CMDA's The Point

How Long is Grief?

January 25, 2024
The author on the right with her zany, full-of-life sister, Martha.

by Amy Givler, MD

How long is grief? I guess what I’m really asking is, “Does grief ever end?”


Last week I had a five-hour drive ahead of me, so I looked at my list of downloaded audiobooks borrowed from the library. Seasons of Sorrow by Tim Challies was one of them. The subtitle was “The Pain of Loss and the Comfort of God.” That was all I knew about it. Who had recommended that I read it? I did not recall. It was due in a few days, so I started listening.


Within a minute I was plunged back into the world of grief I first entered 45 years earlier, when I lost my 21-year-old sister who was also my best friend. So how long is grief? At least that long.


Challies, a skilled writer, suddenly lost his 20-year-old son to an undiagnosed heart problem in November 2020. He started writing about his and his family’s anguish that very day. He is one of those people who process emotions best by writing about them.


However, this book is far more than an “emotion dump.” It covers the first year of grief, divided by four seasons, and he vividly describes his struggle to make sense of his loss in the context of what he knows about God and His love.


Listening to this book in one long stretch, from the initial shock and disbelief through the slog of pain and agitation, walked me once again through the first year of grief after my sister died.


On the afternoon of February 1, 1979, I was a 20-year-old college junior and knew, of course, that people died. Two grandparents died before I was born, and the other two, along with a beloved cousin, within a few years of each other when I was a young teen. But—back then—I rarely reflected on death.


So I was utterly unprepared for the phone call from my mother.


“Martha has died. You need to come home.” Her voice was strange, and she was crying. Surely I hadn’t heard her correctly.


“Wait, what?” I asked.


“Her housemates found her in her room at college. Come home.”


“But, Mom, I just spoke to her two days ago. She can’t be dead.”


“But she is,” Mom sobbed, her voice loud and harsh. My other sister came on the phone. “Amy, come home as soon as you can. We need you here.”


“But how?” I choked out. “How did she die?”


“Maybe a seizure,” Franny said. Martha had a poorly controlled seizure disorder. That eventually became the presumptive cause of death.

Getting home meant flying from Boston, Massachusetts to Washington, D.C.—and the earliest flight was the next morning. I’d been a Christian since I was 12, but that evening I craved connection with other Christ-followers, more than ever before in my life. God brought two friends to comfort me, one from across the campus, and one from another college who had never visited my school before but impulsively decided to swing by on his way home. I know Who prompted that impulse, and I am forever grateful.


Remembering these details is remarkably easy. If I was writing this in July, I think I would be straining to remember exactly how the conversations and the sequence of events went. However, this is late January, and every year around this time my memories of Martha and the shock of her death become crisp and frequent.


I’m not the first one to notice this. The anniversary of a loved one’s death, especially when it was sudden, often brings a fresh wave of grief. In the 45 years since Martha’s death, that wave has diminished, but it is always there, year after year. It’s a bit uncanny, really. I will remember some funny thing that Martha said (she was a clown), or I will wake up having had a vivid dream about her, and only upon reflection do I become conscious that it is late January or even February 1.


As the years have passed, the wave of grief is not always gloomy. In fact, throughout the last few decades I am seldom sad as I have thought about her and her brief life. Melancholy, perhaps, as I ruminate over all she has missed. I wonder what she would have thought about my husband, whom I met 18 months after she died. She would have put him through the ringer, I know, since she was incredibly protective of me. I think, though, she would have liked him, at least eventually.


I think she would have been an amazing aunt to my three children. I regret that loss—their loss, my loss and Martha’s loss—as well as the thousand times I haven’t been able to ask her for advice.


The first year of grief after losing her, which was so wrenching and confusing, and the yearly waves of grief I’ve experienced since, have shaped me into someone who wants to understand the grief process. I have studied grief deeply over the last 45 years, reading scores of books on the subject. Experts talk about “the work of grief,” and it really is work. When thoughts of Martha emerge, it takes work to process my complicated emotions. It would be easier to just stuff them down and move forward through my day. Nevertheless, I give myself the time needed to mull over my memories, asking God once again to give me more insight into why she died, and thanking God for giving her to me as a sister.


This year, listening to Seasons of Sorrow facilitated that process. For five hours, I was flooded with memories of Martha and that miserable first year of grief. I do not cry easily, but I shed a few tears. Those tears, and the processing of those memories, is part of the work of grief—work I won’t have to do next year. Next year, I’ll have another segment of the journey to work through.


So how long is grief? I think my friend Libbie Groves said it well in her book Grief Undone, which describes the difficult years of her husband Al’s dying of cancer, as well as her grief after his death. When Al had been dead seven years, she wrote:


“I love Al as much as ever, and I miss him. But the grief does not dominate every waking moment anymore, though it’s always there as part of the scenery. Being a widow is one piece of my identity. Most of the time I live in the present with joy and thankfulness, and both the sadness of missing Al and the anticipation of seeing him again in heaven remain in the background.”


Grief does not dominate my life, either, but I will always be a woman who lost her beloved sister. That is one piece of my identity, part of the scenery of my life. It’s sort of like a tree in the landscape that gets more beautiful as it grows and matures.


The biggest piece of my identity is Jesus. He is like a massive rock, right in the center of the landscape. As the psalmist wrote:


“I love you, Lord;

you are my strength.

The Lord is my rock, my fortress, and my savior;

my God is my rock, in whom I find protection.

He is my shield, the power that saves me,

and my place of safety” (Psalm 18:1-2, NLT).


Having Christ as my rock has made all the difference.


About Amy Givler, MD

Amy Givler is a family physician in Monroe, Louisiana. She and her husband Don met in 1980 at a CMDA student event her first year of medical school, and they have both been active members of CMDA ever since. Amy graduated from Wellesley College and Georgetown University School of Medicine, and she then completed her family medicine residency at the same indigent-care hospital where she now works part time. She also works at an urgent-care clinic and is the medical director for a Shots for Tots clinic. Amy loves to write and has written many articles and one book, Hope in the Face of Cancer: A Survival Guide for the Journey You Did Not Choose. She and Don have a heart for missions, and hope to do more short-term trips now that their three children have launched from the nest. Connect with Dr. Givler at


  1. Avatar Nicole Hayes on January 26, 2024 at 6:29 pm

    Amy, thank you for sharing with us your personal journey in grief, a subject that touches all of us.

  2. Avatar debbie mcalear on February 13, 2024 at 2:28 am

    Amy what a great perspective on grief. I will share this with a friend who is struggling right now. Thank you!

  3. Avatar Bob Cranston on July 7, 2024 at 10:52 am

    Thanks very much, Amy. We too have experienced long grief. You captured the emotions and thought process well.

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