Narrator: Imagine a man with a lifelong, irrational terror of ponds. He imagines sentient vines and zombie-corpses lurking in the murky water, a fear so elaborate he once jumped into a London pond and immediately leaped out, vowing never to return. Now, picture that same man, months after the death of his two-year-old son, sitting at the bottom of a twelve-foot pool during a scuba drill, mask off, eyes closed, feeling no fear at all. Instead of panic, he feels a dark peace, a harmony with the idea of his own death. He sees it not as an end, but as a doorway to a reunion with his child. This profound and jarring transformation lies at the core of Rob Delaney's memoir, A Heart That Works, a raw and unflinching exploration of what it means to love, to lose, and to continue living when your world has been shattered.

Narrator: Before tragedy struck, Rob Delaney and his family were building a life. Having moved to London for his work on the acclaimed series Catastrophe, they were navigating the anxieties of life in a new country. With their third son, Henry, on the way, they created an "emergency childcare spreadsheet," a tangible symbol of their vulnerability without a local support network. Yet, this period was also filled with joy and discovery. Delaney contrasts the American healthcare system with the British NHS, praising the accessible, midwife-led maternity care that felt vastly superior. In a moment of proactive fatherhood that would later become hauntingly poignant, Delaney took his two older sons on a "dad recon" mission to Whittington Hospital. Worried about its confusing layout, he wanted to map the route to the maternity ward for when his wife, Leah, went into labor. He recalls it as one of his favorite memories, his two young "lieutenants" helping him find the way. He didn't know then that he would become intimately familiar with every corner of that hospital, as it would later become Henry's home for seven long months. This period of preparation, joy, and "normal" family chaos established a world of love and order, a world that was about to be irrevocably broken.

Narrator: The family's world fractures with Henry's diagnosis: a large brain tumor. Delaney pulls no punches in describing the terror of this new reality. He details the brutal, thirteen-hour surgery, the agonizing wait, and the immediate, devastating aftermath. Henry survives, but the surgery leaves him with severe complications, including burns from a heating pad and damage to his brain stem that robs him of his ability to swallow or even cry. This ushers the family into a world of "fascinatingly terrible" decisions. When faced with the option of radiotherapy, they learn it would cause permanent brain damage in a child so young. They instead choose chemotherapy, a "blunt tool" that brings its own host of painful side effects. Delaney critiques the landscape of pediatric cancer research, noting that brain tumors are the leading cancer killer in children, yet receive less funding because they are less profitable for drug companies than adult cancers. This forces parents into an impossible position, weighing torturous treatments with minimal chances of success against the quality of their child's remaining life.

Narrator: Amidst the sterile and often terrifying hospital environment, the book reveals that true care extends far beyond medical procedures. Henry's family discovers that moments of human connection are as vital as any treatment. They learn Makaton, a communication program using signs and symbols, which allows Henry, unable to speak due to his tracheostomy, to express himself and experience profound joy. His world is lit up by the "Singing Hands" duo, who perform nursery rhymes in Makaton on the hospital's TV channel. In a touching scene, Delaney meets one of the performers, Tracy, in the cafeteria, and she later visits Henry's room to sing with him, a moment of pure, unadulterated happiness. This theme of holistic care is also embodied by Katie, a healthcare assistant who not only masters Henry's complex medical needs but, more importantly, gets on the floor to play with him, read to him, and treat him as a "whole kid." These moments, along with the immediate therapeutic effect of a visit from Lola the therapy dog, prove that fostering joy is not a distraction from treatment, but an essential part of it.

Narrator: As the family navigates the all-consuming crisis of Henry's illness, they are struck by a second, unthinkable tragedy: the suicide of Delaney's brother-in-law, Tobias. This creates what Delaney calls "twin waves of horror," a compounded grief that is both isolating and, in a strange way, clarifying. He describes how this dual-tragedy fundamentally alters one's perspective on suffering. In a darkly humorous anecdote, his sister and mother, fresh from getting grief tattoos for Tobias, encounter an acquaintance at a bar who complains about his daughter's divorce. When asked how they are, his sister bluntly states her husband just died by suicide, and his mother follows by detailing Henry's terminal cancer. The man, dumbstruck, staggers away, leaving the two women to erupt in "the cackling, dolphin-like laughter of the insane." This moment illustrates the chasm that opens between those who have experienced unimaginable loss and the rest of the world, and the unique, dark bond forged between the deeply afflicted.

Narrator: After Henry's cancer returns, the family makes the agonizing decision to stop treatment and bring him home. This decision is met with profound relief from the medical staff, who saw the futility of further suffering, but also judgment from others who couldn't understand. The final months of Henry's life are a paradox. He is terminally ill, yet he is also "functioning at the highest level of his life," thriving at home, playing with his brothers, and expressing his vibrant personality. The family lives in an "insane" state, balancing the joy of Henry's presence with the certainty of his impending death. They fill his days with trips to the park, an animal-themed birthday party, and countless moments of love. Amidst this, Leah becomes pregnant with their fourth son, Teddy. This decision to embrace new life while another is fading is a testament to their resilience and hope, a bittersweet continuation of their family in the shadow of immense sorrow.

Narrator: Delaney makes it clear that grief is not a phase to be overcome, but a permanent alteration of one's being. After Henry's death, he mourns not just his son, but the physical remnants of his caregiving role. He describes his anger as the callouses on his fingers, formed from operating Henry's suction machine hundreds of times a day, begin to fade. These callouses were a tangible connection, a reminder that he was needed and that Henry was real. He rejects comforting platitudes like "everything happens for a reason," instead expressing a profound, almost theological anger. Yet, he finds a way to conceptualize his son's absence. He concludes the book with a powerful metaphor, stating that he is a "glass of water," and when he dies, his contents will be poured into the same vast ocean as Henry's. They will mingle together forever, not as distinct individuals, but as part of a unified, eternal whole.

Narrator: The single most important takeaway from A Heart That Works is that profound grief is not a sickness to be cured, but a testament to the depth of love. It is a permanent transformation, adding what Delaney calls a "band of black" to the rainbow of human emotion. The pain is not a sign of being broken, but proof that the heart is still working, still capable of the immense love that makes the loss so devastating.

In a world that often shies away from the raw reality of death, Rob Delaney forces us to look. He offers no easy answers or spiritual comfort. Instead, he provides something far more valuable: honest, unflinching companionship in the dark. The book's ultimate challenge is for us to do the same—to not turn away from the suffering of others, but to meet their pain with genuine empathy, to understand that sometimes the most helpful response is not to offer solutions, but to simply acknowledge the irreparable disaster and sit with them in the wreckage.