Getting by with a little help from your friends

“This much I can tell you from experience: for many of my patients, part of their dilemma results from an unspoken conspiracy of silence. People do not want to talk about imminent death in modern Western culture, save possibly with a few trusted family members or friends.” — Dr. Stephen J. Iacoboni, The Undying Soul,“The Lonely Vigil”

An excellent article at addresses some of the most difficult subjects facing cancer patients: what do you want to say? To whom? When? How can you talk about what’s happening now and what may happen in the future? Think carefully. Are you sure you prefer the privacy provided by silence and detachment? Are you “protecting” others who truly wish to help? Or is it only awkward to initiate or accept an invitation others hardly know how to extend.

“The diagnosis of cancer can be overwhelming, not only for you, but also for your friends and relatives. People often don’t know what to say…Sometimes just being with a person can be more meaningful than anything that might be said.”

You’re likely aware that American society as a whole struggles to discuss directly serious illness and death issues.  We tend to talk around these issues, use pat phrases and clinical descriptions, or just stick to “neutral” topics. This is especially obvious when a case may be terminal. That’s when the cancer patient finds him or herself at a loss for words, or even a framework for real conversation. As a result, little or nothing is said and shared.

There’s no rule against this approach, or any other you choose. But there’s also a chance you may find a way — perhaps a way new to you — that will allow friends to offer you comfort you might find welcome, which is just what they hope to do.

“Think about how much you want to share,” continues the article. “It is healthy to share what you are feeling with others. If you do not feel comfortable doing this, you may want to find a support group or a mental health counselor to help you.”

There’s another side to all this, however. It’s also fine to identify things you don’t want to talk about, and things you don’t wish to hear. Make a list of trigger points too sensitive for you to talk about yet (or maybe ever).

Do you get angry when people question your choice of treatments? Maybe this is a topic you will have to avoid. Does it annoy you when people bring their religion into it, saying things like, “God never gives you more than you can handle?” Think about the things that people have said or could say that bother you. Then, plan a response that is comfortable for you and cuts off the conversation. And once you’ve shared what you wish to share, be prepared to change to another topic. Maybe you can say something like, “I really get tired of talking about cancer. Let’s talk about something else.”

Finally, know that you are not alone when experiencing occasional frustrations: “I said I was going to get cards printed up saying what kind of cancer I had and what treatment I needed. I know people cared, but I got sick and tired of repeating the same story every time someone asked…” — Van, age 26

What’s most important of all is to honestly sort out for yourself what will help you most. Part of what’s overwhelming about cancer is all the processes happening at once, so it’s often too easy to be swept along, distracted and feeling helpless, when in fact there are conscious decisions you may want to make.

That brings us full circle. What do you want to say? To whom would you like to say it? How, and when?