Talking about it

Late last week, I read a short newspaper piece about author Judy Blume’s recent bout with breast cancer and the current status of her recovery.

Meanwhile, a friend whom I drove weekly last summer to radiation appointments in Boston wrote to say she was leaving her current job – not for health reasons, she emphasized, but because a better job opportunity had come along.

On my run this morning, I saw my neighbor, who lost his wife just a little less than a month ago to cancer, driving his 12-year-old daughter to her new school.

And earlier today as I was preparing to interview a local sculptor for a story about a current exhibit of her work, I remembered that a year ago I had talked to her about a different show she was in, and she mentioned that she was undergoing chemotherapy.

“How are you these days?” I asked at the beginning of today’s interview.

“I’m doing great!” she answered. “I don’t know if you remember, but a year ago I was undergoing cancer treatment. The treatment is behind me and I’m in great health now!”

That fact had nothing to do with the exhibit I was writing about, but an hour later I sent her an e-mail. “Is it okay if I mention that you were treated for breast cancer a year ago?” I wrote. “Some people in the arts community will know you were undergoing treatment and will be happy to hear that you’re doing so much better.”

She wrote back right away and said that it was fine to mention, and I was grateful for that. It somehow seemed important to include the detail of the sculptor’s recovery in my story. The article is not about cancer or recovery; it’s about an upcoming exhibit. But most of the people I know who have experienced cancer treatment want it discussed more, not less. Unhappily, it’s quickly becoming a mainstream factor in most of our lives.

“I’m just relieved that the day is gone when it was inappropriate to talk about breast cancer,” the sculptor wrote to me.

Or any kind of cancer, really. From my uneducated perspective, there’s such a wide spectrum right now. I know people who have made full recoveries and are cancer-free. People who are okay for now but expect a recurrence eventually. People still undergoing treatment. And people like my recently deceased neighbor who knew all along that they wouldn’t survive long.

It’s easy to feel helpless. But telling people’s stories is one thing I can do, and that’s why I included it in the sculptor’s story. “We need to talk about it more,” she said. If other recovering patients feel the way she does, we absolutely should. It may be just about all we can do, and it may not seem like much. But it may matter anyway.

What not to say - but according to whom?

Last month, Bruce Feiler wrote a feature for the Sunday New York Times Style section about what not to say to someone who is in the throes of a serious illness. Soon after reading the article, I heard Feiler discuss the same topic on Talk of the Nation. Both reading the article and listening to the discussion left me with essentially the same feeling: while he made several important points, some of it seemed a little nitpicky to me.

I do understand that Feiler himself went through an awful time not long ago with cancer diagnosis and treatment, which included both chemo and extensive surgery, and I realize how horrible this must have been for him. He’s my age, with children even younger than mine; additionally, we have a good friend in common, so although we’ve never met, I’ve been familiar with his work since he first started publishing articles and books. But I still think his approach to determining what people should and should not say to a seriously ill friend overlooks the critical point that most of the time, those of us who offer any words at all are doing our very best to say the right thing.

I feel fortunate for not having been in his situation myself, nor very many situations at all in which people expressed their regrets to me. When my father was very ill last year, I appreciated anything that anyone said about it – even though, as with Feiler’s experience, there were a few expressions of sentiment that struck me as odd. For example, my father oversees a small farming operation. When he landed in the hospital for four weeks last summer, several of our fellow townspeople said to me, “It sure will be good to see him back out on the tractor.” The reason that seemed peculiar to me is that farming isn’t exactly recreation; it’s hard work. So in a way, it was analogous to if my mother had been sick and people had said “Can’t wait to see her washing dishes again!” Unlike our neighbors, I wasn’t particularly thinking how much I wanted to see Dad out laboring in the hot sun, more just that I wanted to see him back home rather than in a hospital bed: perhaps reading or watching a ballgame.

But when I told my friend Nicole this, she had a sensible explanation. “Seeing your dad on the tractor as we drive past the farm is what we’re all used to,” she said. “It’s familiar, and therefore it’s comforting to us. People who say that really mean that they themselves will feel better when they see him back on the tractor, because a sense of normality will have returned.”

Bruce Feiler would probably point out it’s still not a helpful thing to say because if Nicole is right, the commenters are thinking about themselves and not the patient. Still, some of the points he made seemed a little murky to me. For example, Feiler told Talk of the Nation host Neal Conan that it’s fine to say “I’m thinking of you” but it’s unhelpful to say “My thoughts are with you.” I’m a professional writer, and even I am not sure I quite see the difference between those two sentiments, beyond the syntactic.

Among the worst things to say, according to Feiler, is “It will be all right.” “Not according to my oncologist!” he recommended retorting, and I can understand that; no one has the right to profess omniscience. But surely if you talk about your own feelings – in common parlance, make "I" statements, whether it’s “I’m thinking of you,” “I’m so sorry,” or “I wish I could help more” -- the recipient of your sentiments is likely to appreciate them, or, at the very least, to understand that your intentions were only to be kind. One thing I found curious about his statements was the implication that these situations happen in a vacuum – as if no one who expressed sympathy to him when he was sick had ever undergone their own catastrophic situation, and similarly as if he himself had never been on the comforting (or attempting-to-comfort) side of the equation. Even though he was only in his early 40’s and might well have been the first of his peers to be treated for cancer, surely at some point in his adulthood Feiler has had to conjure up sympathetic words for a friend or loved one. I’m curious as to whether, looking back, he’s satisfied with how he handled it at the time.

The most useful message from Feiler’s essay, in my opinion, is the reminder that saying “Tell me if there’s anything I can do to help” rings hollow; no one ever knows how to answer that honestly. Instead, he says, offer help in the form of whatever mundane tasks you need to do for yourself: take their car in for an oil change, weed their vegetable patch, check the batteries in their smoke detectors. Today’s technology has made it much easier to extend sincere offers of help, as I discovered late last month after receiving unhappy news about a casual friend’s diagnosis. Very soon after I sent a note of concern, I received an email inviting me along with several other people to sign up for a web-based service called Lotsa Helping Hands that provides a personalized calendar detailing what kind of help our friend needs and when. By the time I opened the link, other people had already signed up for the first two opportunities, but I grabbed an available spot late next week to drive her to a chemo appointment. Now I’ll receive updates any time she lists a need.

Of course, rides and casseroles only go so far. Bruce Feiler’s point remains valid: it’s helpful to know what is and isn’t useful to say when you are trying to express sympathy. I do appreciate his essay. But I hope that he too appreciates how much even those who said the wrong thing just wanted to make it clear that they cared and were trying to reach out to him. I hope he does not find himself in this situation again. But maybe another time, what they say will be more meaningful to him, whether or not they follow the rules he sets out.

Under the weather

All was well until 10:30 on Sunday night. Holly had been in bed for two hours when she stumbled into our bedroom crying.

I asked her what was wrong.

“I don’t know!” she sobbed. “I can’t fall asleep and I can’t stop crying!”

The peculiarity as well as the illogic of that response tipped me off that all was no longer well. I tried to settle her back in bed, but she returned to our room within the hour. That time I lay down with her until she fell asleep, but the pattern continued four or five more times throughout the night. By daylight on Monday, she had a fever of 101. I dosed her up with Motrin and left a message on the absent line at school as Tim headed off for the bus.

Holly rested and watched TV all day. Her face was puffy, her nose stuffy. “Mommy, my nose is so tired from blowing!” she wailed at one point. She looked so miserable I didn’t have the heart to try to curtail the TV habit. Quite honestly, I’m surprised the child actors who play the twins on “The Suite Life with Zach and Cody” have lived enough hours to have taped the number of episodes she watched that day.

In the afternoon, my parents were kind enough to babysit for her at their house since I had a previously scheduled appointment. She’d barely eaten all day, but my mother cajoled her into downing a bowl of fresh strawberries. We weren’t even off my parents’ driveway yet after I picked her up when she started to fret. “Mommy, I suddenly feel much worse,” she said, followed by the inevitable projectile vomiting of the whole bowl of strawberries.

At the risk of giving far too much information, I’ll go even beyond my usual Pollyanna look-on-the-bright-side tendencies here to say that if there has to be something that your eight-year-old is going to throw up all over the back of your car, you could not do better than fresh strawberries. It was more like someone dumped a smoothie across the seat than had an actual digestive accident. But anyway.

We continued home. Once there, I mopped out the car with towels and put Holly’s jacket and blankie in the washing machine. Holly took a bath and felt better afterwards, at which point Tim came home looking very pale.

Holly had a good night’s sleep; this time it was Tim who woke on Tuesday with a fever of 101. Holly woke fever-free and cheerfully prepared for school; Tim struggled not to cry in light of the unhappy news that he was going to miss the first day of the sixth-grade three-day outdoor education trip. I promised him if he could shake the fever after one day, we’d drive him up ourselves and catch up to the rest of the class.

So Tim spent yesterday at home watching TV and dosing with Motrin. By the afternoon, he felt better. Holly returned home from school looking well and happy. Until she fell down the stairs and landed on her back. It was a pretty bad fall, although after extensive inspection Rick and I determined that the damage wasn’t serious. She’ll probably have a black-and-blue torso within another day or two, though.

So it hasn’t been the best start to the week for us. Some weeks are like this. We’re lucky ours aren’t worse. The kind of flu from which Holly bounced back easily (and then bounced on down the stairs on her back – but I don’t think that’s any more than a coincidence) would have landed my niece, who has a compromised respiratory system, in the emergency room. I’m grateful both my kids are so resilient to germs and recover from illness so quickly.

Now the upholstery in the car has been shampooed and the empty bottle of Motrin replaced. Disappointingly, Tim woke again today with a fever of 100. There’s still the possibility that he can make it to the third and final day of nature camp with his classmates tomorrow. All in all, we got through it relatively easily. Those weeks when everyone gets sick at once are the kind of experience every parent has but non-parents can’t quite imagine: the stress, the tiredness, the mess of it all.

We managed. Tim needs another day of rest, but soon we’ll all be back on our feet, and Holly has promised to skip a little more cautiously up and down the stairs from now on. Holly probably won’t ask for strawberries again for a good long time, but other than that, as far as I can tell, we emerged unscathed.

Running, symptoms, and lessons from 2010

The idea of a long run midmorning on New Year’s Day was appealing. I thought about how good it would feel to get out into the fresh cool air and meditate on the year ahead: set goals for myself, imagine possible outcomes, focus on areas for improvement.

Instead, I found myself reflecting on the ways in which an unexpected situation – namely, the sense that I had an incipient sinus infection – served as a metaphor for the year that had just ended.

The sense that a sinus infection was about to take hold over me was unpleasant in itself but didn’t really put a damper on my wish to hit the six-mile route I’d already planned out in my mind as I indulged in a little sleeping-in that morning, in the wake of New Year’s Eve festivities.

And besides, I didn’t have a full-blown infection, just the approximate symptoms of one.

So I set out. But it wasn’t as much fun as I anticipated, because even though I was feeling generally fine, I couldn’t stop worrying. What if it got a lot worse? What if after a couple of miles I started to feel really uncomfortable? What if it turned into actual pain? What if I developed a fever?

But you don’t even have a sinus infection, I told myself. You just have symptoms. You’re probably absolutely fine. Besides, it’s a New Year’s Day, so just be brave. This isn’t like the middle of the week when you can call your doctor and ask her to prescribe antibiotics just in case things get worse. Sure, you could put in a call to the practice, but it’s closed for the holiday: you’d have to wait for a call back from the covering physician, and explain your symptoms, and figure out where and when you wanted to pick up the prescription…that’s way too complicated. Just keep running and stop worrying about it.

I reminded myself again that I didn’t have an infection, just symptoms.
And then I told myself that my worrying was ruining what was supposed to be a peaceful, meditative, six-mile run on a mild sunny New Year’s Day.

At that point I started to feel better. I stopped worrying and the symptoms lessened. I started to enjoy the sunshine, the scenery, the tranquility of having the road almost to myself on this holiday morning, the sight of a snowman in a front yard, a red-tailed hawk circling over a field, the aroma of baking from a house I passed.

Then, inevitably, I noticed how many similarities existed between my condition on that run and much of what had transpired in my life in 2010. It was almost as if the incipient sinus infection stood as a symbol for lessons I may or may not have assimilated, but certainly had plenty of opportunities to do so, throughout the previous twelve months.

For example:

• I nearly ruined my chance to enjoy what I was doing because I was too busy worrying about what might happen in the near future. Even though I was feeling fine, the prospect of hypothetical problems kept me from focusing on what was actually happening.

• At the same time, I tried to tell myself that what all signs pointed to couldn’t possibly be true. Although I had the three or four primary symptoms of a sinus infection, I kept telling myself I didn’t have one, rather than accepting the fact that most of the time, if enough signs are pointing in the same direction, chances are it’s an accurate reflection of the truth.

• And finally, there was the conclusive realization that it was just good sense to take precautionary measures. Even if I was bound and determined to will myself back to perfect health and refuse to admit the possibility that an infection might still be brewing, trying to reach the physician on call at my doctor’s office and asking for a prescription for antibiotics early in the day rather than waiting until the middle of the night was a sensible solution.

Inexplicably, by the end of the day I felt all better. The symptoms were gone. And that was great; I was delighted to have started the new year on such a promising note. But if I needed one last review of the lessons of 2010, I’d had that as well. Don’t worry so much. When irrefutable information presents itself, use that to draw logical conclusions. And pursue sensible measures to improve the chances of a positive outcome.

Illness as metaphor: a peculiar phenomenon indeed, but I paid attention. And I very much hope not to make any of the same mistakes in 2011. Here’s to wisdom. And health.