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The title of the book is taken from Macbeth. Malcolm urges Macduff, on receiving the news of the brutal slaughter of his wife and children:
… ne'er pull your hat upon your brows;
Give sorrow words. The grief that does not speak
Whispers the o'er fraught heart and bids it break
This second edition of Judd's book, first published in 1989, offers a highly sensitive account of clinical work with a dying child in the context of an astute and masterly discussion and review of the theoretical debates about working with terminally ill children and young people. Through the rigorous and meticulous uncovering of the research and fuller understanding of death, of the moral and ethical issues raised by certain treatments for life-threatening illness, the reader is opened to a deeply distressing experience, while at the same time feeling contained by the detailed exposition and attempts to understand the grief and sense of loss, mourning and outrage that the death of a child brings. The attempt to find words for the sorrow that the dying child, and those involved with him, experience is ever-present.
There are eight years between the publications of the first and second editions of the book. The salient issues in working with the seriously ill, the disabled and the dying remain under the microscope in this second edition. Judd considers when defences are useful and when they are maladaptive; how the chronically ill child can work through the normal developmental phases, especially adolescence, with its thrust towards independence and autonomy, when illness or disability makes him dependent on adults for basic care. She asks the anguished question about the point beyond which life should be sustained by medical intervention and how we evaluate the quality of the remaining life for a child whose death is prolonged. She looks at the crucial issues around the care of dying children and young people and the need for the therapist to learn to ‘acknowledge the “not knowing” about the meanin