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Taking Questions

What are ways to be a friend to a friend who's sick?

The New Old Age Blog—The New York Times

The Caregiver's Bookshelf May 29, 2013, 1:05 p.m.

What Not to Say at the Bedside

By JUDITH GRAHAM

Having breast cancer four years ago taught Letty Cottin Pogrebin, 73, a lot about being a good friend to someone who is sick.

Some people knew how to strike just the right note, offering love and support without hovering. Others rubbed her nerves raw with excessive solicitousness when all she wanted was to be left alone. Ms. Pogrebin eventually realized that many interactions surrounding her illness were shaped by obligation and politeness, not by honesty and directness — qualities she dearly values.

So this longtime journalist and activist — a co-founder of Ms. magazine and more than a dozen women's groups, and author of several books — decided to write about her experience and those of her many other fellow patients at Memorial Sloan-Kettering Cancer Center, hoping others might learn from it.

I caught up with Ms. Pogrebin by phone in Los Angeles as she traveled the country speaking to groups about her new book, "How to Be A Friend to a Friend Who's Sick." Our conversation has been edited for length and clarity.

Q.

When you were ill with breast cancer back in the fall of 2009 and early 2010, what did you most want from your friends?

A.

I wanted them to really tune into my moods. Because I'm somebody who sometimes needs a lot of love and sometimes needs to be left alone. And the illness heightened those extremes. Being sick magnifies everyone's essential characteristics.

Q.

What kinds of responses were most helpful to you?

A.

The people who asked, "Would it be good if I came over now, would you rather I don't come over at all, or would you rather I come on Saturday?" And the people who said, "I'm going to bring you a present, so you might as well tell me what you want."

I learned through these interactions that you can be direct and candid — on both sides.

Q.

What kinds of responses were most off-putting?

A.

That everyday question, "How are you?," with the portentous overlay of tragedy. You would say, "Fine." And then they would say, "How are you, really?," with a sort of sanctimony bordering on pity.

In normal discourse it's common to say, "How are you?" And we all say, "Great, fine." But when a sick person is asked, "How are you?," we have to calculate how much we're going to tell and how much someone really wants to know. If it turns out someone is just going through the motions in asking, that leaves a really sour taste in your mouth.

Q.

So, what's a friend supposed to do?

A.

Ask, "What are you feeling?" That will elicit a much more honest answer. Then the person who's been sick can say, "I'm really depressed and tired of people asking me how I am, and I want to normalize my life."

That's how I felt: I really didn't want to revisit my diagnosis and the fear I'd felt.

Q.

What did other people with cancer tell you they like to hear from friends?

A.

"It's so good to see you" is something people love to hear. Because that speaks volumes and it's a truth between friends.

Try to get at the truth of this enterprise. Which is, I want to make you feel better, and I feel bad that you're sick or suffering. Just say the simplest thing: "I'm sorry." If you're not naturally empathetic, say, "I'm not good at this. I need you to tell me what's helpful and what's not."

"I hope you're not suffering, but if you are, tell me if there's anything I can do. I really mean it."

If I had to pick three things to say, it would be: "Tell me what's helpful and what's not. Tell me when you want to be alone and when you want company." And, "Tell me what to bring and what to leave."

Q.

You ask people to understand their own response to illness before they reach out to a friend.

A.

People need this layer of honesty, so that when they're in a hospital or a sick room they can monitor themselves and realize they're pulling back, getting too close, appearing too upset or being too anxious. And that these responses are really about them, not the sick person. And that it's up to them to control that.

Take a pause, a beat, before you say what you think you want to say to someone who's sick. Stop and think, "Would I want someone to say to me what I'm about to say to you?"

Q.

Are there things people should never say?

A.

Oh, yes! Believe it or not, friends say things like, "Is it terminal?" Never do that! Never say, "What do you think you did to cause this?," as if it were your friend's fault. Never say, "God only gives as much as you can handle."

Q.

Are there times when words don't suffice?

A.

In the sick room when you're nervous, the tendency is to overtalk. And I had to learn to live in the silence. It isn't easy for me; I'm a big talker.

Sometimes the nicest thing to do might be to say, "I'm just going to stay with you for a few minutes, and we don't have to talk." People respond to that. And that silence can be a bonding silence, not an awkward silence.

Q.

What about when someone's died? That's often awkward.

A.

Tell the truth. Say something like, "I feel so sad for you." And if you have a memory, give it. Tell how you'll always remember how beautifully this woman's husband played the cello or how his smile could light up the room, or how your friend's mother had the most magnificent voice. Something that establishes that the person left a mark on your life and acknowledges the meaningfulness of the life that's just ended.

Suggested questions for future editions can be sent to goodmourning@archildrens.org (please put "Taking Questions" in the subject line).

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