Recently someone I know said he found out via Facebook that a friend of his was diagnosed with an aggressive form of breast cancer. She was in that horrendous waiting period between diagnosis and before treatment starts. She poured out all her fears and frustrations in a Facebook post. He said he didn’t respond to the post because he didn’t know what to say. And he noticed no one else touched the post either.
“I didn’t want to make it worse,” he said.
Which leads me to today’s topic: What do you say when you find out someone has cancer? How do you talk to the person?
So, someone you know just announced they have cancer. It’s not terribly surprising. Millions of people have cancer. Millions more will be diagnosed (The Google says 12.7 million every year).
Except, it is surprising. Every time. Cancer is always surprising when it stops being a statistic and happens to someone you know.
And, while I’ve never had any of the other big, nasty diseases floating about the skin of this world, I’m going to go out on a limb and say my advice applies to any life altering diagnosis. But for the sake of clarity, we’ll go with cancer since that’s what I know best.
Feel free to swap diseases and pronouns as applies to you.
Their mental state.
First you need to understand the cancer patient’s mental state.
Here’s what not saying anything does to a person who has just been diagnosed with the big C: it makes them feel very alone. It makes them feel less than human. It makes them feel like everyone is backing away from them (because they are), and now they have to deal with this big, nasty, terrifying beast alone.
If you ask how she’s doing, she’ll probably say, “I’m fine.”
She is not fine. She is so fucking far from fine she might as well be in another dimension. And hopefully that dimension doesn’t have things like cancer or Parkinsons or Multiple Sclerosis or ALS or any number of really awful other diseases.
But she’s going to tell you she is fine because if she tells you how she really feels (alone in the middle of a tornado with only a single flickering candle keeping the darkness at bay) she knows she will frighten you. She knows this because she has already told people and she’s already seen her own fear reflected back at her. She has sensed the drawing back of others surrounding her. She feels like a member of the herd that has been culled and left behind. She’s seen the fear that if she isn’t safe from cancer then no one is safe from cancer.
And worst of all, she sympathizes. In the same way this aloneness cuts her open, she also understands why others want to get away from her. She has suddenly, inexplicably become a reminder of human frailty. She knows they want to turn and run so they can get back to curtain shopping or taking the dog to the groomers because she would like to focus on those things, too.
She says “I’m fine,” because cancer puts up a fence between the patient and the rest of the world. It’s just a picket fence, everyone can see through it, but it’s topped with barbed wire and isn’t easily climbed.
On one side are green meadows and fields of flowers. That’s where most people live.
But a cancer diagnosis throws you bodily over to the ugly side of the fence. It’s swamp land out there, full of mosquitoes and thorn bushes and things that bite. Her friends and loved ones will brave the barbed wire and take the cuts it gives them to join her.
Others will just stare from their lawn chairs on the meadow side watching the struggle, feeling secure on their side of the fence because they work out, or eat right, or don’t drink or don’t smoke, or whatever. The people struggling over on the swamp side know getting cancer is more about dumb luck than the meadow dwellers would like to believe. People on the swamp side know that Christian, nonsmoking, nondrinking, vegetarian, workout junkies still get cancer.
But over there on the dirty side of the fence they’re caught in brambles and stuck up to their necks in quickmud and too busy trying to survive so no one really hears what they’re saying.
THAT is a cancer patient’s mental state. Now let’s take a look at the next piece of the puzzle.
Your mental state.
I’m going to say this as politely as I know how: Your mental state is irrelevant. It is extraneous. It is trivial. It is entirely unimportant, unnecessary and immaterial to the situation.
Maybe that sounds harsh. Maybe you’re thinking, “But I’m going through a divorce” or “My dad just died” or any number of really awful things are happening to you right now and those thing are awful. But I promise you the person with cancer gives zero fucks about your problems, however large they may be. All their fucks are being given to what is happening to them.
And minor things? Your boss pissed you off at work? Your mom hung up on you? Your teenage daughter is dating an inmate?
Less than zero fucks given. On a number line between all the fucks they can give and zero fucks, you’ve crossed over into negative-fuck territory.
As uncomfortable and difficult it is to hear or read about a cancer diagnosis and it’s subsequent fallout I promise you, your discomfort is negligible. It is vastly harder to live with.
I’ve heard the excuse “it was too hard to read/listen to.” I have zero sympathy. Your inability to digest what is happening to someone you call a friend is one hundred percent your issue. Not theirs. Don’t tell me you can’t handle what they’re saying. They can’t handle what they’re living, so I’ll say it again. . . Your mental state is irrelevant.
Now, a list of DON’T’s.
Are you still with me? Some of you are nodding along. Some of you probably already got pissed off and left. To those I say *meh*. Bye. If you’re still with me and you want to help your friend, here are some things to avoid:
Don’t lay your problems at her feet. The person with cancer cannot handle whatever it is you’re dealing with. She cannot be there for you. She cannot deal with your shit and hers too. Her shit will overshadow yours every time. She might like to hear what’s going on with you because it makes her feel normal (and feeling-normal moments are few and far between for her now) but she will not be able to provide support or solve any problems. Don’t expect her to.
Don’t tell her to ‘think positive.’ In all sincerity, fuck your “think positive.”
Sometimes things aren’t positive. Sometimes life is a shit sandwich that you have to eat and the only choice you get in the matter is whether you want mustard or ketchup on your turd.
That’s what she’s learning right now.
She is grappling with the biggest shit sandwich of them all: mortality. And unless you’ve done the same, you cannot assuage that conflict by saying “think positive.” I mean, really, don’t you think she would if she could? And if she can’t, now she feels like a failure at positive thinking on top of everything else.
“Think positive” or any variation thereof are empty words. It’s you holding her at bay so you don’t have to get too close. It’s you projecting your fears onto her. It’s dismissing her very real, very overwhelming feelings.
Being told to “think positive” is the seed that births the lie of “I’m fine.”
Don’t ask anything resembling “Why?” As in, “Why did you get cancer?” She won’t know why. And I guarantee you she’s looking for a cause, because she wants to know why, too. She’s not going to be able to tell you the magic formula for avoiding cancer because there isn’t one. Know that when you ask her “Why?” what you’re really asking is “Why not me?”
Don’t make your fear her problem. Do not for a moment expect a cancer patient to help you grapple with their diagnosis. This is among the most unbelievably selfish and inconsiderate things someone can do to a cancer patient. Here’s an example:
Someone I know was diagnosed with breast cancer. I went with her to her pre-op appointment. As we sat in the waiting room waiting for the doctor to call her name her phone rang. From my chair I overheard the conversation. My friend’s friend was complaining that she, the caller, didn’t know how to cope with her, the patient’s, diagnosis.
I was so astounded I laughed out loud, stood up and walked away. My friend was quicker on her feet than I would have been. She described where she was (a surgeon’s office, planning the removal of a body part) and told her friend, the caller, what she’d said was inappropriate.
It was a lot of things, ‘inappropriate’ representing only the tip of the ice burg.
Look, I don’t care how shocking the diagnosis is. Don’t expect the cancer patient to help you understand a goddamn thing. This is not your party, and you can leave your need to understand at the door.
Don’t tell her scary stories. This is a big one. For the love of all things holy, please do not tell the cancer patient about every man, woman, child, dog and cat who you know that died of cancer. Everyone knows someone who has died of cancer. She knows cancer kills people. Keep your horror stories to yourself.
I’ve given you lots of examples of what not to do. To which I hear you asking, “Then what DO I do?”
You’re not going to like the answer, but here it is: If you want to make it better for her, even just a little bit, you have to be brave.
DO listen and not interrupt, even when she talks about difficult things like mortality and how much she hates the thought of leaving her children behind.
DO accept it if she cries.
DO save your own tears for later when you are away from her. Your own fears are inconsequential and to be dealt with at a later time and with someone else.
DO put aside your own fear that this could happen to you (because it can).
DO put yourself in her shoes.
(DON’T tell me you can’t. You may have never gone through cancer, but you have an imagination. Use it. It probably falls short, but it’s a good start.)
DO tell her stories of people who lived.
DO check in on a regular basis. Cancer treatment is long and the people who are there in the beginning may disappear before it is over, yet she still has to finish this march.
If you ask, “How are you?” DO be sincere in your question and DO be prepared to hear that she is not fine.
(If you can’t do this, DON’T ask. You’ll only put pressure on her to act fine just so you will feel better.)
DO show up and hold her hand at an appointment.
DO hug and tell her you love her.
And another thing regarding the DO list? You have to mean all of it. She will know if you’re insincere. And she will remember.
Sounds hard, right? See what I mean about being brave?
I wish there was an easier way, but there isn’t. Note that I didn’t say helping a cancer patient is impossible. It isn’t. But there is no way to truly help that doesn’t cost you a small piece of yourself.
So how ’bout it? Are you brave?