I give her a look.

“Well, sure, the vows say ‘in sickness and health’ and ‘for better or worse’ and all that, but that’s kind of like clicking okay to the terms and conditions when you download an app or sign up for a credit card. You don’t think any of that is going to apply to you. Or if you do, you don’t expect it to happen right after your honeymoon, before you’ve even had a chance to be married.”

I’m glad that Julie is thinking about the impact of her cancer on Matt. It’s something she’s avoided talking about by changing the subject whenever I mentioned that maybe it was hard for Matt to go through this too.

Julie would shake her head. “Yeah, he’s amazing,” she’d say. “He’s so solid, so there for me. Anyway . . .”

If Julie had any awareness of the depth of Matt’s pain, she hadn’t been ready to face it. But something shifted with Matt’s outburst, forcing her to acknowledge a difficult tension: their togetherness on this unfortunate journey, but also their separateness.

Julie is crying now. “He kept wanting to take back what he’d said, but it was already out there, hanging between us. I understand why he wants a night off from cancer.” She pauses. “I’ll bet he wishes that I would just die already.”

I’ll bet sometimes he does, I think for a second. It’s hard enough in a marriage to do the give-and-take of putting one’s wants and needs aside for another, but here the scales are tipped, the imbalance unrelenting. Yet I also know it’s much more complicated than that. I imagine that Matt feels trapped in time, newly married, young, wanting to live a normal life and start a family, all the while knowing that what he has left with Julie is temporary. He sees his future as a widower, then as a father in his forties rather than his thirties. He probably hopes that this doesn’t go on for another five years, five years at the prime of his life spent in hospitals, caretaking his young wife whose body is being cut apart. At the same time, I’ll bet that he is touched to his core by this experience, that in some ways it makes him feel, as one man told me in the months before his wife of thirty years died, “forever changed and paradoxically alive.” I’d wager that, like that man, Matt wouldn’t choose to go back in time and marry a different person. But Matt’s at a life stage when everyone else is moving forward; the thirties are a decade of building the foundation of the future. He’s out of sync with his peers, and in his own way, in his own grief, he probably feels completely alone.

I don’t think it would be helpful for Julie to know every detail, but I believe that their time together will be richer if there’s space for Matt to show more of his humanity during this process. And if they can have a deeper experience of each other in the time that they have left together, Julie will live more fully within Matt after she’s gone.

“What do you think Matt meant by wanting the night off from cancer?” I ask.

Julie sighs. “All the doctor appointments, the lost pregnancies, everything I want a night off from too. He wants to talk about how his research is going and the new taco place down the street and . . . you know, the normal things people our age talk about. The whole time I’ve been going through this, all we cared about was finding a way for me to live. But now, he can’t make plans with me for even a year from now, and he can’t go meet someone else. The only way he can move forward is if I die.”

I hear what she’s getting at. Underlying their ordeal is a fundamental truth: For all of the ways that Matt’s life has changed, it will eventually return to some kind of normal. And that, I suspect, pisses Julie off. I ask if she’s angry with Matt, envious.

“Yes,” she whispers, as though she’s sharing a shameful secret. I tell her it’s okay. How could she not be envious of the fact that he gets to live?

Julie nods. “I feel guilty for putting him through this and jealous that he gets a future,” she says, adjusting a pillow behind her back. “And then I feel guilty for being jealous.”

I think about how common it is, even in everyday situations, to be jealous of a spouse and how taboo it is to talk about that. Aren’t we supposed to be happy for their good fortune? Isn’t that what love is about?

In one couple I saw, the wife got her dream job on the same day that her husband was let go from his, which made for extreme awkwardness every night at the dinner table. How much should she share of her days without inadvertently making her husband feel bad? How could he manage his envy without raining on her parade? How noble can people reasonably be expected to be when their partners get something they desperately want but can’t have?

“Matt came home from the gym yesterday,” Julie says, “and he said that he had a fantastic workout, and I said, ‘That’s great,’ but I felt so sad, because we used to go to the gym together. He’d always tell people that I was the one with the stronger body, the marathon runner. ‘She’s the superstar, I’m the wimp!’ he’d say, and the people we became friends with at the gym started calling us that.

“Anyway, we used to have sex a lot after the gym. So yesterday when he gets back, he comes over and kisses me, and I start kissing him back, and we have sex, but I’m out of breath in a way I’ve never been before. I don’t let on, though, so Matt gets up to shower, and as he’s walking into the bathroom, I look at his muscles and think, I used to be the one with the stronger body. And then I realize that it’s not just Matt who’s watching me die. It’s me, too. I’m watching myself die. And I’m so angry at everyone who gets to live. My parents will outlive me! My grandparents might too! My sister’s having a second baby. But me?”

She reaches for her water bottle. After Julie recovered from her initial cancer treatment, her doctors told her that drinking water flushes out toxins, so Julie began carrying a sixty-four-ounce bottle everywhere she went. Now it’s no longer useful but it’s become a habit. Or a prayer.

“It’s hard to see what’s still there,” I say, “and to let it in when you’re grieving for your own life.”

We sit in silence for a while. Finally, she wipes her eyes and the slip of a smile forms on her lips. “I have an idea.”

I look at her expectantly.

“You’ll tell me if it’s too wacky?”

I nod.

“I was just thinking,” she begins, “that instead of spending my time being jealous of everyone else, maybe part of my purpose for the time I have left could be helping the people I love to move forward.”

She shifts on the couch, getting excited. “Take Matt and me. We won’t grow old together. We won’t even grow middle-aged together. I’ve been wondering if, for Matt, my death will feel more like a breakup than the end of a marriage. Most of the women in the cancer group who talk about leaving their husbands behind are in their sixties and seventies, and the one in her forties has been married for fifteen years, and she and her husband have two kids. I want to be remembered as a wife and not an ex-girlfriend. I want to behave like a wife and not an ex-girlfriend. So I’m thinking, What would a wife do? Do you know what these wives say about leaving their husbands behind?”

I shake my head.

“They talk about making sure their husbands are going to be okay,” she says. “Even if I’m jealous of his future, I want Matt to be okay.” Julie looks at me like she just said something I’m supposed to understand, but I don’t.

“What would make you feel that he’ll be okay?” I ask.

She shoots me a grin. “As much as this makes me want to vomit, I want to help him find a new wife.”

“You want to let him know it’s okay to love again,” I say. “That doesn’t sound wacky at all.” Often a dying spouse wants to give the surviving one this blessing—to say that it’s okay to hold one person in your heart and fall in love with another, that our capacity for love is big enough for both.

“No,” Julie says, shaking her head. “I don’t want to just give him my blessing. I want to actually find him a wife. I want that gift to be part of my legacy.”

As when Julie first suggested the Trader Joe’s idea, I feel myself recoil. This seems masochistic, a form of torture in an already torturous situation. I think about how Julie would not want to see this, could not bear this. Matt’s future new wife will have his babies. She’ll go on long hikes and climb mountains with him. She’ll cuddle up with him and laugh with him and have passionate sex with him the way Julie once did. There’s altruism and love, sure, but Julie’s also human. And so is Matt.

“What makes you think he’ll want this gift?” I ask.

“It’s crazy, I know,” Julie says. “But there’s a woman in my cancer group whose friend did that. She was dying, and her best friend’s husband was dying, and she didn’t want her husband or her best friend to be alone, and she knew how well they got along—they’d been good friends for decades. So her dying wish was that they would go on a date after the funeral. One date. So they did. And now they’re engaged.” Julie’s crying again. “Sorry,” she says. Almost every woman I see apologizes for her feelings, especially her tears. I remember apologizing in Wendell’s office too. Perhaps men apologize preemptively, by holding their tears back.

“I mean, not sorry, just sad,” Julie says, echoing a phrase I shared with her earlier.

“You’re going to miss Matt a lot,” I say.

“I am,” she squeaks out. “Everything about him. The way he gets so excited about little things, like a latte or a line in a book. The way he kisses me, and the way his eyes take ten minutes to open if he wakes up too early. How he warms my feet in bed and looks at me when we’re talking, like his eyes are soaking up everything I’m saying as much as his ears are.” Julie pauses to catch her breath. “And you know what I’m going to miss most of all? His face. I’m going to miss looking at his beautiful face. It’s my favorite face in the entire world.”

Julie is crying so hard that no sound comes out. I wish that Matt could have been here for this.

“Have you told him?” I ask.

“All the time,” Julie says. “Every time he holds my hand, I say, ‘I’m going to miss your hands.’ Or when he’s whistling around the house—he’s an amazing whistler—I’ll tell him how much I’m going to miss that sound. And he always used to say, ‘Jules, you’re still here. You can hold my hands and hear me whistle.’ But now—” Julie’s voice cracks. “Now he says, ‘I’m going to miss you just as much.’ I think he’s starting to accept the fact that I’m really dying this time.”

Julie wipes her upper lip.

“You want to hear something?” she continues. “I’m also going to miss myself. All those insecurities I’d spent my life wanting to change? I was just getting to a place where I really like myself. I like me. I’m going to miss Matt, and my family, and my friends, but I’m also going to miss me.”

She goes on to name all the things she wishes she’d appreciated more before she got sick: Her breasts, which she used to think weren’t perky enough until she had to give them up; her strong legs, which she often thought were too thick, even though they served her well in marathons; her quiet way of listening, which she feared some might find boring. She’s going to miss her distinctive laugh that a boy in fifth grade called “a squawk,” a comment that somehow stuck like a burr inside her for years until that laugh made Matt glance her way in a crowded room and then make a beeline for her to introduce himself.

“I’m going to miss my freaking colon!” she says, laughing now. “I didn’t appreciate it enough before. I’m going to miss sitting on a toilet and shitting. Who thinks they’ll miss shitting?” Then come the tears—angry ones.

Every day is another loss of something she took for granted until it was gone, like what happens to the couples I see who take each other for granted and then miss each other when the marriage seems to be dying. Many women, too, have told me that they loathed getting their menstrual periods but grieved the loss of them when they reached menopause. They missed bleeding the way Julie will miss shitting.

Then, in almost a whisper, Julie adds, “I’m going to miss life.

“Fuck, fuck, fuck, fuck, fuck!” she says, starting soft and getting louder, surprising herself with her volume. She looks at me, embarrassed. “Sorry, I didn’t mean—”

“It’s okay,” I say. “I agree. It fucking sucks.”

Julie laughs. “And now I got my therapist to say fuck! I never used to swear like this. I don’t want my obituary to read, ‘She swore like a sailor.’”

I wonder what she does want her obituary to say, but time is almost up and I make a mental note to come back to this next time.

“Oh, who cares, that felt good. Let’s do it again,” Julie says. “Will you do it with me? We’ve got a minute left, right?”

At first I don’t know what she’s talking about—do what? But she has that mischievous look again, and then it clicks.

“You want us to—”

Julie nods. The rule-follower is asking me to yell obscenities with her. Recently in my consultation group, Andrea had said that while we need to hold hope for our patients, we have to hope for the right thing. If I can no longer hold hope for Julie’s longevity, Andrea said, I have to hold hope for something else. “I can’t help her in the way that she wants,” I’d said. But sitting here now, I see that maybe I can, at least for today.

“Okay,” I say. “Ready?”

We both yell, “FUCK, FUCK, FUCK, FUCK, FUCK, FUCK, FUCK!” When we’re done, we catch our breath, exhilarated.

Then I walk her to the door, where, as usual, she hugs me goodbye.

In the hallway, other patients are leaving their sessions, doors opening at ten to the hour like clockwork. My colleagues look at me questioningly as Julie leaves. Our voices must have carried into the corridor. I shrug, close my door, and start laughing. That was a first, I think.

Then I feel the tears well up. Laughter to tears—grief. I’m going to miss Julie and I’m having a hard time with this myself.

Sometimes the only thing to do is yell, “Fuck!”