In the entire eighteen months that it took to battle cancer, Dad never said the “D” word once—never directly, anyway. It was spoken about at length, but only obliquely.

“I updated the will.”

“I have a new song for my funeral playlist.”

“I now know why your mom chose not to do this more than once.”

It had to be that way—spoken around, and not at—because he took real issue with the concept as a whole. He believed in science but wasn’t sure about God. He knew the neurons no longer fired at the end but couldn’t comprehend what it would mean to cease existing. It was the only question for which he could find no answer, and the only thing that he could not control.

He wrestled for control of it in small ways. He believed that science was only a few years away from storing the human consciousness in a robot body. He invested money in medical start-ups that showed promise toward that end. Whenever he discussed it, he would tell everybody that he intended to be the first man to live forever.

He could not be dissuaded from the thought. Truly, no one ever thought to try. Why would they? Dad liked living. He fumbled through its joys and miseries and came out on the other side, declaring that he’d do it all again. The idea that he would live forever made good sense.

I tried to talk about the “D” word once. I told him that I liked the idea of reincarnation.

“Maybe when it’s all done, I’ll come back as a bird, and maybe you could also be a bird and we’ll live together in the same big tree,” I suggested.

He could have been a squirrel if he wanted. That was a fine choice too. What was most important was that he would come back with me, and we both lived in the same tree. I didn’t tell him all of that, but I really wish I had.

He replied, “Yeah, maybe,” and the conversation petered out.

When they told him he had cancer, the first thing he asked was how long he had to live. The oncologist on staff said many of her patients had a good quality of life, some five years after their diagnosis. He cried when he told me that.

“If I’m lucky, I get five more years.”

Months passed, and with them went the effectiveness of the tier-one chemotherapy drugs. He sought second opinions, then third. He tried. He tired. Finally, sixteen months after his diagnosis, he was approved for surgery. It was a breath of hope—a treatment that showed good potential for metastatic cancer spread into the liver. He was a great candidate: young, strong, good weight, good support system.

At the seventeen-month mark, they opened him up. When he awoke, they told him that his liver wasn’t working.

It turns out, nobody likes to say the “D” word.

It starts with the oncologist.

For the fifth time that week, he taps his shiny loafers on the tile and discusses Dad’s rising bilirubin levels. Today it is at 12.9, which means that his liver is still “struggling.” He should say it more plainly, but he doesn’t. He only says that it is “struggling,” when what he means is that Dad’s liver is no longer working. It’s a high number, much higher than what would be recommended for sitting through another round of chemotherapy.

“But,” he adds. “It’s still your choice.”

Moments pass. No one says the obvious thing out loud.

Finally, I say, “His liver isn’t working. What happens when he can’t process the drugs?”

The oncologist frowns and gives us all that pithy nod of someone who is burdened with delivering the worst news. Then, he says, “Yes. That might hasten things,” but doesn’t say the word.

It follows with his friends.

Every single one of them engages in this awkward dance of how to ask him if this is the end. The men bring their wives, and the wives engage in pleasant small talk with the room. Meanwhile, the men stare. Sometimes they say a passing thing that isn’t very helpful. One passes out and crumples to the floor. Otherwise, the solemnness of them and him is all that fills the room.

I call his oldest friend to come. I tell him that the prognosis is poor. He arrives and tells Dad that he looks like shit. Finally, Dad laughs. They chat, and when he goes to leave, he tells Dad he has enjoyed their friendship. Dad says he’s had a very good life.

It is at this point that I wish somebody would say it. I do not like that everyone knows what is happening but will not say it openly. Everyone is staring at him like this is the last time they will see him, but nobody has even said the word. He’s still Scott. He’s still a patient. He’s still here.

Nobody will, and I know I won’t either. Somebody else must. I am too busy being scared of cancer. I am watching it devour Dad, and so is everybody else, but I am watching it and knowing half of what I am is being eaten. I need someone else to give him a label. I need someone else to change his state. I need someone to say it, because maybe then something about this all will change.

Nobody does, of course, and for good reason. Nobody says the “D” word because it is the thing that Dad fears most.

It doesn’t matter what I need. It won’t change anything.

But what if?

And anyway, how can we avoid it? It’s happening right now.

How quiet can we be?

Who should say it, if at all?

Does it matter?

The answer is: nobody knows. Sometimes yes, sometimes no. The “D” word has as much ability to empower as it does to diminish. It applies labels. It demands decisions. It sets the scene for something permanent and inescapable, which is the thing that Dad was not inclined to consider. The “D” word had been thrust upon him without any warning, and nobody knew what they should do about it.

The closer it loomed, the more desperate I became. I wanted someone to say it. I thought it best that someone did, but that was what I wanted, and I wasn’t dying. I wasn’t navigating the experience of my own mortality in real time. Dad was, though, and I could not conceive of something worse than asking him to verify out loud that he was going to go.

“I want to go home,” he said.

“I want to go to sleep,” he said.

That was all it was–just rest, just sleep. Not forever, just for now. I knew it wasn’t true, but it could be if nobody said the word. Nobody did, so I pretended.

Pretending is a thing we do when we are desperate to survive. I do not ask myself anymore if it was right or wrong to pretend that there was something different at the end of Dad’s story. Nobody said the “D” word, and in doing so, it became survivable.

Nobody said the “D” word, but we talked about it constantly, so much so that it developed something like a body. It became another thing inside the room that could be comprehended or, if we turned our heads far enough, could almost be ignored.

We watched it ebb and flow as Dad gained energy, then lost it. We let it sit beside us in a chair as we reminisced about the times we got drunk at the beach. We forced it into laughter. We asked it to leave when the candy cart arrived. When the silence was too silent, we stared at it incredulously until it dissipated. It tried to be polite by helping Dad sit up in his bed one final time. We listened to it cough and heave. We held it as it wept.

Does saying it matter? I don’t know. It’s not like Betelgeuse. You don’t summon it by saying its name thrice. It’s always there, even if nobody wants to say it.

Sometimes, though, somebody does.

There is a kind CNA at the hospice center. She pulls me to the side while I am standing over Dad and gives me all her updates from the night. The summary is that it was all typical. He rested with the sound of SportsCenter in the background and did not exhibit any agitation. His breath was calm. Sometime before the sun rose, she came to wash his face and freshen up his sheets.

She left him there to rest, and then he died.

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