I have come to believe that our paths in life are determined by loss and how we manage loss. Every change in our lives, we know, involves an ending. After endings, there are certainly beginnings—new times, new experiences, new eras. But what those new beginnings are, and how our life moves forward, is a result of the endings, both how we coped with them as well as how profound their impact has been on our lives.

Loss has been on my mind today, as it has been for so many, because of the death of six more Israeli hostages. For more than 300 days, prayers and hopes had been focused on bringing the hostages home, bringing them home alive. For these six people, that did not happen and the lives of their families, friends and communities will bear the mark of that loss forever.

When we change something, even for the better, even based on a choice we have made, we recognize that we have to say goodbye to one thing to say hello to another. We walk around the empty house we are moving out of and, although we are looking forward to our next home, we pause and think about the memories that were made in those rooms, the moments that we had or, perhaps, shared. Leaving one role for another, we may be filled with excitement and, yet, emotional at leaving our colleagues and familiar surroundings behind. Even the joy of the birth of a child brings with it the recognition that the freedom we’d had is no longer ours and that a phase in our life is now over.

But most challenging losses, I think, are those that are associated with illness and end of life. Illness or disability not only alters the way we see ourselves but also the way others see us, as well as the way we interact with the world. Our sense of self is shattered and we have lost the trust, the reliance, we had on the selves we thought we knew, the identity that we were certain that we had.

Losing someone we love often calls all we know, and have known, into question. If I no longer have parents, am I still a daughter? If my nuclear family of four suddenly becomes a family of just one, how does that impact my identity and the way I interact with the world?

I never believed that my mother would die at 62, never believed that cancer was an adversary that could not be beaten. At 25, I was convinced that she would be there for me, that she would be a grandmother to my children. I had so many questions I hadn’t asked, so much I didn’t know, it was not possible that she would be lost to me. And yet she was. Losing her, re-defining myself as a motherless child, created a hole in me that I have never been able to fill, an emptiness that sits deep in the center of me always.

And my brother’s sudden death, at 46, upended my world forever. It was a year before I felt even marginally myself. It was a year before I stopped hearing the echoes of his voice in other people’s laughter, before I stopped seeing him in every tall, slender man walking down the street, holding the hand of his small daughter.

My life has gone on and, I have moved beyond loss as a part of every day. I am blessed with a loving husband, children and grandchildren who bring me such joy, family and friends who matter deeply to me and work that makes a difference. Yet, I also know that loss has colored the way I see and interact with the world. I know that I worry disproportionately, about everyone and everything that I care about. I worry about health and safety. I create scenarios that are always the worst case, always the disaster that could happen. The understanding that devastating and traumatic loss can occur is part of the reality of the way I see the world. And I accept that.

Everything in life changes us, of course. But I think that loss has the greatest impact of all. How we work through loss, how we choose to move forward—whether towards bitter or better—will determine the course of our life and our ability to fill our full hearts.