As depicted in the novel, despair arises out of the individual’s fear of aging, death, and dying alone. The fear of death is the wellspring from which despair emerges. Both Breuer and Nietzsche experience despair, and their relationship is one of mutual care, as each attempts to serve as doctor to the other. Both men lost their fathers early in life, and these losses informed their understanding of death. The death of Breuer's father affected him because his father was a primary audience. When the father passed, Breuer felt alone and adrift without his father there to hear him. Breuer says, “For years I imagined him peering over my shoulder, observing and approving my achievements. The more his image fades, the more I struggle with the feeling that my activities and successes are all evanescent, that they have no real meaning” (245). After the death of his father, Breuer was faced with a new outlook, one in which death seemed enlarged. For Nietzsche, his father died when he was young. In a dream that Nietzsche describes, his father appears from out of the grave and grabs a child to bring with him into the land of the dead.