Ask for Candor from Sick Friends

Be direct — and ask them to tell you what they need. Or follow cues.

“I don’t feel very much like Pooh today," said Pooh.
"There, there," said Piglet. "I’ll bring you tea and honey until you do.”
― A.A. Milne, “Winnie-the-Pooh”

If you’ve ever been seriously ill, you’ve seen how it affects the people around you. Some rise to the occasion beyond what you’d ever expect — and others disappoint you. Some try but don’t get it right: A slight acquaintance might overstay her visit in your hospital room, while a close friend may send a stream of texts and never show up. Did you ever wish you could find a way to be polite and also tell people what you need? As the concerned friend, have you felt inept or confused and wanted to ask for instructions? In “How To Be A Friend To A Friend Who’s Sick,” Letty Cottin Pogrebin says go right ahead.

A longtime journalist, Pogrebin began thinking about this book while waiting for her breast-cancer appointments. She became intrigued by the variety of reactions to her own diagnosis in her social circle and her own happiness when friends read her needs accurately. Her advice is distilled from more than 80 interviews, many with patients she met at the hospital. Her key recommendations to helpful friends: Ask and listen.

As soon as sick friends tell you about their diagnosis, Pogrebin suggests that you say something like, “I want to be helpful, and I want you to tell me exactly how I can best do that.” Be specific and say, “Tell me when you want me here and when you want me to leave. Tell me what to bring.”

Don’t offer cheer-them-up homilies like “I’m sure you’ll be fine” or “It could be worse.”  “These lines are not helpful. Ask yourself if you would be comforted by the words you are about to say to a sick or distressed friend,” Pogrebin says.
For the same reason, don’t talk about people you know who had something similar and are now fine. Don’t tell your friend she looks great when it is obvious that she looks anything but.

Don’t say “I know what you’re going through” unless you actually do.

Don’t assume your friend would want the same things you would. Some gifts, for example, your own favorite DVD or book, are a way of sharing yourself. When your friend is ill, give her the new book by her favorite author.  

Don’t offer advice on health matters. It may be a struggle if you think your friend isn’t getting the best advice or making the right decision, but avoid second-guessing. People “don’t need us to add to an already complex, frightening and confusing situation,” Pogrebin says.

Don’t call or write with questions. “My interview subjects told me over and over that they felt stressed by phone calls and emails containing questions about their illness,” she says.

Don’t gossip. Ask your friend what you can and can’t talk about with others. As a patient, be explicit if you want confidentiality. Some people are worried that gossip could affect their job security. Health providers can give you information if your friend doesn’t object and you can pick up prescriptions. For more details, see this Q & A.   

Don’t overdo it. “You have to tune in, read her body language, and ask her to tell you when you’re too solicitous or overbearing. We have to give our sick friends permission to be honest, and assure them that we won’t be offended or insulted if we’re asked to back off now and then,” she says.

Many people don’t want visitors when they feel most sick. The instinct is “to make conversation, to make people feel at ease, to reassure our friends that we’ll be okay when they look stricken by our situation — all of which is hard work,” Pogrebin says.

Do draw up a list of possible chores you could perform — such as picking up children at school or shopping for groceries.

Do offer help to the direct caregivers in your friend’s life, usually a spouse, sibling, or adult child.

Do make it possible for a terminally ill friend to say goodbye. Pogrebin suggests, “gently open the door to a last conversation and leave it up to the patient to either close it or walk through.”

For other tips, you might look at “Passages in Caregiving: Turning Chaos into Confidence,” by Gail Sheehy; or “Do Good: 201 Ways to Lend a Hand,” by Marcy Silverman and Cindy Sacks.

Pogrebin says she’s changed her own behavior with sick friends. “I have the ‘honesty conversation’ at the outset. I don’t ask a million questions about their illness. I wait for them to indicate whether they want to talk about their condition or Other Things — that vast category of subjects that make up normal conversation among friends. I try not to treat them as Cancer Girl or Heart Attack Guy,” she says.