Juliet—my friend since grade school—was calling from Michigan: “Are you sitting down?” And then she told me she had cancer.
She was overwhelmed, and so was I. We were both tearful as I stumbled over my words. How to reassure a terrified friend who has just been forced into cancer treatment? What to say? I had just started reading Letty Cottin Pogrebin’s new book How to Be a Friend to a Friend Who’s Sick. But I was still on Chapter 1.
A shameful thought struck me. Juliet and I were born only two weeks apart. I confess to getting a flash of fear: I must be next.
This combination—anxiety about a friend’s perilous situation plus sudden awareness of our own mortality—is what leaves us tongue-tied when a friend is turning to us for comfort. It makes us routinely blurt out remarks that either offend the patient or re-ignite her panic.
Pogrebin, a feminist activist since the sixties, a co-founder of Ms. Magazine, and the author of 10 books, is well qualified to offer us advice on how to be a friend to a friend who’s sick. She was diagnosed with breast cancer the day after the Jewish New Year in 2009. A month later, she had lumpectomy surgery, and began radiation the day after the secular New Year. She can, therefore, render exquisitely the heightened sensitivity of a patient diagnosed with a life-threatening condition—the annoyance at platitudes; the exhaustion that makes having to explain the state of her health so tiring (“How are you?” is a draining question); and the tamped-down fear that explodes back into the mind when a friend utters a shocked “Omigod!”
Pogrebin details vividly her dismaying sense of transformation from active, self-reliant woman to powerlessness. The frustrating loss of control is manifest in the treatment waiting rooms; the patients, no matter how forceful and accomplished in their careers, are as powerless as children to affect how long they must wait. Pogrebin used the waiting-room time to interview her fellow patients—indeed, the book is based on interviews of some 80 people—patients, their relatives and friends, parents of children with terminal illnesses. She synthesizes their reactions in the book. “Everything I know,” she writes, “I learned in the waiting room.” Her interactions with these patients helped her regain her personal mojo.
Exhaustion is a major issue for Pogrebin. Current “sickness etiquette” decrees, “Be there for your friend! Show up!” Show up, of course, Pogrebin declares. But first, call to make sure the patient wants a visit. (Many sick people are so miserable or embarrassed that a visit is a burden.) Ask what time your friend would like you to come. (This sensible advice, it seems, is not self-evident to far too many friends and relatives of the sick.)
And stay no longer than 20 minutes—less time if the patient is in pain or is drooping into sleep. (Pogrebin acknowledges that she can’t make a rule for everyone, but this timing was right in her case.) When you’re at the bedside, “Ask and Act”: Ask what you can do (don’t offer the vague “If you need anything, let me know”) and Act (do what’s needed—especially, if the patient is at home, the shopping, cleaning up, laundry, cooking the patient really needs). Happily, this is just the kind of thing women do. One of Pogrebin’s interviewees, Nick, advises bachelors and widowers, “If you don’t have women friends, don’t get sick!”
Chapter 3, “The Perfect Present,” is full of ideas that complement the wise counsel in Chapter 2, “How to Give Good Visits.” Pogrebin lists resources for puzzles and intellectual games, light reading, “cancer humor” (she is qualified to vet this), funny videos, and “restorative gifts.” So many of her interview subjects wanted what is most elusive for the sick: pleasure, whether it be a book you know your friend will love, a spa certificate, or something less tangible that binds you together.
Pogrebin’s wit, forthrightness, and perceptiveness make the book special. She calmly addresses the fears and selfish motivations we visitors would never admit to, as well as dilemmas we have no idea how to handle. She is honest enough to admit her own limitations as a friend to sick or grieving people.
We all have concentric circles of friends, with our family members and our Uberpals in the center ring and our other friends and acquaintances in the outer rings. Poegrebin did not have the energy to tell everyone about her diagnosis, so she told only her family members and her inner ring of pals, and swore them to secrecy. She regrets that choice: It hurt the feelings of friends she hadn’t told. But telling it this way was all she could handle at the time.
Sickness etiquette: Is it okay to send out the news of the diagnosis by email? Pogrebin thinks so. She sent out a mass email to her Uberpals and a different email to her children. She did this to spare her fragile self; she simply couldn’t deal with telling each of her loved ones face to face.
And that’s what we friends-of-the-patient are meant to understand—getting a mass email, or not being among those first told, is not a sign of rudeness, but rather the best way this patient found to cope.
Pogrebin quotes a line from a Jewel song: “In the end, only kindness matters.” Ah, but putting kindness into words—that’s the difficult part. I found Pogrebin’s suggestions helpful. “I’m so sorry this happened to you” is her substitute for the dreaded “Omigod!” But, of course, not everyone would choose to cry “Oh, fuck!” on getting the bad news (a reaction Pogrebin welcomed). But phrases like that—direct, real, and non-scary—work for some of us. And Pogrebin can, as she sets out to do, help keep us from doing harm.
And harm can be inflicted. One of Pogrebin’s interviewees told his friend, “They got it all.” His friend said, “How do they know?” My own brain-tumor-stricken husband was deeply troubled, his behavior hard to deal with. But I did not laugh at being told that I’d soon be rid of him. I redoubled my efforts to help him get the right treatment, a good result. The awkward “comforting remarks” were not funny, then or years later.
Real help: A friend of Juliet’s set up a closed Facebook page; it has 71 members at present. Her progress and needs are reported on the site, relieving her of the problem of dealing individually with everyone at a time she needs rest and focus. This is the kind of practical help Pogrebin suggests in her eight pages of resources, including a valuable site that helps patients organize assistance. Inspired by How to Be a Friend, I contacted someone I don’t know well who is under long-term treatment—interviewing her, learning about the online help-for-caregivers site www.lotsahelpinghands.com and promising to come work in her garden.
Read this book! That is my advice, and you will thank me for it. It has already proved useful to me. Indeed, everyone on Juliet’s site is interested in reading it—including Juliet.