Joe Biden’s cancer diagnosis and his legacy of grief

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Former President Joe Biden has been a fixture in Washington since 1972, starting with his career in the Senate, followed by a combined 12 years in the White House, first as vice president and later commander-in-chief. His most common (and persistent) companions, though, have been grief and tragedy.

The new senator from Delaware was sworn into his first term at the hospital as his young sons recovered from the car crash that killed Biden’s first wife and infant daughter. Four decades and a promotion to vice president later, Biden was once again grieving publicly, following the loss of his eldest son, Beau, from brain cancer. 

Now, the former president, 82, faces his own cancer diagnosis. 

On May 18, a spokesperson for Biden said he had been diagnosed with an “aggressive form” of prostate cancer. 

At times, grief was said to have stalled Biden’s ambitions. Other times, it appeared to give him heroic levels of empathy and leadership qualities.  

“Joe Biden,” Sen. Chris Coons, D-Delaware, told Politico in 2019, “has almost a superpower in his ability to comfort and listen and connect with people who have just suffered the greatest loss of their lives.” 

Jessica MacNair, a licensed professional counselor, said tragedies like those that Biden has endured throughout his life can often change one’s sense of identity. 

“Grief can become a defining feature of someone’s life when losses are repetitive or formative,” MacNair said.  

“When grief is a central theme in someone’s life,” she added, “coping isn’t about moving on, but instead it is about integrating loss into one’s life in a meaningful way.” 

Death, loss cloud Biden’s story 

Six weeks after Biden won his first Senate election and a week before Christmas, Neilia Biden was driving home with the couple’s three young children, returning from a trip to pick out the family tree.  

A tractor-trailer broadsided their Chevrolet station wagon at the intersection of Valley and Limestone roads in Hockessin, Delaware. 

Neilia Biden, 30, and Naomi Biden, 13 months, died before reaching the hospital. Hunter Biden, then 2, and Beau Biden, then 3, were left with serious injuries. 

Biden described oscillating between a state of numbness and being cut by pain so sharp it was “like a shard of broken glass,” in his 2007 book, “Promises to Keep.” What kept him from his darkest thoughts, he wrote, were his surviving sons. 

“I’d look at Beau and Hunter asleep and wonder what new terrors their own dreams held, and wonder who would explain to my sons my being gone, too,” Biden wrote. “And I knew had no choice but to fight to stay alive.” 

Beau Biden grew up to become a major in the Delaware National Guard, a federal prosecutor and a two-term attorney general of Delaware. He planned to run for governor. 

Then in 2015, Biden’s oldest son and source of his strength, died at the age of 46 after a battle with brain cancer. 

“I miss him so terribly – already,” Biden wrote in his 2017 memoir “Promise Me, Dad: A Year of Hope, Hardship, and Purpose.

“Beau could always chase my fears away. He saved my life, along with Hunter, 40 years ago, after Neilia and Naomi died in the car accident, and now what was I supposed to do?” 

Gina Moffa, a grief therapist in New York City and author of, “Moving On Doesn’t Mean Letting Go: A Modern Guide to Navigating Loss,” said grief can be deeply formative. 

“Grief can act like a harsh teacher, stripping away what doesn’t matter,” Moffa said. “For many, including public figures like Biden, it reorients life around a sense of purpose, service, and connection.” 

She added, “There’s the person before the loss, and then there’s who you become after.” 

‘God love him’ 

Five months after Beau’s death, Biden, then a second term vice president, publicly closed the door on an upcoming presidential campaign.  

“I know from previous experience that there is no timetable for this (grieving) process,” Biden said in an address from the White House Rose Garden. “The process doesn’t respect or much care about things like filing deadlines or debates and primaries and caucuses.” 

The loss of Beau struck other members of the Biden family hard too. 

Former first lady Jill Biden has spoken of the “crushing” grief she felt and finding solace in writing. Ashley Biden, daughter of Jill and Joe, got a tattoo on her wrist reading “courage, dear heart” following her older brother’s passing. 

Hunter Biden suffered a relapse of alcohol addiction and later with crack cocaine. 

His family at one point tried to stage an intervention, Hunter Biden wrote in his 2021 book.  

“I don’t know what else to do,” he recalled his father saying. “I’m so scared. Tell me what to do.” 

As president, Joe Biden watched his son be tried and convicted on felony gun charges, and later Hunter pleaded guilty to failing to pay his taxes. Biden made the controversial decision during his final days in office to issue a sweeping pardon for his son. 

“He’s doing great, God love him,” Biden told USA TODAY in January. “Thank God he’s doing really well.” 

Grief comes in many forms beyond just death; Biden likely grieved the life he envisioned for his younger son, though much like the loss of Hunter’s mother, grew into the person “after.’

A smile comes before the tears 

Biden has been dubbed “America’s grief counselor.” His emotional appeals during the 2020 campaign and COVID-19 pandemic connected with voters. 

In many instances, he has comforted others experiencing the pain of loss with a familiar mantra. 

“The day will come when you open that closet door and you smell the fragrance of her dresses, or you’re going by that park where you walked with your child,” Biden said in a 2023 interview with podcaster Jay Shetty. 

“(For) the longest time it’ll just bring a tear to your eye,” he continued. “But eventually every once in a while, it’ll bring a smile to your lips before it brings a tear to your eye. When that happens you know you’re going to make it.” 

David Kessler, the founder of Grief.com and grief expert who spoke with Biden after Beau’s death, said a diagnosis is a form of grief – “a moment when life shifts in a way we never asked for.”  

“Through his personal experiences, President Biden has come to understand that he is more than the losses he has endured,” Kessler said.  

In a social media post on May 19 that included a photo of himself beside his wife of almost 50 years, Biden thanked everyone who had offered support in response to the news of his cancer. 

“Like so many of you,” he wrote, “Jill and I have learned that we are strongest in the broken places.” 

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