This article first appeared in the March/April 2005 issue.

“I want to build Paul’s coffin myself,” Eric whispers. “I need something to do with these.” He holds out his rough, chapped hands with his palms open.

They’re strong hands, workman’s hands. I’d always assumed that a surgeon’s hands would be long, tapered, and delicate, like a pianist’s. He seems to catch my thought.

“My people were all woodworkers and shipwrights, you remember,” he says. “My dad was a carpenter. He’d understand this. He built Paul’s crib.”

I nod numbly as I try to absorb the image of building a coffin for one’s child. Eric’s son, Paul, is 15 years old. He’s slowly dying from a brain tumor. n Eric pauses and looks out the window of my office at my magnolia tree, now shedding its fat, pink blossoms. He turns back to me. “I’m so sick of the waiting,” he says. “Don’t get me wrong. It’s not like I want it to be over. It’s just, well, maybe you can’t understand.” Eric pulls his hands back and tucks them under his armpits. He bows his head.


He’s right. I can’t understand. I have a son just a few years older than Paul. What would it be like to watch cancer slowly devour my son Sam, day after day? And the notion of building a coffin for Sam–unthinkable. I envision, suddenly, Sam’s coffin balanced on the broad shoulders of his friends, bobbing its way down the church aisle over a sea of heads. I want to run out of the room.

David, this isn’t about you, I scold myself. But I can feel myself going foggy, blurring around the edges. I look at Eric in his impeccable, pinstripe suit and blue, paisley tie. He’s an orthopedic surgeon at Mass General Hospital, famous for his ability to put shattered bodies back together. But here, he’s helpless. He’s holding onto himself in his stolid, dignified way as best he can. What the hell can I say to him?

“I think it’s a good idea,” I finally reply.


“The coffin.”

“Oh, that.” Eric shrugs. “Yes. Thanks. Actually, what’s really hard is feeling like I just want it to be over.”

“Of course.” I realized that I hadn’t heard him before. “Unfortunately,” I say stiffly, “it’s a natural part of the process that the waiting becomes intolerable.”

Now he’s glancing at his watch. Waiting to go.

Later, my wife and I are lying in bed. She’s doing the Times crossword puzzle. I’m trying to read. I turn toward her.

“You know, I can’t figure out how to be with this guy.”

“What guy?”

“You know, the surgeon whose son is dying.”

Kate pauses, puts down her magazine. “Just don’t be afraid to talk with him about anything,” she says. “Whatever feelings he has are okay.” Kate’s an internist who helps families deal with loss all the time. She’s very good at it.

“That’s the problem,” I say. “This guy has never really talked about his feelings. He’s sort of a classic Scandinavian.” I think of the blur of tears I sometimes see in Eric’s eyes; how he blinks them away before they even have a chance to fall.

“The thing is,” I continue, “he’s got to get out of bed every day, go to work, operate on patients.” I hear my voice rising; I can’t stop it. “Look, his only child is dying right before his eyes. Maybe a dose of good old-fashioned denial isn’t such a bad idea.” I roll over and curl into a tight ball.

Kate looks at me quizzically. “Are you sure it’s him that needs to shut down,” she asks, “or are you having a hard time dealing with this yourself?”

“Oh, for God sakes, Kate!”

She goes back to her puzzle, while I glare at the glow of the streetlight outside my window.

Lately, I’ve been getting a crash course in the death of children. Several people I’ve been treating have lost their kids–some slowly, to disease; others with the cruel suddenness of a 3 a.m. phone call. First was the couple I’d been working with on relationship issues when they discovered that their 8-year-old daughter had developed leukemia. Then, last year, I kept a vigil with a family in my office while the Coast Guard searched for their son, lost at sea. I remember handing the phone to the mom when the Guard called to say they were giving up the search. Soon after that, I was in the midst of helping a couple deal with their overprotective anxiety about their teenagers when, one sunny winter afternoon, their eldest daughter died in a freak skiing accident.

What blindsided me about these tragedies was that they’d struck clients with whom I’d been working on all the usual presenting problems–parenting stresses, sexual issues, career conflicts. In Eric’s case, we were nearing the end of a very successful individual therapy when he discovered that his son’s headaches weren’t migraines, but were caused by a tumor. For me, encountering these ambushed, suddenly grieving, parents has been dramatically different from working with those who come into my office expressly to deal with loss. When we meet people in their grief, we can treat the loss as a therapeutic issue, erect boundaries around it, keep it safely separate from our own lives. But the lightning bolt of death–especially a child’s death–in the lives of ordinary clients smashes through our safety barriers. Each time I heard the news, I felt mugged. If it happened to them, it could happen to me.

It’s been my constant fear since the birth of my oldest son, Michael, 26 years ago. Every parent knows this terror, feels it pulsating just below the surface of their lives. But for me, the trepidation is even older, more insistent: I can barely remember a time when my body wasn’t primed for bad news. The knot in my stomach began to form on a lazy Saturday morning nearly 40 years ago, when the phone rang in my college dorm room. “David,” my father had said, his voice bizarrely calm. “Your mother took an overdose of pills and died this morning. I think you might want to come home.” I can still remember the sensation of blood draining from my body. I felt instantly embalmed.

I’ve been a therapist for 30 years now. I’ve dealt with all manner of critical, dangerous, and horrifying situations. But these cases of sudden loss have touched something raw, something unstrung in me. As I sit with these folks, watching them sink into their black grief, I feel the old numbness return. Often, I feel as though I’m just going through the motions with them, muttering inadequate and sometimes fatuous words of condolence. “Acting as if,” as they say in A.A.

Maybe Kate’s right. Maybe I’m just as emotionally frostbitten as Eric is. But it’s not just about walling off emotions. The truth is, I’m not sure what good therapy is for a man whose son is dying right before his eyes. Do I simply sit with him as he impassively recites the details of his son’s ordeal, respecting his need to protect himself? Or do I encourage him to unwrap his despair? If I were in Eric’s shoes, what would I want from a therapist?

Probably not much. This, of course, is partly a guy affliction: most of us men go to great lengths to keep our pain at bay, as though connecting to our actual feelings might overwhelm us, immobilizing us for the duration. I remember my own therapy experience, in my mid-forties, when I first broke into sobbing tears about my mother’s suicide. My therapist, Barbara, clearly believed that I was having a meaningful, healing breakthrough. She encouraged me to stay with my feelings. I shut down instantly.

“You don’t understand,” I snapped. “I’m not having a goddamn ‘good cry.’ Crying doesn’t change a goddamn thing.” And a cold, hollow bitterness arose within me.

It took me a long time to learn to locate and tolerate my grief, and then to allow it to explode from my gut like the howl of a wounded animal. Yet even now, in the midst of emotional turmoil, my first response is to retreat and regroup. I’m a product of the WASP culture of my family and New England boys’ schools, where any display of male vulnerability signaled weakness–pathetic, disgraceful, humiliating weakness. Real boys, real men, bent their emotional pain into the more presentable shapes of problem-solving and protecting others.

Just like Eric is doing now. So how do I know what’s right for him? Eric exudes a steady, stoic fortitude. His family and his patients are leaning on him. He’s behaving like a strong man in the tradition of his Scandinavian culture. Perhaps, his way is simply to build his son’s coffin. Let the working with wood provide the gifts of action and distraction; let his hands do the weeping.

It’s the morning after a session with Eric. The couple sitting in front of me is in crisis. The wife has just been caught having an affair. The husband is furious. He’s threatening to tell the children.

There’s a knock at the door. I step outside my office to see my 20-year-old son, Sam, who’s home from college. “Sorry, Dad,” he says, but Mom says she’s got to talk with you.” He holds the phone out to me.

“Sam, I’m in an emergency session,” I whisper, trying to keep the irritation out of my voice. “I can’t talk right now, for Chrissakes.”

“She says it’s an emergency.”

I grab the phone. “What the hell’s going on?”

“Sam just had a seizure,” Kate says crisply. “You have to bring him to the hospital. Now.”

I look at Sam and see, for the first time, the dazed, frightened look on his face. My stomach twists. “What happened?”

Kate reports that Sam went unconscious while shaving and collapsed on the floor. “He told me he woke up shaking wildly,” Kate says. “The whole bathroom was covered in shaving cream.”

I drive to the hospital like a maniac, while Sam dials up clients and hands me the phone so I can cancel my day’s sessions. In between, I keep up a steady patter of conversation in the desperate hope that our chatter will somehow prevent another seizure while I’m driving. Magical thinking. Mental CPR.

“Just chill, Dad,” Sam says. “I don’t think it’s going to make anything better if we crash the car.” Sam is trying to be his usual tough teenager self, but I can tell he’s really scared.

I slow down and smile at my boy. “Well, at least one of us can keep a cool head in a crisis.”

As we sit in the reception room awaiting the neurologist, Sam and I joke around about how doctors are always late. There’s a cartoon on the bulletin board that has the doctor saying into the phone. “Next week won’t work, either. How about never? Will never work for you?”

I stand up and start pacing. Maybe Sam just fainted, I tell myself. He’s fainted a couple of times before. I clutch at the idea like it’s a life preserver.

“You can never wait for anything, Dad,” Sam observes, looking up from the Glamour magazine he’s been idly flipping through. “Why are you so impatient?”

I feel like screaming: “Because I don’t know what’s wrong with you, Sam! Because I’m going out of my mind with fear! Because . . . I’m afraid you’ll die.”

Instead, I sit back down. I concentrate on breathing normally. “So,” I say, “do you think the Patriots can make it back to the Super Bowl?”

My son rolls his eyes. He thinks my football mania is a character flaw.

The neurologist, Dr. Rothenberg, can see us now. As he listens to Sam’s story, I watch his face closely. When my son describes waking up on the floor shaking, I see Dr. Rothenberg raise his eyebrows, ever so slightly. Shit.

“It sounds like a seizure,” he says.

An MRI will tell us for sure, but we can’t get one until late that evening. We have eleven hours of waiting. Sam and I go home. We play some chess. We watch a couple of Star Wars videos.

What if Sam had fractured his skull on the side of the tub when he fell? What if he’d been driving at the time? Suppose he really has a brain tumor? One nightmarish thought piles on another. The hours drip by like a leaky faucet.

Saturday morning. The phone rings. “This is Dr. Rothenberg.” I brace myself.

“We got the MRI results and . . .”

I can’t breathe.

” . . . there’s no sign of a tumor or any abnormality. Completely clear.”

He goes on to say some stuff about how the seizure was probably medicine related, but we’ll have to be cautious and watchful; no driving for Sam for six months, etc. etc.

I’m not listening.

I’m holding the phone like an idiot, hearing nothing, saying nothing, while tears stream down my face.

Later, as I overhear Sam and his mother have deliciously normal debates over packing for college–should he be allowed to take his Sony PlayStation? does he have room for his beanbag chair?–I suddenly think of Eric and Paul. How many tests have they endured? How many hours have they spent in doctors’ waiting rooms? What must it have been like to hear the words “malignant” and “inoperable” and, finally, “a matter of months, not years”?

And what’s it like now for Eric, sitting at his son’s bedside watching Comedy Central and old reruns of Saturday Night Live? Eric told me that Paul particularly gets a kick out of the early stuff with Chevy Chase, John Belushi, and Gilda Radner. They watch a lot of it together. Eric reported that, late one night, Paul asked him about Gilda. “Didn’t she die of cancer, too?” he’d asked. “Yep,” Eric had responded quickly, hoping his voice wouldn’t break.

When Eric told me that story, I remember forcing myself to ask him if he was planning to talk with Paul about dying. I’d practically choked on the words.

“No, I wouldn’t bring it up,” Eric had said. His voice was calm, rational. “I figure I’ll wait for him. See if he wants to talk about it.”

“But what if he’s waiting for you, Eric?”

“Well, he’s kind of a chip off the old block, you know. We’re not much for talking.” He said this with a shrug that seemed to be definitive. Subject closed. I was secretly relieved.

But now I wonder: what would I do if I were waiting with Sam for death to come? Wouldn’t I want Sam to able to talk about his fears, his rage, his grief? Or would I? Maybe we’d tough it out the same way Eric and Paul are doing. In the face of implacable death, what difference does it make, really, what gets said or doesn’t?

Then I see myself again with Sam, waiting for the doctor, then, later, waiting for the phone call. I think about those agitated hours, how I’d careened between hysteria and numbness, in no shape to talk with Sam about anything that mattered. If we’d gotten bad news and I’d stayed frozen, would I have missed the chance to sit quietly with my son and share our sorrow–and then grieved for that forfeited chance forever? I realized that if Sam were facing death, I’d need to dive straight down into my fearful emotions–the terror, the desolation, the wild, ungovernable love–until I knew, finally, how I wanted to say goodbye.

I know, then, that this is what’s been missing in my work with Eric. I’ve been so paralyzed with fear–both his and mine–that I haven’t been able to help him truly choose his way of saying goodbye. I need to encourage him to open himself to the emotions he’s holding so manfully at bay, and grant him enough space for the right choice to emerge. Maybe Paul is holding back because he’s afraid his dad can’t handle it. Maybe Eric is holding back because he senses that I can’t handle it. Who’s protecting whom?

My instinct is that Eric’s tears won’t harm his boy, and that maybe they’ll be a comfort to him. Or perhaps not. It’s not for me to know. It’s my job to help Eric make a genuine choice.

It’s two days after Sam flew back to college. Eric is sitting in front of me, slumped on the sofa. His face is ashen.

“Well, we’ve decided not to pursue the experimental chemo of last resort,” he says. “Too little chance for success and too many bad side effects.” His voice is dull, flattened out. “You don’t know Paul, Treadway, but he was amazing. He said to Dr. Fleming in a very polite but firm voice: ‘I think I’d rather not go through that hassle, if it’s okay with everyone.’ His mother, Dr. Fleming, and I nodded, and there was a long silence.

“Then Paul wisecracked, ‘Hey, didn’t mean to spoil the party, guys. Are we done here, Doc? Can we go home?'”

Eric says that on the car ride home, Paul kept up a chipper patter about the Red Sox and their chances. “He said, ‘You know, Dad, this has got to be their year.'”

Eric sighs heavily. “I clenched the steering wheel like I’d break it,” he adds. “Paul was being so brave. I love him so much.” He looks up at me, his eyes bright with tears. “I didn’t know what to say. I said something stupid like, ‘Well, we’ll know soon enough.'”

I plunge in. “Is there something you wish you could have said?”

“Like what?” Eric says. “How about ‘Yep, they’d better win this year, son, because you’ll be dead next year?’ What about, ‘Gee, son, what’s it like to know you’ll never get to drive a car or make out with a girl in the back of one?'”

Eric’s chest begins to heave and a low moan escapes from him. He sags forward and covers his face in his hands. He starts to cry, and just as quickly, catches himself. He sits up and looks at me fiercely.

My eyes are tearing up, too. “You know, Eric, maybe it’ll help you to be even stronger with Paul if you can just let yourself be with your heartbreak.” I lean forward in my chair and look directly into his eyes. “Maybe Paul needs to cry, too. Maybe he’s afraid that if he breaks down, you’ll be disappointed in him.”

“Me, disappointed in him? I . . . .” Eric starts to cry again. His head is bowed. After a few moments, he reaches for the box of tissues. He’s shaking his head as he wipes his eyes.

I wait in silence for a bit, and then say softly, “Why don’t you ask Paul if he wants to talk about it?”

“You mean, just ask if he wants to talk?” He looks at me, incredulous.

I nod. “The worst that can happen is that he’ll say no, and then you’ll know.”

Eric looks away. “I don’t know if I could do that. How do I know it wouldn’t put pressure on him? You know, puncture whatever defenses he has left?” He shakes his head again. “I don’t know.”

“Well, Eric, here’s the truth. I don’t know if it’s a good idea either. But if it were my son . . . .” My voice catches in my throat.

Eric looks at me quizzically. I wonder if I should tell him about Sam. In an instant, I know it would be a mistake. My kid’s going to be okay. I fumble for the words. “I’m just trying to say, I don’t know how I would deal with this if I were in your shoes.”

“You’d do okay, Treadway. It’s nothing heroic. You just do what you have to do.”

It’s past time on the hour. I look at Eric and feel, suddenly, that we’re just two scared, sad fathers, one of whom, at this moment, is vastly unluckier than the other. “Listen,” I say, “I’m just doing my best to go through this with you, side by side.”

“I know. I’m glad you are.”

“Well, we’re a little over time. Would you like to take a hug home with you?”

He flashes me a look of surprise and shy gratitude. “Sure.”

We stand up and give each other an awkward guy-hug. Eric nods and turns for the door.

“I’ll be thinking of you and keeping you in my prayers,” I tell him. To my ears, it comes out clumsily. But I mean it.

He turns back, looks me in the eye, smiles. “Thanks.”

As the door closes behind him, I turn toward my messy desk. The phone light is blinking: I’ve told clients I’d be free in this hour. But I move away from the phone and find myself dropping onto the sofa, still warm from Eric’s presence. I lie down. For just a little while, I let myself close my eyes.

David Treadway

David Treadway, PhD, is a therapist and trainer of 40 years.  His latest book is Treating Couples Well: A Practical Guide to Collaborative Couple Therapy. He’s also the author of Home Before Dark: A Family Portrait of Cancer and three other books.