The surgeon who operated on our son’s tumor (the one we thought was a benign cyst) apologizes to me. He tells me about receiving the preliminary test results on Christmas Eve, about how his wife told him that you don’t call a family with bad news the night before Christmas if you’re not absolutely sure of the diagnosis.

His manner is warm, solicitous, intimate even (we can talk about this, just the two of us), but there’s a nervousness behind his smile. I feel as though he’s gauging my mood, my stance. Is he, I wonder, afraid of a lawsuit, or is he simply thinking like a father (he has children of his own) and trying to reach me in a personal way? I tell him I agree with his wife and that I’m grateful he didn’t call. We had a happy Christmas together, at least. We still thought Niles had the flu on Christmas; we were still looking forward to our trip to New Hampshire. Our lives were still right-side up on Christmas day. I’m thankful for that, and I’m thankful that our future Christmases won’t be anniversaries of Niles’s diagnosis.

“Tell her,” I say, “that she was absolutely right.”

The surgeon looks relieved and seems, in that moment, to become more solid, to regain authority. He pats my upper arm and turns to wash his hands at the sink outside the door to Niles’s room, then pushes the door open with his back and waits for me to walk in ahead of him.

He shakes Peter’s hand and greets Niles in a jolly manner. Our boy (not a boy, really; he’s an eighteen year-old college freshman) is propped up on pillows in his hospital bed. He looks relaxed and contented. One of his favorite nurses–a young woman from New Zealand with a hearty sense of humor–is cleaning and dressing the site of his surgery, on the top of his head. Niles is enjoying her attention and smiles as he’s ministered to. The surgeon banters with him in a casual, friendly way until the nurse has finished her work; then he sidles up to the bed.

“I just want to get a look here,” he murmurs as he leans in.

Niles’s hair is shaved around the suture site and the skin, which had been clean and smooth following the operation, is now puckered and swollen. It looks as though the scar is being pushed up from below. The surgeon glances our way and mouths to Peter and me: “The tumor.”

He makes a gesture with his hands of something expanding. I’m not surprised by the news; it’s easy enough to see that Niles’s tumor is growing anew, but the surgeon’s expression chills me. He looks keen, as though he’s just made a significant discovery. Gone is the buddy-buddy persona he established with Niles just moments before. Now, he’s a scientist observing the fascinating progression of disease in an organism.

I don’t begrudge him the disinterested curiosity of a surgeon, but I’m appalled by his silent invitation for us to join him as objective observers of Niles’s illness. His pointing finger demands that we look more closely at the malignant tumor pushing its way out of our son’s scalp, while his silent mouthing urges secrecy. He’s asking us to be in cahoots with him, to join in his professional objectivity, while–wink, wink–we humor Niles. He is, in effect, inviting us to distance ourselves from our son. What the surgeon doesn’t seem to realize is that proximity to Niles is the only thing we’ve got. Peter and I can’t cure him. We can’t keep him from pain. We can’t assure him that he’ll survive. All we can do is stick by him, no matter what, no matter where this disease takes us, or how ugly it gets.

Confident in his knowledge and experience, safe in his own wellness, the surgeon extends to me a smile that’s like an outstretched hand, ready for a seal-the-deal shake. I know this man has saved lives. I know he is beloved by patients and admired by colleagues. I even believe his bonhomie to be sincere, but I can’t return his smile without somehow betraying Niles. What I give him is a flat, closed look.

He turns to Peter, the more receptive parent, and they speak together for a few minutes before the doctor leaves the room. On his way out, he gives our boy a jolly wave, unaware, it seems, that he has alienated Niles as well as me.

Unlike most of the surgeon’s patients, Niles is not a young, distractible child. He won’t tolerate adult conversations mouthed over his head. He caught a reflection of the surgeon’s gestures in the dark screen of the television above his bed and he knows something is up. As soon as the door closes, he demands to know what the surgeon was mouthing and miming. We tell him, and when Niles asks us to promise–no matter what happens in his treatment, or how sick he gets–never to keep secrets from him, we solemnly give him our word.

The surgeon, continuing on his rounds, is unaware–we are all, of course, unaware–that within the year, he will die of complications following his own surgery. Our son the cancer patient will still be in treatment, but the surgeon will be gone.

Months from now, when I’m shocked by the news of his death, I’ll think of this afternoon. I’ll think of him leaning over Niles’s head and pointing insistently. I’ll think of his warmth and kindness, and of his arrogance–an arrogance that has little to do, finally, with expertise or position, and more to do with wellness. His confidence in his own health. It’s an arrogance we all share, any of us who are well and tend to the sick, no matter how lovingly, how expertly or diligently. It’s what sets us apart, even when we don’t want to be set apart.