Speaking to Someone Who Has a Serious Illness

Most people who are well and never experienced a serious illness themselves are often at a loss for words on how to talk to someone with a serious illness such as cancer, AIDS or heart disease. People tend to work on the basis that if they don’t bring up the subject perhaps the person who is ill won’t either thus sparing everyone the need to face the reality of the situation.

In speaking with someone who has cancer, for example, people often won’t mention the word “cancer”. Or if they do, they may refer to it as, “you-know-what”. When and if they do discuss the illness, they usually lower their voices when the conversation comes to “that word” as if they will catch it by saying it aloud.

You may be one of those people who are uncertain as to whether your approach will be construed as too forward or too patronising, so you hold back and say nothing. Or worse, you avoid visiting them completely.

When friends and family treat such illness light-heartedly, avoid the subject, or withdraw their company, the person who is seriously ill can become isolated and, as is generally true, come to believe that only others who have been through the same experience or faced a similar problem can understand how they really feel. As for those who hold back and say nothing, the person who is ill may be wondering, "What do you know that I don’t?’ Most patients feel that the people they once thought to be sensible and intelligent have suddenly become mutes with long and mournful faces.

If you want to know what someone with a life-threatening disease is thinking, consider the following: for those with a life-threatening illness, the fear of death is surpassed only by the fear that you and others will see they are afraid and abandon them. Because of this they withdraw into themselves and others because distance is the easiest way to cope with their overwhelming sense of impending loss. They are concerned about how others will manage emotionally, practically and perhaps financially without them. Of no less concern is that they feel that they have or will become a burden to their family.

To smooth the way through this often-difficult time, it is well to remember that people have definite responses to the diagnosis of a serious illness and other life-changing event.

Apart from the initial shock – which can leave one totally dazed, incapable of action, and even forgetful of the simplest things - people typically have a sense of disbelief. “I feel as if I’m in a dream,” they may say. This sense of unreality usually extends to a state of denial where the response is “This can’t be happening to me,” or “The lab results must have got mixed up.” Denial usually gives way to anger. “Why me!” is a typical response, as if Fate has singled them out while sparing the person down the road who smokes two packs of cigarettes a day and drinks like a fish.

When people can no longer deny that the diagnosis was correct and they do have a serious illness, they usually try to “buy time” by bargaining with their God. They believe strongly, that in exchange for changing their ways perhaps, their condition will be reversed or put on hold until some long-awaited event takes place, such as a wedding. There are many stories of how people have hung on in such a way and for some time.

When people realise no one is coming to their rescue, feel increasingly impotent to change or reverse the course of their illness and that they have no future, they become depressed. When people realise there is no more help, they usually come to an acceptance of their fate and to the realisation that this is the natural order of things. Whether you call it resignation or acceptance, the atheist and the believer come to their acquiescence in their own ways.

You should always be aware that these reactions do not follow a prescribed and orderly fashion.

In my next article I will provide you with some handy hints and explanations on how best to communicate with someone who is seriously ill. Of course, you may have found some useful skills yourself and I urger you to write to me at joel@healthnews.com with these so we can share them with everyone.

In the meantime, consider these “clangers” you should avoid:

• Bad Clanger: “Don’t worry, you’ll be fine. The doctors know what they are doing”
• Worse Clanger: “I’m sure everything will be OK. Just be positive.”
• Worst Clanger: “ Everything happens for the best.”

In light and peace

Joel