How to talk to someone who's terminally ill
So you have a friend or relative with a terminal illness, and you’ve decided to go and see them.
Well done! You are a hero. For many people it takes a lot of courage to confront death in any shape, whether it’s someone who’s dying, or someone who has lost a close relative or friend.
Now the next big question arises. What do you do, and what do you say when you get there?
First of all, it’s important to realise that your very presence is at least half the battle won. The fact that you took the time to come speaks a huge amount about your caring attitude, and the person you visit will already appreciate that very much. So you are starting from a winning position.
As for how to behave with the dying and bereaved, there are no hard-and-fast rules, because everyone approaches their own death differently; some want to talk about it, others don’t. Some are at peace, others are bitterly angry with their lot. Some are in pain and discomfort, others are managing pretty well with their meds. So what I’m about to say is personal to me, and you’ll have to figure out how to adapt all this to the specific person you are going to see.
Right, having said all that, here it is:
Muzza's A-Z for how to (and how not to) talk to the dying
A is for Almond Cake
Or apricot slice. Or apple juice (but maybe not alfalfa seeds).
It’s by no means essential to bring food or drink, or any sort of gift for that matter. But if your visit does include a cup of tea and something to eat, that is always a great way of breaking any ice and dispelling awkwardness.
A great thing to say to a terminal patient (e.g. me!) is: “Here, have another slice of almond cake and a glass of wine - and why not some more chocolate while you’re at it.” (Patient makes Homer Simpson drooling noises...)
Grade: A
B is for Big Hug
Ok, this is a hard one for Kiwi blokes, so it might just have to be a Big Warm Handshake for some. But a huge amount can be communicated in a physical touch, and often it is a trigger for the release of healing emotion (see G for Grief).
Grade: A+
C is for Cousin Charlie
"Let me tell you about my cousin Charlie who also has cancer - you’ll be interested in this."
Sorry, but I’m having enough trouble coping with my own cancer; it’s not really all that helpful to hear about other people’s doom and gloom. It’s not that I don’t care about your cousin Charlie and his ailments, but I’m already up to my eyeballs in medical strife, and I don’t need any more of it in my life right now.
Grade: D
D is for Days
..as in “How are you spending your days at the moment?”
Good question: gives me an opportunity to tell you about my world, what I’m doing, what I’m thinking about. Helps me to feel you really are interested in me as someone more than a terminal patient - I am still engaging in interesting stuff. Might not be appropriate if the person is confined to their bed and hooked up to seven different machines. Or then again, maybe it is - you never know where they can go in their mind.
Grade: A-
E is for the Elephant in the Room
I’m surprised by the number of people who come, pass the time of day, and then go, with no mention being made of why they are there. There are words like Cancer, Terminal Illness, Death that are so charged with terror that some people feel the best way to cope is to avoid them. This leads to a slightly surreal conversation which tiptoes carefully around the essential. That's ok if the sufferer is wanting to avoid the sensitive topics too - but not ok if they want to engage with you about their situation.
Grade: C
F is for Family
“How is your family coping?”
Great question. This is often overlooked, and it’s the family of a terminal patient who often bear the biggest burden. You’re giving the dying person a chance to unload some real concerns for his or her loved ones.
Grade: A
G is for Grief
Emotions sometimes run high as you see someone who is dying, and realise they may soon be gone. Don’t be afraid to cry if you feel like it. Your tears are a way of showing how deeply you care, and even if I don’t feel like shedding any myself (which may or may not be so) I will always be deeply touched to see yours. It feels like you are wanting to enter my pain and share it with me, which is powerful. And don’t apologise for crying - it’s a perfectly normal way to behave in the circumstances.
Grade: A
H is for “How are you?”
This is usually ok as a way of opening a conversation, what the experts call “phatic communion”. But if you really think about it, the correct answer in my case is “Not so great, I’m dying of cancer.”
Grade: B-
Just a small change can boost your grade bigly: “How are you feeling today?” allows me to say “Quite well, actually”, or “I’m pretty exhausted”, or whatever the truth is.
Grade: A
I is for International Politics
“Speaking of bigly, what do you think of Trump then?”
A good conversation about politics or history or anything interesting is fine. Again, it allows me to be someone much more than a “terminal patient” - I am still fully engaged in the human race.
Grade: A-
J is for Jokes
Or any sort of humour. Often it will be mordant black humour, as we all face mortality and try to “keep them laughing as we go”, to quote Eric Idle. You have to know your audience here, and gauge whether their laughter is genuine or forced. If it’s genuine, you will have brought the dying person a great gift.
Grade: A (if your jokes are any good, and not too long...)
K is for Knowledge
“I know just how you feel.”
No you bloody well don’t. This is one of the least helpful things you can say to a terminal patient - or to anyone for that matter. No one can truly “know” what it is like to be someone else or go through what they are coping with. But there’s nothing wrong with saying “I had a similar experience”, or “That resonates a lot with me”.
Grade: F
L is for Longer
“How much longer do you think you’ve got?”
A tricky one, and it would depend on how willing the person is to discuss the details of their illness, and their prognosis. It can lead to all sorts of interesting other questions about mortality and what they intend to do as the clock ticks down. I’m very comfortable talking about this, but I admit I may not be a typical sufferer in this case.
Grade: C+
M is for Mud
“Have you heard about this incredible alternative treatment: my grandma had terminal cancer of the belly button, and she found this amazing website and ate only mud and grass for six weeks, and last we heard, she’s rowing solo across the Atlantic! You should try it too. You’ve got nothing to lose… (oh, I forgot to say, it’s a special sort of mud you can only get through a pyramid selling scheme, and it costs $800 a kilo, but hey - better than the alternative, right? Ha ha!)”
DO NOT, I repeat, DO NOT try to convince a person who is dying that you have some miracle cure for them. They have their own medical specialist; they have chosen their own pathway, and that must absolutely be respected. Suggesting that they might be missing out on something special is dumping a big load of guilt onto them - what if this mud really is the ticket, and I turned it down? Besides, there are very good debunking websites like quackwatch.com, and your miracle cure will have to be pretty friggin' good to get past those guys.
Grade: F- -
N is for Normal
You can probably take the rest of these instructions with a grain of salt - and please don't get paranoid about them if you are actually coming to see me!! But this one really is important. Just be normal. The fact that I'm facing a terminal illness hasn't turned me into a museum specimen, or a some sort of terrifying freak. I'm still the same lovable idiot I always was. Treat me as you have always treated me and you can't go wrong.
Grade: A
O is for Opportunity
“Has this experience changed the way you think or believe?”
See your visit as an opportunity - if the person is willing to go there (and, more importantly, if you yourself are willing to do so!) - to explore issues like life’s meaning, the afterlife, and so on. Of course, I'm speaking for myself here: I'm a literature and philosophy teacher, so I would say this, wouldn't I. This stuff might be the last thing your friend is into, so handle with care.
Grade: B+
P is for Prayer
"You are in my thoughts and prayers”.
Hmm. Depends. This can mean a number of things. 1) I am saying what I think you want to hear, but actually I wouldn’t know what prayer was if it hit me over the head. 2) I really am thinking special thoughts about you, or sending vibes to the Universe. 3) I am talking to the Person I often communicate with, and asking Him/Her to look after you and give you peace. 4) I am asking God to heal you.
If your friend is religious, they will be comfortable and encouraged to hear such statements, so go right ahead. If they are not, they may be left wondering how to respond - or they might think you are trying to draw them into your way of believing. In that case, even if you are a genuine person of prayer, it might be better to say something more neutral like “You are surprisingly often in my thoughts - I can’t stop thinking about what is happening to you.”
Grade: Ungraded
Q is for questions
A good conversation will include interesting questions flying from both sides. When you leave, you can ask yourself “Do I know anything significant about this person that I didn’t know before?” - and if the answer is yes, you have probably asked some pretty useful questions. And conversely, a positive answer to “Do they know anything more about me?” indicates that they were asking you good questions too. Don’t get me wrong, it’s not a mutual interrogation, and conversation can flow in all sorts of ways. But a good question (followed by some good listening) can unearth gold.
Grade: A
R is for Rough Weather
“Rough bit of weather we’re having. And what about those All Blacks, eh?”
Nothing wrong with a bit of small talk to get things going, and many people are happy to stay at this level. Once again, I may be a bit of an outlier here, but when people come to see me I don't want to stay focused on trivia for the whole visit (and sorry, New Zealand, the All Blacks are trivia, whatever you may think. Pauses and waits for thunderbolt to strike…. Whew, not this time.)
Grade: C+
S is for Screwed
“So - you’re screwed then?”
Kids, don’t try this at home. Someone actually said this to me a couple of months ago, but he’s a very dear friend, and the kind of guy who can get away with it (and I thought it was quite appropriate and funny!). Euphemisms (“pass away”- yuk!) should be avoided in favour of the good word “die”, but so should language that is too blunt.
Grade: F, unless you are my friend R.K. In which case: A for calling a spade a spade!
T is for Tough
“It’s pretty tough for you right now, isn’t it.”
If you can see that your friend has been having a tough time (and if they have a terminal illness, it’s unlikely that they haven’t) then this is a good way of showing that you understand, and an invitation to explore the levels of toughness that the whole experience has involved. Or they might surprise you and say “Actually, no, it isn’t”, which also opens up a way to explore why this should be so.
Grade: A
U is for Unpleasantness
“Let me tell you about all the unpleasantness I’m having to deal with at work.”
Aaagh! Try to avoid talking too much about the negative stuff in your own life - I need to be uplifted, not dragged down. I may be interested in your difficult work issues, but it’s more likely I won’t want to hear another tale of woe - got enough of my own, thanks. (See also “C is for Cousin Charlie”).
Grade: D
V is for Vacating the Premises
What did Burt Bacharach (or was it Hal David) say - “Knowing when to leave can be the smartest thing anyone can learn, go!” Remember that your friend is ill, and may tire easily, so don’t overstay your welcome. Forty-five minutes to an hour is a good length of time for a visit, but if the conversation is rocking, it’s fine to stay for a lot longer, as long as you make sure you check with them whether they have the energy to continue.
Grade: A (for knowing when to leave)
W is for “What’s it like…?”
“Tell me what it’s like for you at the moment.”
“What’s it like to be coping with this whole thing?”
These are some of the best questions you can ask. They are open-ended, and you are inviting your friend to let you into his or her world, without putting any conditions on the nature of that revelation.
Grade: A++
Y is for Your News
“I’ve just had a promotion”.
That’s great! I do want to hear the good stuff about you
Grade: A
Z is the last letter in the alphabet, and I've run out of inspiration
So that's it. Now you can go and see them, all primed up. Don't beat yourself up too much if you get it wrong. Remember, the fact that you're actually daring to go is the most important.
Good luck!
