“Mostly, I like eating sour worms.” Josh told the dietician. His tone was half-way between a confession and a challenge.

On the way here I’d shared my fear that I’d have to defend my any-calorie-is-a-good-calorie stance.

The dietician smiled and looked down at her notes. Her eye lashes formed a cattish sweep.

“I’m going to put together a report for you, Josh,” she smiled at him, “but let’s make sure we are being realistic. With the nausea, eating more isn’t going to be easy. We can look at some strategies for eating little meals more often but really we have to focus on getting more calories from the same amount of food.” She hesitated. I could feel a moment of anxiety, like she knew we were on wobbly footing. “You know about sugar, right?”

I frowned.

“Our oncologist said there’s no link between sugar and cancer.” I focused on keeping my voice level, removing my defensiveness. She smiled, relieved.

“She’s right. I had a man come in here just last week and he was dying from starvation not cancer. He’d removed all sugars from his diet and he wasn’t getting enough energy.” She looked at Josh again. “We only have two ways of increasing your energy Josh. Traditionally we would increase the amount of fat you eat, but you have biliary duct cancer.” She said it without the accompanying eye drop of apology that I’d become used to. I wanted weep with gratitude for it. “Fats are going to make you feel horrible. So we have to go with option two and that’s glucose.”

“Sugar?” I asked. It sounded too good to be true.

“Yes,” she grinned at Josh, “Not only sour snakes, OK?” Josh nodded. He grinned back.

“Really?” I asked again.

“Yup.” She went on to suggest ways to replace veggies with fruits; for adding honey and syrup to nut butter and replacing water with fruit juice.

For a moment I basked in the twin glows of being right when the food-Nazis have been wrong and in the utter pleasure of knowing that, for once, eating everything good was not just allowed, it was encouraged.

In the parking lot I reached to hug my son.

“That went a lot better than I expected.” I said as he lent in towards me.

My hand rested on the thorny outcrops of his spine. I became conscious of being careful, of not crushing him. The image of holding him as a newborn flashed through my memory. I kissed his bony cheek and noticed again the indent along his temple where the outline of his skull protruded. I reached for his hand and felt the frail, spindly length of his fingers.

Any sense of victory was gone.

Sweets are the dietician choice