About halfway through Rob Delaney’s 2020 standup special, “Jackie,” which was filmed in London, the American comedian professes his willingness to sexually pleasure the British National Health Service. Delaney’s career as a comic was launched on Twitter, where he amassed a huge following of people who enjoyed his concentrated bits of absurdity, and were unfazed by onslaughts of the fecal, genital, and masturbatory. The N.H.S. bit feels like watching a thread of these tweets unspool onstage. In America, Delaney explains, when you seek medical care you “have to take your credit cards, and your mom’s credit cards, and your neighbor’s credit cards and then melt them down, and fashion them into a kayak that you paddle into the hospital and beg them to help you.” Plus, “you immediately become filled with molten hot diarrhea that blasts out of your asshole, ’cause you’re so terrified of what’s going to happen to you financially.” The N.H.S., though, protects you from all that. “If the N.H.S. had a dick, I would suck that dick,” Delaney, who has lived in the U.K. since 2014, says. “If the N.H.S. had a pussy . . .” He grunts and shivers simultaneously, overwhelmed by enthusiasm.
Most of the audience had likely heard Delaney raving about the N.H.S. before. He and his family moved to England so that he could act in the British sitcom “Catastrophe,” which he starred in and co-wrote with Sharon Horgan. After the show took off, Delaney and his family stayed; in the years since, he’s become a British household name. In 2015, his wife gave birth to their third son, Henry. Shortly after Henry turned one, he was diagnosed with brain cancer. He spent much of his life in hospitals, and died before he turned three. Ever since, Delaney has been publicly candid about his grief, and about his appreciation for all that the N.H.S. did for his family. He made a campaign video for Jeremy Corbyn and the Labour Party, sharing his family’s story to give emotional weight to arguments against health-spending cuts and health-care privatization. He’s made similar appeals to American audiences, urging people to vote for Bernie Sanders, to join the Democratic Socialists of America, and to fight for health care as a public good.
In a Guardian piece published in the run-up to Britain’s 2019 parliamentary elections, he wrote about how Henry had been able to die at home, in comfort, thanks to help from the N.H.S. Having a child die is horrible; the gist of Delaney’s argument is that, within horrible, there are degrees, and that political choices can influence which degree you experience. He took time, amid arguments about income inequality and political imagination, to dwell on moments of happiness in Henry’s life, like the first time that he got to go on the hospital roof and, after many months inside, feel sunlight and wind on his skin.
Delaney’s slim new book, “A Heart That Works,” tells the story of Henry’s life and Delaney’s grief, freed from the confines—in both length and tone—of the short campaign video or political op-ed. There’s a linear narrative, one Delaney recaps toward the end in a tone of stunned disbelief:
From the start, everything is narrated from a present tense in which Henry is already gone; just as in life, where grief explodes and warps time, everything feels incredibly close one second and unbearably far away the next. “Henry began to struggle pretty quickly,” Delaney writes, describing an incident where his son’s breathing tube was removed to see how he fared, “and I began to cry, and I’m crying now typing this.” The book can feel like a dagger that stabs you again and again. Delaney and his wife get bad news. Worse news. We watch over his shoulder as he re-creates moments of intimacy he knows will never come again. We get to know Henry, and we see him go.
But we also get some laughs along the way. Alongside the recounting of panicked hospital visits, scary infections, and breathing-tube struggles, there are comic riffs and asides that wouldn’t be out of place in a Delaney standup set, or on his Twitter feed. These two strands—the grief and the laughs—don’t just sit side by side; they work together. When Delaney gets going about the confusing nature of hospital layouts, or his troubles having his American voice understood by a phone menu designed to respond to Brits, it does a few things at once. It’s a momentary reprieve, however partial, from the book’s unalterable trajectory. It’s a formal embodiment of Delaney’s advice, to other parents of severely ill children, about finding opportunities for immediate delight, resisting the power of disease’s shadow to darken everything. It’s funny. Then Delaney yanks you back to grief. You wonder, guiltily, if you latched on to the reprieve a bit too eagerly.
Sometimes these rapid leaps of register coincide, to powerful effect, with Delaney’s swerves through time. The riff on hospital layouts comes early, before Henry is sick; Delaney is visiting Whittington, the hospital where Henry will be born, and, later in life, live. Suddenly, we slip through a chronological wormhole: “If I counted correctly, thirteen Whittington nurses attended Henry’s memorial after he died.”
It’s a sucker punch, delivered with a working comic’s facility with timing and surprise. Early on, Delaney says that he knows evoking his experience accurately will hurt people. Therefore, he writes, he wants to hurt people. But he steers clear of easy sentiment. He knows that he’s writing a tearjerker, and is obviously wary of the genre; he doesn’t want Henry’s life to be just a pile of sadness. On first read, it’s easy to overlook just how strenuously he avoids barraging the reader with details of Henry’s suffering. It’s there, to be sure, but we learn just as much—maybe more—about his passions and enthusiasms: the relationships he made in the hospital, the TV shows and music he liked; his connections with his family members; the dancing and play that filled their apartment when he came home. The pain comes less from horrifying details than from the way Delaney lures us into contact with the very aspects of our lives that are easiest to ignore: our fragilities, our constant proximity to calamity, our powerlessness to control what life brings, or when.
Describing the changes in Henry’s affect during the last days of his life, Delaney drops a sentence I’ve already returned to many times, marvelling at the way simple details can function as cracks through which feeling leaks, first as a trickle, then, all at once, as a flood. “A big Lego Duplo ice-cream cone became very important to him, and he liked to hold it in his hand all day.”
Delaney describes watching Henry die at home. He encourages people to spend time with the bodies of recently deceased loved ones, if circumstances allow. He recalls telling “the loud builders next door my son was lying dead on our bed and we had to keep the windows open, so please stop work for the day.” The loud builders stopped. “I will not tell you anything else about the moments before or after Henry’s death,” Delaney writes, opting instead to outline the intensity of those moments in negative, and taking an implicit stand against the idea that writing honestly or usefully about the worst things in the world has to mean listing every single detail of what happened. “I can talk about them, but I don’t want to try to confine them to ink. Maybe you have experienced something like them, or maybe someday you will.”
If, in Delaney’s campaigning for public health care, Henry’s story functioned as an opening—his personal connection to a political subject—in “A Heart That Works” it insistently fills the frame, relegating everything else to the edges, politics included. In “Jackie,” which he recorded two years after Henry’s death, Delaney didn’t mention him, and it felt like an experiment: What does it look like to be a public-facing Rob Delaney who doesn’t talk about death, even when he’s talking about the N.H.S.? “A Heart That Works” is another experiment: What does it look like to talk about Henry without centering the cause of public health care? It’s not that the subject never appears. Delaney praises the N.H.S. and raves about the quality of Henry’s care. He refers to American private insurance as a “pyramid/murder scheme.” To any of his readers who work for private-insurance companies, he has a message: “fuck off and fuck you, forever.” British politicians and newspaper owners trying to advance the cause of health-care privatization “need to fuck off ten times, then gargle a big bowl of diarrhea.” He gripes some about N.H.S. underfunding, and describes a Kafkaesque situation in which Henry was medically cleared to leave the hospital, then required to stay put because of staffing issues in the home-care office. The numerous meetings it took to resolve this issue, he writes, “radicalized me for many lifetimes.”
But that’s basically it for the N.H.S. “A discussion of national healthcare policy would be a book unto itself,” Delaney notes. Talking about Henry for a few moments in a political-campaign video is one thing; going on at any length about those politics in a book about Henry is, we can perhaps imagine, another. In a campaign video, Delaney has a mission: to mobilize his audience. In “A Heart That Works” he has a different one. If you come away with a newfound appreciation of health care as a public good, Delaney would probably like that. But it’s not the point. He’s trying to coax you up to the edge of grief’s abyss, and do what it takes—even tell you jokes—to get you to peer inside a little longer than you might have otherwise and, by doing so, maybe begin to learn something about how you want to live (which is related, but not reducible, to the question of how you want to vote).
All along, the jokes keep coming, letting you laugh, sometimes just to laugh, and sometimes so you can hurt more, the laughter and the hurt getting increasingly tangled, long past the point where it would be possible to prise them apart. At one point, Delaney’s father-in-law, Richard, says he wishes it were he, not Henry, who had brain cancer. The family is in the middle of an emotional group hug. “We do too, Richard,” Delaney says, and everyone laughs together. In another, Delaney’s mom and sister start telling an acquaintance about what the family is dealing with: in addition to Henry’s cancer, Delaney’s brother-in-law has killed himself. When the acquaintance leaves, defeated in his quest to make emotionally safe small talk, the women burst into the “cackling, dolphin-like laughter of the insane.”
Delaney writes, in a similar vein, about his newfound love for horror movies: the way their piling on of catastrophe, in increasingly intense registers, feels, to him, therapeutic. “Mother of Christ,” he says, recalling laughing his way through “Midsommar” with his wife and another bereaved parent, “that movie made me happy. If you’re mentally well adjusted and wondering why, don’t fret. I know for most people, that film induced a state of roiling shock and repulsion.” It’s not hard to imagine some readers being similarly affected by the marriage of Delaney’s comic style with talk of grief. I’m quite sure that he doesn’t care. Cancer knows nothing of propriety, and neither does grief, and so Delaney—never terribly interested in propriety to begin with—doesn’t want to know, either. Recently, on Twitter, an unsuspecting user posted a picture of the British edition of “A Heart That Works” alongside a box of Kleenex, implying his awareness of the sadness and tears to come. Delaney retweeted the image with a bit of commentary attached. He didn’t deny that the book would make readers cry. But he had a request, one that contained a weapons-grade cocktail of the lewd and the deadly serious. “Please,” he wrote, “don’t jerk off to my book.” ♦