Thursday, December 3, 2009


Yesterday a friend told me, “I’m on my way to see my cousin. He’s dying of cancer. What can I say to him?”

People ask me that often. They want to say something not only to comfort, but to feel they’re being useful. But really, what can you say? Certainly not those platitudes that sound unhelpful or even hurtful, like, “Well, hang in there,” and, “I just know everything’s going to turn out fine.”

I suggested to him my usual: don’t say anything. Just ask, “How are you doing?”

But I thought about it more later. That question means something different to me than it does to those who don’t employ it a lot.

“How are you doing?”


Now what?

That question can be the cork in a bottle of unknown contents. If you’re going to ask it seriously, you need to be ready to deal with those contents once the bottle’s opened.

When I first got into cancer counseling over thirty years ago, hardly anyone else was doing it, so there was nowhere to study it, and no one with whom to compare notes. It was scary, especially for a non-psychiatrist physician unaccustomed to raw emotion. I worried that people might “lose it,” that I might rip open a Pandora’s box I couldn’t close, or spring someone into a psychotic break.

People did indeed fall apart. They cried, screamed, and spewed anger at cancer, God, and whoever was handy, including me. And I found to my amazement that I not only could witness it all and survive, but increasingly remain centered. What I feared I’d lacked wasn’t professional training, but familiarity with intense intimacy.

I suspect that in this age of specialization we assume intimacy is the exclusive domain of licensed psychotherapists. An otherwise excellent oncologist told me, “I ask my patients how they’re doing emotionally with their cancer and treatment. If they say they’re doing okay, I leave it at that. If they say they’re not handling it well, I refer them to a psychiatrist.”

That is, he doesn’t feel adequate to deal with their emotions. He doesn’t say that though; he says he doesn’t have time. That’s too bad, since his patients’ cancers and emotional discomforts can be treated simultaneously.

A few years ago some wag published a list of smartass answers to the dumb questions people with cancer get asked.

One question was, “Gee, when you lose your hair with chemotherapy, do you lose your pubic hair, too?”

The answer is, “How badly do you want to know?”

So before you ask someone who’s sick, “How are you doing?”, ask yourself, “How intimate are you ready to get?”

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