June 19, 2012

How can you possibly avoid saying the wrong thing to someone who's ill?

Instapundit links to an article called "10 things not to say to someone when they’re ill." The things are all things that an ordinary person would think of saying, like "I feel so sorry for you."

It made me want to look up a passage I remembered from David Rakoff's excellent book of essays "Half Empty." Rakoff has cancer, and he's been told the treatment will need to be the amputation of an arm and shoulder. He writes:
A friend asks if I’ve “picked out” my prosthetic yet, as though I’d have my choice of titanium-plated cyborgiana at my disposal, like some amputee Second Life World of Warcraft character. Another friend, upon hearing my news, utters an unedited, “Oh my God, that’s so depressing!” Over supper, I am asked by another, “So if it goes to the lungs, is it all over?”...

But here’s the point I want to make about the stuff people say. Unless someone looks you in the eye and hisses, “You fucking asshole, I can’t wait until you die of this,” people are really trying their best. Just like being happy and sad, you will find yourself on both sides of the equation many times over your lifetime, either saying or hearing the wrong thing. Let’s all give each other a pass, shall we?

46 comments:

tiger said...

Interesting and something I've always wondered about:

If someone has a visible handicap or you know has a disease do you talk/ask about it or not?

I still don't know but three years ago at a Springsteen concert I got stand very close to the stage because I was talking to woman in a wheelchair and usher thought I was with her and didn't make us move...

ricpic said...

"Have you picked out your prosthetic yet?" sounds pretty innocuous to me. Touchy touchy.

kcom said...

Of course, much depends on the person. My friend is scheduled for another dose of chemotherapy tomorrow and she's always been open and matter-of-fact about what she's going through. We talk about it and I ask her direct questions and she doesn't seem to mind. But we talk about other things, too, and it's not the sole focus of her life or our conversations. It's just one more thing. I imagine with someone with a different personality it would be completely different.

dbp said...

I thought nearly the same thing when I saw the list earlier today: Okay, you've eliminated all the things I might have said. Now What? Just stare dumbly at them? That is somehow better?

grgeil said...

Reminds me of the old Dear Abby and Ann Landers columns. The two most common themes were:
1) The letter writer was outraged at the insensitive comments made by well meaning but inconsiderate friends in the letter writer's time of tribulation.
2) The letter writer was outraged that friends were afraid to talk to her in her time of tribulation. Of course those friends had probably read about situation 1 too many times in Dear Abby / Ann Landers.

bagoh20 said...

As someone who has been there a few times, I don't care what you say. Any of those quotes would be fine with me. Facing facts and being open and honest about it is best I think. The worst is when people get all uncomfortable and worried about what they will say. That is just bad for us all. Just say what you're thinking. If I'm dying, we don't have time for bullshit. It's not your fault. You'll get your turn soon enough.

Rick Caird said...

They are trying their best. Most people have no idea what to say or how to act. It is best to give them every benefit of the doubt.

edutcher said...

Saw the piece on Insta. One man's list and that's all it is.

A friend will understand what you're trying to say. If he/she has a problem with it, they'll say so.

Anybody else, sometimes it's best to ask if there's anything they need.

elkh1 said...

Commiseration is out, understanding is out.

How about "when it's time to go, it's time to go", "it's your turn", "you are on borrowed time", "you had your chance, you blew it"...?

AllieOop said...

From my observations, it's worse to be too sensitive. Being natural and sincere, even if it means putting your foot in your mouth, is more important than uncomfortable silences or worse avoidance of an ill person, because it make YOU uncomfortable.

MadisonMan said...

I've always liked your car. Can you leave me your car?

Is that a better thing to say?

I usually say I'm sorry, and follow it up with can I bring you some dinner?

ed said...

It is an illness, disease or condition and it happens to us all at one time or another, in one way or another unless we're all really lucky and die first.

As someone with end stage renal disease and the rather severe complications from it. I'd have to say that anybody who gets overwrought over friends and family trying to do their best really needs to look in a mirror and recheck their jackass quotient.

Like the author of the article in question.

Fact is that unless and until you've walked that mile in those shoes nobody can really know what it's like. And each illness, disease or condition is different and many ways and often with very disturbingly embarrassing details. And most often those details involve personal hygiene. Which is why I personally detest having visitors in the hospital until and unless I'm able to shower; something that isn't always a given.

But having someone say that they felt sorry for you and then being angry? Really? Getting upset because someone you know is trying their best when they say you're looking well? Seriously?

This doesn't require management. Doesn't require you to expend any energy. Just say "thank you" and leave it at that.

Personally I just came home from a month spent in the hospital because I ripped the tendons in both knees. It completely and utterly sucked. But it was nice having a friend drop off some real clothes for physical rehab so I didn't have to try and walk wearing those drafty gowns. And when he expressed that he was sorry it happened to me and hoped I'd feel better. I said "thank you" and left it at that.

Do I feel sorry for the author for having cancer and dealing with chemo? Yes I do. Do I want to slap the hell out of that person for being a jackass? Yes I do.

Ann Althouse said...

"As someone who has been there a few times, I don't care what you say. Any of those quotes would be fine with me. Facing facts and being open and honest about it is best I think. The worst is when people get all uncomfortable and worried about what they will say. That is just bad for us all. Just say what you're thinking. If I'm dying, we don't have time for bullshit. It's not your fault. You'll get your turn soon enough."

Yes, that sounds right. I have never been the sick one, but dealing with family members, I have always gone on the theory -- with what seemed like a positive reaction -- that what they wanted most was for our relation to continue with them being the regular person that they were all along. Just as you wouldn't get nasty, you shouldn't become unnaturally nice or diplomatic. Be normal! If articles like the linked on make people think there are a lot of pitfalls, they might limit contact with the person who most wants (I assume) to be kept as a regular person who is part of normal life.

ed said...

"I've always liked your car. Can you leave me your car?"

Actually the funniest thing a friend ever said to me was "So. Is it too late to take out life insurance on you then?".

I really enjoyed that even though I needed morphine afterwards.

Shanna said...

people are really trying their best

I like that he's taking it in the spirit it is intended. People say the same kinds of things over and over again in a lot of situations, but they generally mean well. As grgeil mentioned, the other option is staying away or saying nothing, for fear of offending. That's probably not better.

Shanna said...

Also, the person who made that list is awful. Read the entry on why 'Whatever I can do to help' is bad.

ed said...

"I thought nearly the same thing when I saw the list earlier today: Okay, you've eliminated all the things I might have said. Now What? Just stare dumbly at them? That is somehow better?"

Personally I'd go with Althouse's POV. Just act normal. Don't ignore the elephant in the room; the illness. Just don't make it the centerpiece of everything. If you've got a question, ask it. If you want to know more, ask. Just keep in mind that when you're ill your energy levels drop like a rock. And if the patient has difficulty in getting out of bed or moving around and needs to visit the bathroom, offer to clear out for a bit and come back. Such a trivial thing can sometimes be an incredible ordeal.

If the patient is or has faced death then keep in mind that some people like to pretend it isn't a concern. Some people simply have accepted their mortality and find humor in it.

As for bringing something such as food make absolutely certain that what you are bringing is acceptable to the nurses in charge of your patient. Last thing you want to do is bring food to someone on a clear liquids diet or on fluid restrictions. But sometimes a small bag of cookies or a small cup or two of pudding. Makes a really crappy day just a little less crappy.

Michael K said...

"what they wanted most was for our relation to continue with them being the regular person that they were all along."

I have spent over a decade teaching medical students not to say optimistic things to patients. The temptation to say, "Oh, you'll; be fine," is almost overwhelming and is innocent in the average person. The patient knows you mean well. Medical students are average people who are now entering a different world. I tell them that, as odd as it seems, patients think they know what they are talking about.

All it takes is a white coat and a bedside manner. I have seen patients turn down critical heart surgery because some student said they didn't need it. In that instance, in the bloody 60s, the student asked to do the surgery. When we told him that we didn't allow medical students to do open heart surgery, he went back and told the patient he didn't need it.

How I hated the 60s !

Anyway, student don't realize they have acquired mysterious powers and must adapt.

Carnifex said...

My Dad was diagnosed for some type of lung cancer that kills 95% of its victims in 5 years. He got through the chemo, and radiation, but had to be hosptalized for 1/2 the past year. The lump has stopped growing, which is good, but he now has bone cancer. One of his ribs literally blew apart from it. They think they have THAT under control now. But the words the oncologists used, selected, were like ripping a band aid off. He said "It will likely jump to another part of your body now". Harsh, but we know we're on the clock. Tick...tick...tick...

I try not to argue as much with him. I visit a lot. And his great granddaughter thinks he hung the moon, so it's not all bad. I need to bring MY grandson to visit...harder to do, they live several counties away.

Ann Althouse said...

I imagine it would be burdensome to feel that the other person is trying not to say the wrong thing. That would be worse than saying the wrong thing UNLESS you could tell that they actually are conveying hostility.

And yet, even if people do bear some hostility, it's only human. And that is normal life, which is what I think I would want. The real jerks... why would they even be visiting you? Only if they're... your own kids or your spouse. You've got to accept that, whatever it is.

Carnifex said...

Speaking of hostility...

When I had my tumor rupture 13 years ago, and thought I was gong to die in 2 minutes( I had a count down going on in my head) I had a prolonged hospital stay of 2 weeks.

My wife visited zero times... but we hadn't met yet so I forgave her.

My Mom and Dad, who live 20 minutes from the hospital visited twice...once even turning down my asking for them to visit.(it was the 4th of July)

My boss, visited me every day. Every day.

Wow!

bagoh20 said...

Humor works best for most of us. I'd love to die laughing. They should have a stand up comic in the O.R., just in case. I'd take a magic marker and write "Encore" on my ass.

"
My wife visited zero times... but we hadn't met yet so I forgave her."


Oh no. I would hold that over her head forever.

David said...

What you have to realize is that the person afflicted, more often than not, is consoling the purported consoler. I realized that my job was to assure others that my cancer would not be too burdensome or distressing to them. This did not bother me.

I did get a little tired of hearing people tell of others they knew who had been through the same experience.

But mostly, as Bagoh said, if people say anything at all they are trying to do their best. So what if they are not skilled at the art. I've gotten pretty skilled at it (or so I think), but only through experience.

David said...

"sometimes it's best to ask if there's anything they need."

A good friend of mine from high school is a doctor. His father, also a doctor, practiced well into his 80's. Finally age and various afflictions caught him and he was in the hospital where he had been on staff, dying with some difficulty.

A younger doctor came in to pay respects to the dying old may and asked if he needed anything.

The reply was a firm whisper: "Hemlock."

Peter said...

If you want to offer me condolences on my recent tapeworm diagnosis I'll be grateful.

So will Wormy.

Pogo said...

Few people who become ill have any idea what to say either. For some things, there are no words.

From the movie/play Wit:

"I've been asked, "How are you feeling?"

while throwing up into a plastic basin.

I have been asked...

as I was emerging

from a four-hour operation...

with a tube in every orifice:

"How are you feeling today?"

I'm waiting for the moment when

I'm asked this question and I'm dead.



I'm a little sorry I'll miss that.
"

We are all fragile and weak and rarely know exactly what to say. Better to say it than not. Better to be there than not.

bagoh20 said...

I wasn't gonna but, this is such strange timing, I guess I will.

Just a couple hours ago a guy I work with walked toward me looking kinda in pain, and of course being a sensitive soul like I am, I said: "What are you whining about?" He said: "I gotta go to the hospital."

It turns out he has a collapsed lung, and it might be a lot worse. So, that's the wrong thing to say. Just shoot me.

After he told me, all I could think to say was: "Don't worry - lungs heal."

I still can't think of anything.

I hope he's OK, but he smokes a lot, and this is the second time. He's only in his twenties.

Pogo said...

The only wrong words are
(1) None at all
or
(2) Anything said by MSNBC's Lawrence O'Donnell.

Christy said...

Years ago I read that it is best, rather than ask "Is there anything I can do?" to offer to do a specific task. Laundry was one of the listed suggestions. So I did. Do you know how weirded out people get when you offer to do their laundry?

I went back to casseroles.

spot belly said...

How about those words kindness, empathy and humanity. It's difficult to be sick for so long. How about a simple "I'm here if you need me, friend."

Michael K said...

"I hope he's OK, but he smokes a lot, and this is the second time. He's only in his twenties."

Spontaneous pneumothorax is usually related to congenital anomalies. Is he tall and thin ?

Tell him to avoid scuba diving. It's a well known cause of sudden death in these folks. Breathing positive pressure.

bagoh20 said...
This comment has been removed by the author.
bagoh20 said...

"Spontaneous pneumothorax is usually related to congenital anomalies. Is he tall and thin ?"

Yes, he is. Thanks. I hope that's all it is. He's been trying to stop smoking so that he can donate a kidney to his father this year. He's afraid this will make that impossible.

As I was writing this, I just heard from his wife. He going to be fine they say. He had a pinhole in his lung which leaked air into his chest collapsing his lung. The doctor said that if he had not gone to the hospital he likely would have died during the night. They don't think it's cancer or anything acute right now. It happened before many years ago when he was a kid. Anyway, they say he'll be fine. Happy ending. He has two very young kids.

William said...

In the last few years I've had a couple of friends and relatives with major illnesses. I have enough trouble relating to people in perfect health, so I'm sure my presence at their bedside wasn't all that comforting. Anyway I showed up and didn't trip over the catheter. I don't know if there's truly anything you can say to brighten or, for that matter, to further darken the day of someone contemplating their own demise. We make the effort more to lessen our own sense of futility and impotence in the presence of so much malignity. It's nice to pretend that there is some kind gesture that will really matter.

Donna B. said...

This reminds me of a situation some years ago where two "unhealthy" individuals and one "healthy" one were faced with the consequences of a choice they'd made together... one that didn't turn out well.

The first "unhealthy" person said, "Well, I have xyz disease, therefore I shouldn't be held responsible for my choice."

The second "unhealthy" person said, "Well, I have an xyz tumor, therefore I shouldn't be held responsible for my choice."

The third person -- very healthy -- said, "Well, I am a lawyer!"

Whereupon all parties succumbed to uncontrollable laughter and decided "who the hell cares" was the best solution to the now not so embarrassing situation.

This, more than anything, told me that a law degree is valuable.

mrs whatsit said...

I had a major injury last year and while I was getting over it, most people were great. As several have already said, it doesn't matter a whole lot what you say -- the main thing is to show up and behave as if you care. Just doing that means a lot.

But one person -- after showing up, behaving as if she cared, and even going to the trouble of bringing home-baked cookies -- suddenly scolded me, quite sharply, for getting quick treatment when I arrived at the hospital. She asked me how long I had to wait when I got to the ER, and when I said they took care of me as soon as they got me out of the ambulance, she said quite angrily that it must be because a relative of mine was a nurse there. Then she told me a long story about how long she had to wait once when she went there with a fever. I tried to explain about triage but she would have none of it. Favoritism, it was favoritism!

Ordinarily I'd laugh off something like that -- but I was still pretty bunged up and defenseless and it was shocking to be scolded. I'm still mystified.

The Crack Emcee said...

I saw that link on Insty but didn't click it because it was obviously stupid.

like this Rakoff guy - he, too, is smarter than Glenn.

Republican said...

Survived(ing) cancer, discovered a year ago. Tumors removed. Six month road to recovery. Now recovered.

After the fact, I heard from plenty of ppl who were shocked I survived.

THAT is what ppl are really thinking if you beat it. And if you don't, you aren't around to hear about it.

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D.D. Driver said...

Questions on the "approved list":

"Can I bring over a fish pie?"

------------*

The more you know.

glenn said...

After my successful cancer surgery 18 years ago one of my co-workers (not noted for his tact) said in a meeting "well, you know about cancer, 5 years and that's it. Nobody lasts longer than that". I considered the source and ignored the comment. One of the other guys in the room said "Nice, Charlie" and that was it. You have to consider the source.

Marie said...

Refusing to visit someone ill because "I don't want to see him in that condition" or because "I don't want to remember her that way" or because "visiting people in the hospital isn't easy for me"...those are the things that truly should not be said.

Holmes said...

Totally. I thought the person in the Instapundit link was somehow trying to transcend the disease by looking down on anyone not in their situation. Nothing anyone said was good and the general rules basically eliminated everything.

ed said...

@ mrs whatsit

"Then she told me a long story about how long she had to wait once when she went there with a fever. I tried to explain about triage but she would have none of it. Favoritism, it was favoritism! "

I once waited 27 hours on a stretcher in a hallway during Memorial Day at a local hospital with a high fever, chills, sweats, etc. Why? It was Memorial Day, I live in the Jersey Shore and on that day, in that area, come every damn idiot in NYC metro area.

You get treated according to triage, availability of medical staff and availability of rooms. Is there some favoritism in the system? Sure along with every other system. But by and large these are very dedicated people trying to do a very difficult job under some really difficult circumstances.

Frankly your friend was probably one of those for whom treatment is never fast enough, good enough, professional enough and who would send back a glass of water for having fingerprints on it after having touched it herself.

Astro said...

During the 3 years that my wife was ill and dying our friends said all of those things to her, or to me. And I knew they meant well and wanted to help, but beyond that the phrases were empty because we all knew there was little anyone could do.
What really, actually helped was food. A few friends brought soups, casseroles, or even entire meals. A few others sent gift cards to restaurants that had take-out. That eased my burden, saving me time and money. My wife understood this appreciated it as well.

karrde said...

I notice that I'll pray for you didn't make the list.

Interesting, that.