She said the worst thing that you can do is try not to be sad. How did hearing that affect your own grieving process?

BRAITMAN: It brought me to my knees. I spent decades trying to avoid feeling sad. I tried to achieve my way out of sadness. I tried to use excellence as an analgesic on a pain that I believe I couldn't have admitted was there. And seeing these kids face their own losses and their own pain with such bravery just brought me to my knees.

PFEIFFER: When you realized that you had misinterpreted in a way why your dad had pushed you to accomplish so much, how did you then begin to live your life differently?

BRAITMAN: Well, first I realized that grief wasn't something to run from, that my negative feelings weren't something to avoid. And that grief isn't something that we move through. And I think we really get that wrong in Western culture, that we think of grief, if not in stages, we do think it's something to survive or get to the other side of. And I realized that that was impossible. And not only that, but by turning towards it and turning towards my own pain, the joy of my life, the wonder, the beauty, all of that was turned up in the world. It was like I could finally see in a new color spectrum.

PFEIFFER: Laurel Braitman is the author of "What Looks Like Bravery: An Epic Journey Through Loss To Love." Laurel, thank you.

BRAITMAN: Thank you so much for having me. Transcript provided by NPR, Copyright NPR.