Poems & Essays

14 Nov

I Know It In My Heart: Walking Through Grief With a Child–Book Review

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I Know It in My Heart is the title of a book that chronicles the grief of a child and the mourning of an aunt who provides love and care for her bereaved niece when “no one else could.” It is a poignant line in the story, uttered by a lonely child named Liamarie who exhibits wisdom beyond her years. It is the center of a compelling narrative that takes readers down the dark roads of doubt and death and yet with grace leads them to pathways of hope and life.

Written by Mary E. Plouffe, I Know It in My Heart is both a moving memoir  and a powerful guide through grief. Plouffe is a clinical psychologist who uses her education and training to expertly lead her young niece through the complex and confusing grieving process. But she uses the understanding of a mother’s heart to give solace to a sad and terrified child.

Calling herself “a solitary soul,” Plouffe claims she does not share easily. But several years after her sister Martha’s untimely death due to cancer, Plouffe takes pen to paper believing that her family’s pain, if shared, could help others endure the painful loss of a loved one.

“I wrote this,” says Plouffe, “because I know that if Martha could have given me instructions before she died, she would have asked me to use her story to make a difference.” While the loss of life is a universal theme, the narrative that tells of each individual’s experience is unique.  In Plouffe’s case, the story begins with the bleak diagnosis Martha received on a cold January afternoon.  Doctors found a very large aggressive malignant tumor and recommended an immediate mastectomy. Plouffe travels to Virginia to take care of her then three-year-old niece Liamarie while her mother undergoes surgery.  It is the first chapter of their profound  journey together.  It is the beginning of  “not just how we got through the horror,” says Plouffe, but also “how we got back.”

After the mastectomy, Martha receives chemotherapy and radiation and could have stopped treatment at that point with what appeared to be about a five-year survival rate.  But Plouffe remembers Martha saying on several occasions that “Five years is nothing. I need twenty. I need twenty years to raise Liamarie.”

With that thought propelling her forward, Martha chooses to proceed with a Phase II clinical study at  Johns Hopkins.  She opted to be part of research being conducted to determine whether  a “stem cell transplant procedure  would increase long-term survival rates for patients with high-risk primary tumors when it was done as part of the initial treatment plan, before any recurrence.”

During the extended time for the procedure, Liamarie lives with her aunt in their home in Maine. She adjusts well to what everyone thought would be a brief temporary situation, and bonds with her aunt and develops close relationships with her uncle and three cousins.

Martha hoped the procedure would extend her life. Instead it ended it. Unexpectedly and without warning, Martha’s lungs went into Adult Respiratory Distress Syndrome (ARDS) and she never recovered.  At the conclusion of the book, Plouffe discusses the controversial nature of the treatment and questions, in retrospect, the advisability of the decision to proceed with the bone marrow transplant. But the book primarily focuses on and recounts her immediate response to her sister’s untimely death. In her heart, Plouffe knows that as she grieves, she must be the one to support Liamarie’s father Herb, and to guide her niece through their shared journey of grieving, growing and remembering.   She becomes the mother figure for the tiny child who calls her “Mary Beth.”

Liamarie lives with her father but Plouffe visits often and after one of her first trips, describes her sister’s home as a “house full of her absence.” It is this absence in her life and in Liamarie’s life that she must accept and endure. She writes movingly of how her love of music and her ability to put her thoughts into words help her through her grief. But if grieving is difficult for adults with their maturity and ability to cope,  it is much more frightening and challenging for a child who cannot possibly fathom the permanence of death nor begin to understand why the terrible tragedy happened.

Perhaps that is why this young girl sometimes looks for answers in imaginative play and in her favorite fairy tales.  A small petite youngster with big brown eyes almost “too big for her face,” Liamarie often turns those beautiful eyes toward Mary Beth as she seeks understanding.  In her favorite fairy tales, “Sleeping Beauty” and “Snow White,” this grieving child finds hope because in each of these magical stories, the main character dies and comes back to life.  Liamarie imagines and wants to believe that this scenario can come true in her situation.

“Over and over again we would come back to the same concern. Stories have magic. People die and come back to life,” says Plouffe as she recounts the experience.

“People have magic too,” Liamarie  would say.

And each time, Mary Beth had to take that hope away.

“No, Liamarie. Not that kind of magic,” Mary Beth tells her.

But in so many tangible and intangible ways, Plouffe gives hope through her mother’s heart that embraces little Liamarie as her own child and through her professional role as a practicing psychologist. Perhaps what makes I Know It In My Heartso compelling is the juxtaposition of a heartfelt narrative with the clinical exposition.  The profound journey of Mary Beth and Liamarie engages and enthralls the readers because it is a moving story of life and death. But the explanation of the grieving process at various stages informs, enlightens and helps those who are grieving just as Plouffe hoped would happen when she wrote the book.

The magic of mother love and professional wisdom that Mary Beth beautifully combines and effectively imparts to her niece  lead the little girl with the big brown eyes  down a pathway through pain  to a place of happiness. About five years after her sister’s death, Plouffe and Liamarie are sitting on a couch, giggling and laughing and gently pushing at one another in jest. A memory of Martha flashes through Plouffe’s mind and she says that Liamarie must have seen an expression of sadness cross my face. And then the little child speaks.

“It’s ok, Mary Beth. Mama wants us to be happy. I know it in my heart.”



About the author of our book review: The mother of six grown children, Lori R. Drake is a freelance writer whose work has appeared in Mothers Always Write, San Diego Woman, the Gaithersburg Gazette in Maryland and the Daily Reflector in North Carolina as well as other publications. She has received four Honorable Mentions in the Writer’s Digest National Writing Competition.  The founder and former Headmistress of Roseleaf Academy, the only girls’ school in eastern North Carolina, Lori is working on a book about her innovative school that has since closed.  She currently teaches communications classes at her local community college. 


Mary E. Plouffe Ph.D is a clinical psychologists and author who lives and works in beautiful southern Maine. She has been in private practice for 37 years, treating adults and children, and consulting to schools, treatment centers, and the courts. She was on the faulty of Maine Medical Center’s Psychiatry Residency Program, supervising residents’ psychotherapy training, and teaching courses in both Child and Adult Divisions. She received her Ph.D in Clinical Psychology from the University of CT, and also hold a M.Ed in Counseling ( Rehabilitation)  from Boston University. As a writer, she has published essays on NPR, Mothers Always Write, Brain, Child Magazine, Survivor Review, Story Circle anthology, among others, and has written op-eds for the Portland Press Herald and Bangor Daily News. Her memoir, I Know it in My Heart: Walking through Grief with a Child was published in May of 2017 and has been a finalist or winner in the  2017 International Book Awards, the  2017 Living Now Book Awards, 2018 Story Circle May Sarton Memoir Award, 2018 Reader’s Choice Book Awards, 2018 Maine Literary Awards,  and 2018 Forward Indies Book award. The book is currently a finalist for the Independent Publisher’s of New England Book Award in Narrative Non-Fiction. Further information can be found on her websites: www.maryeplouffeauthor.com; www.maryplouffe.com; and on her Facebook Mary E Plouffe author page.


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