Give sorrow words: working with a dying child

What an extraordinary book this is. Now in its third edition, the book arrives garlanded with well-deserved praise from those in our own and related professions, and all people involved in working with dying patients, whether children or adults, are enjoined to read it. While treatments may have evolved and changed somewhat, Judd’s book addresses the fundamental issue surrounding ‘the worst fears anyone with a child can imagine’ as Claudia de Campos says in her new introduction to the book. And of course the worst fears of any child too. This introduction is a significant new feature of the book this time round. It brings us up to date both with the changes of hospital care for children and their parents, as well as with significant advances in paediatric oncology. De Campos interviews an array of policy makers and practitioners, addresses the increasingly interlocking skills available in multidisciplinary teams, and deals with the explosion of information now available through the internet, and its impact on parents and families.

‘I do not have words to express the sorrow’ – Judd quotes Mandela at the beginning of her first chapter, as well as Freud’s words that while acute mourning may fade over time, ‘we also know we shall remain inconsolable’. Yet Judd struggled mightily at times, berates herself in hindsight for not doing enough (and maybe this is something we would all do in these harrowing circumstances), but did find the words. When you are losing a child, how can any death be called ‘a good death’? Is the child allowed the right to be depressed, to be angry or does he or she have to join in the often manic denial that this life is close to its end? At her last meeting with seven-year-old ‘Robert’ before he dies, he screams ‘I don’t want Mrs Judd to go!’ He did not want to let go of a mind which carried on processing meanings, however painful, right up to the end. This is a picture of a mind, as Margaret Rustin says on the back cover, ‘working at full stretch