As a specialist in issues of death and grief, I was called in by an oncologist to see a 29-year-old patient named Leslie, who was dying of cancer. As I approached her hospital room, I found her mother, tall and straight-backed, standing outside like a guard waiting to meet me. She said, “Under no circumstances should you tell Leslie that she’s dying.” I nodded, having heard this kind of thing before. “I don’t want her to know,” the mother continued. “She needs to keep fighting. She needs to have a complete life.”

“Well,” I told her, “it’s not my place to break any news to her.”

I entered the room to find Leslie sitting in a chair next to her bed. She stood up to shake my hand but immediately sat down from the effort.

“Nice to meet you,” I said, finding it hard to believe that Leslie was only a few years younger than me. Her sunken cheeks and fragility had aged her dramatically. “How are you doing today?” I asked.

“I’m dying,” she said. “That’s how I’m doing today.”

“Oh, so you know?” I asked.

“Yes, of course I know,” she said. “It’s my body. I was the first one to know. But, listen, I’m really glad you’re here, because I need to talk to you about something.” I took a moment to remind myself that whatever was on her mind, I was there simply to be present, and to bear witness to her dying and her grief, no matter what that looked like.

It turned out Leslie didn’t want to discuss dying at all. She wanted to talk about the struggles…