Cowardice and reality: the sick spouse syndrome.

Correspondence and reprint requests: Eli A. Friedman, State University of New York, Health Science Center at Brooklyn, 450 Clarkson Avenue, Brooklyn, New York 11203, U.S.A.

As a boy, over a half century ago, frightened and quaking over a dreaded confrontation with reality, some unremembered adult reproached me by quoting Shakespeare's Julius Caesar.

Cowards die many times before their deaths;

The valiant never taste of death but once.

Reflecting on the recent loss of my wife Barry, my closest companion for 45 years, Caesar's continued wisdom reverberates:

Of all the wonders that I yet heard,

It seems to me most strange that men should fear;

Seeing that death, a necessary end,

Will come when it will come.

In replaying the years of Barry's combat with inexorable diabetes and Addison's Disease, I recognize how my fear of inevitable defeat became a controlling …