I was mainlining pretzels in my office kitchen as I waited for Julie to arrive. Whenever she was late, I would think the worst. Should I check on her between sessions or let her call if she needed me because I knew she had trouble asking for help? Should therapists’ boundaries be different — looser — with terminally ill patients?

Then again, the week before, I’d done something therapists aren’t supposed to do. I told her that I loved her.

Julie, whose real name I am not using to protect patient privacy, discovered her cancer on her honeymoon. A spot on her breast felt tender, and she thought she might be pregnant. She and her husband , both in their 30s, wanted to start a family as soon as they got married. When they returned home, she learned that the tender spot was cancer.

That’s when Julie landed in my office.

Her physician referred me, which was unusual, given that I didn’t specialize in work with cancer patients and I was only about two years into my practice. But that was exactly why Julie wanted to see me. She had told her physician that she didn’t want a therapist from “the cancer team.” She wanted to feel normal, to be part of the living.