In commenting on my latest essay for “Good Letters,” a man “disabled from an odd condition” confided that, when his health crashed, he found himself abandoned by those he depended upon: “My family avoided me thinking that I repre­sented their destiny.” Years later “they still do,” he added.

Not everyone who lives with advancing death or a maladroit disability must live without his family’s succor and society. But I know exactly what this man is talking about, because my family too has avoided me since I was diagnosed with terminal cancer nearly seven years ago.

For five years my younger sister said nothing at all to me about the disease. My other sister will give a “like” to cancer updates on Facebook, but she never gets in touch with me. She doesn’t even leave a short encouraging comment. She clicks the “like” toggle and moves on. And, oh, oh, let me tell you about—but please stop me from tabulating grievances. Already I’m starting to remind myself of John McEnroe after a linesman’s bad call.

I also refuse to quote the first sentence of Anna Karenina, which is usually trotted out in these circumstances, principally because I think it is false. The truth is that unhappy families are more alike than happy families. Unhap­piness takes the universal forms of bitterness, resentment, and the symptom to which Kafka dedicated an entire novel—psychological arrest at an early stage, preventing emotional growth and development.

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