Grief walks in many forms, and its footsteps are padded and quiet, imperceptible even, except to those who lay awake at night, counting its tip taps on the upper floor.

In Granny Must Grieve (Fall 2018 Intima), Suzanne Crowe closes a short and powerful witness to her mother’s grief with the phrase, “We don’t talk about why.” A grieving mother recounts both her own and her mother’s experience of loss in less than sixty simple yet poignant words with the same veiled sterility I witnessed during my time working in a Kenyan children’s hospital.

Grief, especially the overwhelming kind, is particularly inconvenient for mundane things like time, time which marches steadily onward even when it feels like the world should collapse around us. So. We lock grief upstairs to endlessly pace and we experience grief as selective mutes, carefully, quietly and constantly aware.

When Crowe loses a child, she and her mother do not speak about the incident. Instead, five years later, her mother starts knitting for hospitalized children. Crowe watches noiselessly as a pair of old hands laboriously pay tribute to the sick and dying.

I think about my medical colleagues in Kenya calmly wrapping a young body in shrouds. They are pairs of old hands laboriously paying tribute to the sick and dying. They, too, are surviving with the endless march of time and they lay their grief in the ballpoint ink of a medical record - “rest in peace” – before necessity drives them to move on to the next patient.

The title of my reflection, The Valleys Between Us (Fall 2024 Intima), references a healthcare equity gap between children in the U.S. and children in Kenya. However, in light of Crowe’s poem, I think this title also illustrates the invisible walls through which we sometimes silently witness each other’s grief: as great, wide, un-crossable valleys.

Sophia Gauthier, MD is an Assistant Professor of Pediatrics at Duke University School of Medicine. She is a pediatric hospitalist in her real life and a storyteller in her imaginary one, with special interests in narrative medicine and global health. Her short story "Myrtle Beach" was published in Pulse.