My Grandma Died Last Night...but I Only Knew Her As Nellie

My maternal “biological grandmother” passed away in her sleep last night. I say “biological” because that is how I always referred to her in explaining our relationship. To me, she was “Nellie” and to her I was “Patricia.” Nellie had paranoid schizophrenia, and she was unable to care for her children consistently due to extensive stays in psychiatric hospitals.

I consider my grandmother to be Peggy Lawton: the woman who raised my mother from the age of 5, the woman who died months prior to my birth, and the woman I was named after. It was confusing to me as a child to have cousins who had a living grandmother they referred to as my grandma. After my biological grandfather passed and Nellie was cared for by my uncle, she began staying with us for one week in the summers. I did not understand what seemed to make her so childlike or why she mumbled to herself or why she hit her leg often (this was tardive dyskinesia I would learn about years later in graduate school – a side effect of antipsychotic medication). I remember trying to talk with her or connect with her in some way and help her out of her condition and back into reality, but of course this didn’t happen. She was very kind and always referred to me as “Patricia” or “Honey.” I wanted to hear her story. I wanted her to help me understand what happened in her life to result in my confusion over whose granddaughter I was or who my mom really belonged to…these are just thoughts from my child mind. I know now, as an adult, many families are non-traditional and life circumstances create a lot of confusing situations too difficult for children to understand. But at the time, I thought there was an answer I could find and a world of reality I could help her find.

There are questions that will never be answered and many complicated thoughts and feelings swirling around in my head. Nellie died a peaceful death in her sleep and for that I am thankful, and I do not feel sad about the loss of a woman I really did not know. I feel compassion and sadness for my mom, her siblings, and all children who grow up with mental illness in their families. I empathize with individuals like Nellie who lose almost everything because of mental illness, and yet they are blamed for their own conditions.

To my mom, I have no idea what you are feeling, but your long silence on the phone told me there were probably emotions you could not articulate. Since I encourage patients to focus on their own feelings, I’ll try to speak from my own experience rather than trying to address what I imagine to be your concerns. I feel guilty that I work with elderly people in nursing homes, but I only went to visit Nellie once in the last year. I feel guilty that I have meaningful connections with many of my elderly patients with mental illness, but I did not forge this type of connection with Nellie. In my case, probably similar to a lot of other families, I avoided what felt like a complicated situation. Maybe as a kid, it felt too risky to care about someone who couldn’t care about me the same way, and maybe this reaction followed me…followed us into adulthood. Alternatively, we could both be terrible, heartless daughters/granddaughters who care nothing about others…but I would say our career paths/relationships/and contributions reflect quite the opposite.

So, with my complicated mess of feelings – this is what I’m going to do. As I tell patients, even the difficult emotions in life tell us something important. The guilt tells me I do care that I was unable to have a typical “granddaughter” reaction to Nell, so I’m going to allow myself to feel this guilt. This guilt is how I’m experiencing her loss. I am also going to take a step back from my immediate experience to make meaning and see how Nellie’s hardship affected your life, which impacted mine, which will also impact the lives of my daughters and granddaughters. She is part of our story, and she will be remembered – even if I did not know her to be my grandmother.