I think you know the answer to this question, Yes. Trauma always involves some kind of major loss that is followed by a lengthy grieving process that can be lonely in that it IS such a personal loss. Your father left an impression on you where you navigated so much of your life around that impact. Often one doesn't really understand that until a major traumatic event happens that impacts that personal way of navigating. One of the things one has to figure out how to make peace with is how there is actually a limit to our ability to save the people we may love and want to help from "themselves". This is something that tends to come forward in you from your life experiences where you put yourself at the scene of so many traumatic human situations, most of which you could not have prevented.

What stands out the most to me in listening to your life experiences that you have shared is that you had been protected from witnessing a major trauma and how significant that was to you, more than you understood on a deep subconscious level. So, you put yourself in the role of protecting others that same way. However, this trauma was something that did not include someone else protecting you so you did not have to see. That is what makes this specific trauma so much harder for you to grieve because it doesn't fit into your life long theme of the importance of protecting others from witnessing something traumatic the way that had been done for you so many years ago when it came to protecting "you" from seeing what happened to your grandfather.

If you sit and think about all rescue workers and emergency care responders,
the one consistency is minimizing exposure. It is these individuals that are also at a greater risk of experiencing PTSD in that they do see a lot of human trauma. However, these individuals learn to develop a detachment when it comes to dealing with traumas that involve other human beings. Actually, you have described how you had learned how to zone out and focus on dealing with different emergency situations and control the adrenaline rush and hyper focus. Surgeons, and ER workers have to learn how to practice this. Actually, the one area that tends to have a five year burn out is the the ER staff at hospitals that tend to be located in areas where the trauma traffic is high. This is also true when it comes to the police officers that have to deal with high crime areas in inner cities compared to a calmer beat in the suburbs or rural areas. Most of these individuals are at risk when it comes to dealing with a more "personal" trauma that can most definitely break that ability to detach. This is also something that soldiers can experience when it comes to suffering the loss of their partners that they develop a deep relationship with in battle. This becomes a deep personal loss that these individuals cannot articulate the depth of and it's a very deep bond that unless one experiences it first hand, they won't be able to understand it.

Part of this loss when it comes to your father is that this is something that happens to other people NOT YOU. Actually, this is what your brain/mind is struggling with when you recall the traumatic things you witnessed when it came to other people NOT YOUR OWN. What your brain is struggling with is that deep line that takes place where one learns to dissociate in that it's not about "self" but outside self and the self world. This is where you are really struggling with developing the ability to reconcile.

However Trace, you have been making progress. You have been slowly and gradually talking about your personal challenge instead of just sitting and disassociating. Actually, you are doing rather well considering that it's only been four years and what happens when it comes to going through the stages of PTSD that results from a major trauma that deeply affects the individual's personal sense of self in the world. Your father is not in limbo or experiencing his own deep internal battle anymore, he is at peace now, that is what he wanted. I have a very strong feeling that even though he fought cancer, the path in that fight and all the medications he had to take took a toll on his brain and his brain was older too. Often a surgeon doesn't want to do surgery on an older person because of how the brain tends to not handle the anesthesia very well, chemicals and different treatments can be harder on an older more fragile human being so it's always more of a risk. If you think about it, you did have to do more for him because he was failing at doing for himself more and more. This was never something you could stop either.