“Is this your first pregnancy?” Patients and caregivers ask me this all the time when I make rounds at the inpatient hospice facility where I work.
“No,” I tell them. “I’m actually expecting my sixth baby.”
They blink. “But you look so young! And you’re a full-time doctor!”
Then I share my go-to joke: “It must be my coping mechanism for being around so much death. I’m just trying to repopulate the earth.”
I say it lightly. But it actually holds one of my deepest truths: nothing makes me feel as alive as having sex with my husband.
Being so close to death every day has made me extraordinarily aware of what it means to inhabit a body that is warm, responsive, desirous, and still here. Sex is comfort, connection, and release.
When you’re trying to conceive, it also carries the incredible possibility that intimacy might become a person. Not just pleasure in the present, but a wager on the future.
My husband and I both come from small families, and I didn’t grow up imagining a big one. Our first attempt to become parents, in our early 20s, ended in a second-trimester miscarriage. When our son was born a year later, we were in awe.
Loss hovered at the edges of that pregnancy. We’d taken nothing for granted; not one ultrasound, not one reassuring heartbeat, not one weekly milestone. When our son finally arrived, I felt something bigger than joy. Relief, gratitude, absolutely. But also astonishment that life had taken hold. Each time I’ve held another of my newborns, I’ve been struck all over again by how improbable and fragile life is.
Like death, sex has been pushed out of public life. It is something hugely important that many of us experience, but few of us talk about honestly. I remember reading The House of God in medical school and being uncomfortable by how much space it gave to sex and desire. Now, years into clinical practice, I understand better why.
In hospice, I’ve witnessed how illness can overtake not only a body, but also a couple’s private language of touch. We’re comfortable talking about caregiving in practical terms:medications, mobility, bathing, exhaustion, back pain, interrupted sleep, anticipatory grief. But sex and physical intimacy are still relegated to hidden corners, hushed tones, and anonymous online fora. Illness, death, and grief don’t only change how we care for each other. They change how we touch each other.
We can be heartbroken and still want to feel pleasure. We can recoil from touch one day and crave it the next. That whiplash is the body’s way of trying to survive overwhelming circumstances.
A sick person’s body can turn into a medical project. The person you once undressed in a playful, mutual way is now someone you undress to change a dressing, clean a wound, or help to the bathroom. The body you once associated with pleasure is now a map of incisions, bruises, drains, and catheter sites. Sometimes desire disappears under the weight of fear and fatigue. But sometimes, confusingly, desire intensifies.
I’ve heard people say that after a near-death experience, or after a funeral, they went home and had the most intense sex of their lives. I have heard recent widows describe a sudden surge of libido, only to feel ashamed that they could want anything at all. But to normalize the body’s insistence on life, even in the middle of loss, or in the presence of death, is not to minimize grief. It is to admit that human beings are complicated. We can be heartbroken and still want to feel pleasure. We can recoil from touch one day and crave it the next. That whiplash is the body’s way of trying to survive overwhelming circumstances.
People don’t always need solutions. Sometimes they just need the reassurance they are not alone in feeling confused, shut down, or unexpectedly full of desire. They need permission to be complicated. If sex is one way life begins, it can also be one way life continues—through touch, connection, and the tender act of choosing each other again and again in the shadow of loss.
Dr. Charlotte Grinberg is the founder of To Life Primary Care in the DC area with additional expertise in end-of-life care (as a hospice doctor) and beginning-of-life care (as a childbirth doula). She writes on Substack at The Bookends of Life.
