An excerpt from my book – Things Not To Say To Someone Who Has Cancer”
The Three Questions
“So…what do I say to someone who has cancer?”
It’s a great question, and if you’re asking it, especially after everything I’ve told you so far, well done. It shows you’re thinking. A lot of people don’t even do that. This doesn’t just apply to things to say to people diagnosed with cancer by the way – it’s hard to know what to say to anyone with a chronic or acute disease or condition. But rather than simply thinking “There must be something I can say”, I think it would be great if people stopped to think about what a person with an illness might like to say to them. Someone who has considered their own mortality could probably provide a few interesting insights. They might say something like live for the moment, eat more chocolate and fewer beans, or something as simple as thank you so much for listening.
When I tell people the title of my book they will often say well, that’s all great, but what do I say to someone who has cancer? Nobody wants to say the wrong thing. Everybody means well. I think what you can say to someone who has cancer – if you are planning on helping them in any way – is going to be anything that doesn’t spring from your shock about their diagnosis, your fear about their future, your presumptions about how they feel or your assumptions about what needs to be done next. What will help most is you remaining calm. What will help is you behaving as if the ball is in their court now – ask them, what do you want to say? What will help is you creating some space around what’s just happened with your mindful presence and silence and allowing them to fill that space, rather than you feeling you need to fill in that space for them with emotions, super-spiritual babble, cliché’s and platitudes.
After you hear about their diagnosis, let the friend or family member know you are available, and that even though everything seems to have changed, nothing has changed between you. Let them then lead off in deciding how this thing will look – will having cancer be a big deal? Maybe they don’t want it to be. Maybe they don’t want this to be a huge, life-changing experience. Maybe they don’t want to be treated or seen differently. But maybe they want the whole world to stop turning and everyone to look and listen just for a minute, because something very, very bad has just happened. Maybe this is the only time in their lives that it has ever been all about them, and they need it to be, and you need to acknowledge that and be a part of it. Maybe most of the time their having cancer is okay, but every once in a while it will be fucking awful and they will need you to listen to them complain and bitch and moan before they can find what they need to pick themselves up and move on. Maybe it’s always been all about them and cancer is one more way for them to be the centre of attention. Maybe you’ll need to pull back, or maybe you’ll need to lean in. Maybe you’ll need to walk away and say “this is too much for me to deal with right now” and you need to be honest about that. Maybe you’ll need to think about whether this is one of those times it’s okay for someone to be totally self-absorbed, and decide that just for this time, you’re going to let them do that, no matter how painful it becomes. Or not. That is one of the decisions you’ll need to make. I can do this. Or, I cannot. If you have a family and responsibilities, then maybe you need to think seriously about whether all the promises you made at the beginning when you were consumed by shock and fear are what you really want or are able to do. Be honest with yourself, and your friend. Cancer may be the best thing that ever happened to your relationship, but then again, it may expose the thing for what it really is, and you may learn a lot about each other in this in this time. It may be awesome. But then again, you may not like it. This is not Beaches, and you are not Bette Midler. This is real life.
The fact is that a lot if people think they know what it’s like to have cancer because they’ve seen it in movies, but often it isn’t like that at all. Sometimes it’s much worse, but then again, sometimes it’s no big deal. There are probably people in your world right now who have cancer, but they will never tell you because they tried telling someone once and it got them a reaction they didn’t find appealing. Like pity. Or sobbing. Or lasagna. And some people just hate any kind of fuss. Many of our reactions to cancer come because we think we know what that person is thinking and feeling, but often we are very wrong about that. That’s why it’s vital to allow the person with the cancer to dictate how this thing will be for them.
Sometimes a person with cancers expectations of us or of others, or even of their own prognosis, may be unrealistic. But while it’s natural to put boundaries up and not allow ourselves to be taken advantage of, we ought never tell someone this is how it is, and this is how it will be, this is what it will look like and this is what you will do. The person with the cancer must be allowed to decide how their own cancer journey will look, feel and progress, what action they will and will not take, and what they believe the meaning of the whole experience is. Your job is to decide how you might fit into that. This can be particularly hard when the person has a poor prognosis, yet they have more hope than you do. Nevertheless, the support persons’ role is always to support the person with the disease, and not to drive or dictate to them how it ought to be.
For those who are supporting someone who has arrived at the real pointy end of a cancer diagnosis who want to say something helpful and have not just the opportunity but also the relationship conducive to the conversation that may follow, I do have a suggestion. Three actually.
Think about these questions -
Do you think this is your time?
If not, can you do what is required to survive?
If this is your time, are you prepared for it?
I didn’t think these three questions up myself, in fact, I heard someone speak on this subject a few years ago and these suggestions, in one form or another, were part of their message. I hadn’t heard anything as simple, appropriate or practical before, and I haven’t since. These questions open up so many others, and negate the need for some of redundant things people sometimes say that can really make a mess of things.
When you ask “is this your time?” you give people permission to decide for themselves where they stand in relation to what’s happening to them. It gives the person with the illness an opportunity to think about where this experience is situated in their life, and subsequently choose to resist death, or prepare for it. You’re empowering them by showing you believe in their ability to succeed in their choice, whatever that may be, and you also have an opportunity to offer them your support, should you feel able to provide it. Additionally, when you ask someone if they are ready to die, you’re suggesting not just that there is a way to be ready for it, but you also normalize death as being another part of life. Death is coming to all of us at some time, and it does not have to be terrible, wrong, or bad. It’s far more important to help people die with acceptance and peace than it is to try and deny it, or convince the one doing it they must resist it at all costs. Sometimes the most difficult thing and yet most important things you can say to someone who has cancer is it’s okay – I am ready to let you go. This comes up more often than you may think. I know of cases where someone suffering an illness was not just terminal but also quite ready to die, however, they were unable to allow themselves to because they knew the people who loved them were not ready to let them go. The person who is living must transfer their own need for support to someone else other than the person who is dying, although this will never be an easy thing to do.
The second question, “If not, can you do what is required to survive?” is designed to prompt the person to consider what they think it will take to get through this. It’s far less leading or patronizing than encouraging a person to “be brave” or “fight the good fight.” A lot of people who have cancer don’t use these kinds of descriptions, and will resist you if you do. Let the person decide how they would like to now move forward, and dictate both the methods and the language they wish to use. Take your cues from them, and ask them what role if any you can play. It may well be that what you want to offer them isn’t actually what they want from you, and you’ll have to be prepared to either adapt your own expectations, or even accept a refusal of your offer of support. If this happens, try and not be hurt, but just accept that this is one of the biggest calls a person ever has to make in their lives, and it’s probably not meant to offend you. If you are offering your support, do so after careful consideration. Think pragmatically about what you have available to offer – emotionally, physically, spiritually – and do not commit to anything you don’t think you’ll be able to follow through on. It’s far better they be disappointed in you early in the piece than have you pull out at a time when they really need you. Know your limitations, and do not exceed them. You won’t be helping anyone if you do.
The third question, “If this is your time, are you prepared for it?” is only to be asked if the answer to the first question is “yes.” However, It is not an opportunity for you to subject them to your particular convictions concerning the eternal destiny of human beings. If you haven’t asked either of the first two questions, don’t ask the third unless they’ve broached the subject first. And even if they do, don’t shove your own religion or faith system down their throat, unless you shared it in the first place. While the conversation may turn to spiritual things, don’t resort to cliché’s and platitudes such as “God is trying to teach you something,” or “Everything happens for a reason.” These are circular statements and absolutely do not help.
Asking are you ready? opens up the topic of what happens next to the person, not just after death, but in the time leading up to when it occurs, and again, this for the person to decide. It might mean they want to cease treatment, resolve unfinished issues or get busy with their bucket list. Ask them what they need from you, if anything. Offer to pray for them, or with them if you think it’s appropriate, but please, not for their salvation, unless they specifically ask you to. Pray instead that God will grant them strength to endure whatever they may face next, and ask that He will encourage and comfort them. He will do it.
Let the person then decide what role you might play in this chapter of their life, and be prepared to accept their decision. I have had many friends who refused to see me when they were dying, even though I would very much have liked to see them one more time. In each instance I was given a message saying that they wanted me to remember them as they had been the last time we were together, which inevitably had been when they were looking much better and we’d been having fun together. Now if I know someone is particularly unwell, and I’m not in their inner circle of family or friends, I don’t ask to see them, instead, I tell someone close to them that I will come if they would like me to.
One thing I’ve noticed about people when they’re dying is that given the time, they will close down their life in increments, until all that is left is the most inner circle of what is important and dear to them. You may have to accept that you’re not part of that circle, and let them go in your heart way before they actually pass away. Do not make demands on a person who is dying. Unless you are the closest friend or most intimate family, allow them to let go of you when they are ready to, not when you feel you are.
You know, what it probably comes down to is that what someone who has cancer really needs the most from you isn’t actually in anything you can say to them. A person with cancer needs what we all need – compassion, support, acceptance, friendship and love, and these can be wordless. The art of being a good friend is in knowing when not to say anything, when not to do anything, and when to simply be and let others be – be here, be somewhere else, be a crybaby, a complete jerk, a nurse, a friend, or even just be the strong one for a while. However, don’t set yourself up to be the strong one all of the time either. In tough times, strength is like a dance – you both get to have some cool moves, sometimes one leads, and sometimes it’s the others turn. Sometimes, one dances and the other one sits it out. Sometimes no one dances, things are crap, and everyone goes home cranky. But you will both dance again – as long as you have the love, the opportunity, the moves and the energy, you’ll dance.
One thing I do know, if you have someone in your life with cancer, things are going to get very strange sometimes, and you need to be ready for it. People are going to say weird things, and do weird things, and the best you can hope for is that it not be you that says or does them – but it might be. In these instances, what you need is grace, both for others and for yourself. Cancer is an opportunity to learn a lot of things, and one of them is how to be gracious. Remind yourself often that you and everyone else is just doing the very best they can. Forgive often, remember the good parts, and definitely, eat much more ice cream and far less beans.
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