So, one of the bigger issues I’ve tried to tackle in writing over the past two-ish years is, how should healthy people interact with cancer survivors and/or terminal patients? My go-to response is, normally. We’re still the same people you knew two months ago, we’re just in a bit of a crisis. If you want to do a “friend in crisis” thing, bring a casserole. Or whatever you do.

My go-to response is that there really aren’t any horrifically wrong things to do or say.

As is so often the case, I was wrong.

This was discussed at a recent support group — one member was talking about how a friend joking about how her husband would need to learn how to cook after she’s gone. That triggered something in my reptilian brain; I remembered a time some family member referred o me in the past tense — it was only a slight, temporary mistake, but it cut. And other times people claimed I was “at death’s door.”

“You don’t look like a cancer patient,” is a back-handed compliment that should be avoided. “You look like hell,” while an insult, is still preferable to, “The treatment’s taking its toll, huh?”

In short, don’t talk to us as if our fate is a foregone conclusion. As many cancer survivors have noted, that tends to be a self-fulfilling prophecy.

Interpersonal investment is like privilege, or oxygen; you don’t really notice them when you have them, but you absolutely know when they’ve been sucked out of your sphere of influence.

When you refer to us as if we’re already gone or beyond physical salvation/reclamation (I could do an entire essay on how recovery has more in common with rebuilding an antique airplane than it does disease recovery), you’re just saying out loud what we already sense: You no longer have an interest in our future. That absolutely turns out to be a self-fulfilling prophecy, whether we survive or not (and trust me, when you say something thoughtless to someone when they are at their very lowest point, that will echo throughout their life).

Illness is a funny thing in that, it’s like seeing someone in crisis — you get to see an aspect of other people when you are utterly and completely vulnerable and reliant on peoples’ goodwill. In these cases, saying stupid shit like, “You got this” is completely unwarranted, but so is, “You’re at death’s door.” I can understand the impulse to panic — believe me, that’s all we do the first few weeks after the phrase, “Stage 4” — but of all the various luxuries and privileges we lose after that phrase, the hardest one to bear is, we do not ever get to panic. Ever again. Using inflammatory or panic-y language is bad; and, while I’m not big on the law of attraction, there is a certain aspect of it at play in cancer survival.

Here’s how to operate on our level: just show up with a pizza (I know that “cleaning stuff” is a popular go-to, DO NOT do that; some of us have new chemical sensitivities, some of us — like me — have a severely impaired spatial memory, so if you rearrange my stuff, I literally will be unable to find it), use present-tense verbs, and focus on the present. Don’t say, “Let’s go to the beach next week,” take us tomorrow. Don’t plan on a future, but don’t deny us the possibility of one, verbally, either.

Written by

Science journalist, cancer survivor, biomedical consultant, the “Wednesday Addams of travel writers.”

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