The tragic case of a female patient diagnosed with terminal brain cancer as she entered menopause lends itself to exploring the survival and vitality of the body ego under the narcissist blow of aging. Anzieu (1985) bemoaned that the body, so central for Freud, had virtually vanished from psychoanalytic discourse. The current paper highlights Anzieu’s plaint while elaborating on significant cross currents: Anzieu’s (1985) skin ego, Miller’s (2019) psychic penetrability, Schaeffer’s (2011) feminine dimension and Grunberger’s (1989) bodily based early maternal super-ego formation. The author suggests that throughout aging, especially during the loss of menses there is, similar to puberty, the reawakening of a regressive pull for psychic fragmentation, a return to a fierce early maternal superego and a demand on the skin ego as the psychic envelope to hold and contain primal death anxieties. This phase also holds potential for re-organization and psychic growth. The case of Athena illustrates, in addition to the narcissistic blow of menopause, the demand on the psyche when the body falls severely ill: the intertwining of primal anxieties of psychic fragmentation and the reality of the actual death blurring fantasy and reality with severe psychic consequences and unique challenges for the therapeutic frame.