Chapter 22 Death and the Self

Heinz Kohut lived his last decade in the shadow of death. In the summer of 1971, at 58 years of age, just after the huge triumph of the publication of The Analysis of the Self, his doctor discovered in a routine medical examination that he had an enlarged spleen. Kohut decided, somewhat fatalistically, to delay further diagnostic testing and take his vacation as usual that summer in Carmel, California, though he talked morosely at times about it as his last. When he returned to Chicago in September, he went in for tests and was diagnosed as having lymphoma (or lymphatic cancer), which is similar to, but not the same disease as, leukemia.1 The cancer never really went into remission but spread slowly and seemed largely under control until the middle of 1977.2 In those first six years of cancer, Kohut's most serious complaint was it affected his immune system and he often got colds and flus. The worsening of his disease from 1977 on, however, ground him down in general and resulted in the need for more aggressive treatment. First, the doctors tried a round of chemotherapy in the summer of 1977, which gave him a sore throat, aching feelings, pain on the top of his eyeballs, and a mounting fever. Needless to say, the