A few years ago, I used to teach my students about communicating bad news. The algorithm I presented them with, called SPIKES, survived all other fashion up to now. At the time I had not communicated anyone a bad news. I have done it several times since then.

I think I can take every step of the algorithm as I should do it, I know it by heart, I apply it by instinct. And it is still not enough. One is still lying unarmed against sadness, and pain, and denial. One is still projecting and still feels suffocated when imagines oneself on the other side of the table. One knows by heart all the hopes that are still true, and all the disappointments that should never be heard. I do not know how to say "take care of all your administrative stuff, you should do it now" but I answer gracefully 'yes' when being asked if they should do so.

I have invented comparisons with marathons although I have never run one and I am still thinking whether I should try to just to be able it to say it "from the inside", thus diminishing my external view on the subject. I am sometimes protecting myself and that is immediately apparent in my voice and it should not be there. And I still do not know what to answer to the basic question: "Already? So quickly? Why?"

Today she told me "we were preparing a trip. What am I going to tell my grandsons now...?" His husband who stood next to her took her hand: "Don't worry. You'll just have that chemo and then we will go on the trip".