Fine, Thank You

November 15, 2010 at 11:37 AM (Awareness, Family, friends) (, , , , , )

As I climb back out of the chemo pit I fell into last Tuesday, I am greeted by Christopher Hitchens’ latest brilliant column in Vanity Fair, on Cancer Etiquette. Now, as anyone who has personally encountered The Big C will understand, there is a whole new book of rules that apply to those of us on the ugly side of the fence. And, as Hitch so brilliantly reminds us, the proper response to “How are you?” is NOT a lengthy discussion of your latest symptoms, scan results, and tumor diameters.

Conversely, the asker, when returned with a simple, “Fine, thanks, and you?” should NOT, as happens so frequently, re-state, “Yes, but how ARE you?”  There may be things the patient doesn’t want to talk about. Maybe she’s had a long day of explaining to everyone how she’s really doing, and is sick of it. Maybe the news is bad and she doesn’t want to get into it right now. The sharing of bad news is particularly difficult, as the toughest part for me of having Stage IV cancer (and, as Hitch notes, the thing about Stage IV is that there is no Stage V) is having to explain to people what’s really going on inside my body, how dire it is, and watching and dealing with their reactions. Because, frankly, I’m not very comfortable with my own reactions to the situation, and I’m not exactly equipped with the emotional fortitude to comfort you when you hear my news. Hence the “No-Cry” zone I’ve erected around me since 2006; if you lose it, I’m going down, too.

On the flip side, there are those who feel it will be encouraging to share with the patient the story of another person they’ve known, personally or, my favorite, “my sister’s best-friend’s boyfriend’s cousin’s mom” who had the same, or perhaps completely different, cancer as I have, and who took every treatment plus radiation and is now hiking Amazonia/lived thirty years past doctors’ expectations/died a horrible, lengthy and agonizing death in sub-standard hospice care. Whether uplifting or depressing, these stories leave the patient wondering: 1) Is she telling me this story to make me feel better? 2) Is she telling me I’m going to die the same way? And, as Hitch found out, 3) What the hell do I say next? Frankly, we can all do without (see para. 2) having to come up with conversational tidbits to make you feel better about your story/aunt/distant acquaintance and the outcome of their cancer.

You see now why my standard response to the question in question has become, “Upright and conscious.” For those not in the know, my answer is funny, just another frazzled, sleep-deprived mom-on-the-go; for those who are well-versed with my sitch, it’s an honest assessment of my day, at least that part of it that I’m in right now. “Fine, thank you” just leaves too many open ends.

Instead of trying to relate to your friendly neighborhood cancer patient, to make her see how closely you understand what she’s going through (because, unless you’ve been the one holding her hair back for her in front of the throne and massaging her neuropathic feet, you can’t), just ask her if she’d like some company. Bring her a coffee, or take her out for one. Talk about the weather, your kids’ soccer games last week, how annoyed you are by Christmas commercials on November 1. If she wants to talk about cancer, she’ll be more likely to when she knows you’re there for the long haul than just the quick update.

Gee, chemo seems to make me a little bitchy. Aren’t you glad I’m back?

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  1. Thad said,

    I love your posts Sarah.

    Oh… and how are you? 🙂

  2. Carol said,

    So glad that you’re back. Want a foot (or back) rub?

  3. Mr. Wonderful said,

    God I love you. And glad you have climbed out of that chemo hole.

    Great post. Could not have said it better myself. Having spent much of my time explaining to others how you’re doing, I find myself in the same place – watching the person’s face change or go to tears and trying to help them understand or feel better. But, as I love to say – it is what it is. You cannot talk your way out of cancer. Wish you could, but you can’t.

    “Upright and conscious” and “in my office” are perfect for you – even the kids know that.

    Looking forward to family dinner tonight. Love you.


  4. tori said,

    Do NOT confuse bitchy with honest. (because I’d be the biggest bitch of them all) That said…I’m totally gulity of some of that. Sorry – won’t happen again.

  5. Betsy said,

    The courage to tell it like it is. I love this.
    Don’t know you very well, but would love to bring you a coffee and chat sometime.
    Keep telling us what you need, and what you don’t need. It’s a good thing.

  6. Kale said,

    oh my, how perfect! I *love* this post. Thanks, Carcinista!!!!! I’m linking this as my post today on my tiny new thing, so at least my friends and family can read it! xxooo

  7. Laura B said,

    Thank you. I have been struggling with this issue, all summer, now fall, too… I was going to have a t-shirt made that said something like

    ask what, not how

    I’ve tried telling people that “what’s going on” leads to a more interesting conversation than “how are you” but, it is hard to change a culture, with merely one sentence…

    Wish I could come and give you a foot massage, having been there, on the neuropathy front… hugs, even tho’ I only know you thru your blog…

    “Laura Doula”

    ps I agree, honest is not the same as bitchy! tho’ those not liking honesty, might try to use that label, in order not to listen, or hear

  8. Anna said,

    It’s hard to find that middle ground with the “How are you? or How are you feeling ” isn’t it ? It’s such a loaded question. I mean, do you really want to go there ??? I think most of the time all I really want is a normal conversation and not an analysis of my entire medical file and current mental state. Could we just talk about the latest train-wreck episode of Real Housewives ? Puleeeeeassse !

  9. Stacey said,

    I hate the “How are you feeling?” question. It’s always from someone giving two minutes of their time to seem concerned. I just want to tell them to shut up. They’re not helping, but that would be too shocking and then I’m seen as the pitiful, cranky one. It’s true you really learn who your friends are. Real friends will never ask that ridiculous question. They know how to show concern without that.

    Great post.

  10. Christy said,

    Thank you for another honest and humorous post. I laughed hard reading about the same experiences I have had. I am amazed how many people say the same things to us, such as they know someone who was a Martha Stewart/Betty Crocker/Mary Poppins who worked full-time and volunteered at an orphanage, all while enduring treatment with the positive attitude of Pollyanna. Or, they knew someone who died from cancer and they seem to enjoy sharing every detail. It does get tiresome to have to deal with others’ feelings and drama, especially when they are just casual acquaintances. It’s amazing what some people will say! I’d love to see a post on stupid/rude/ridiculous things that people say to us.

  11. Maggie said,

    Great post! My favorite comments include those that compare my situation with theirs.

    “I understand because my business is just awful right now, like a cancer, and you and I have much in common!”

    The only difference is that if I stop showing up to fight the cancer, I die, you stop showing up at your job, you just lose your job.

    You keep showing up, and so will I. Thanks for your wonderful wit and honesty!

  12. Sven said,

    This is a very wonderful and inspiring post and blog. Even from a non-cancer perspective I’ve always hated the whole “How are you? routine. I mean, we all know we can’t and don’t want to share all our most intimate feelings with every neighbor, so why pretend and then constantly force ourselves to self-edit or even lie? I think it would be cool to have a post with all the possible translations of the dreaded “How are you?” That would be book-worthy!

  13. Sue Mellusi said,

    Awesome post, as always Sarah.

  14. WhiteStone said,

    There is no stage V?????
    Dang. I was looking forward to an upgrade.

  15. Elaine said,

    This post perfectly describes with precise honesty the internal reponses that we often do not articulate. I laughed out loud… keep writing!

  16. Nancyspoint said,

    I find most people who ask me how I’m doing don’t REALLY want to know the details anyway, so I just give a quick pat answer revealing little. Sometimes you can almost see their sigh of relief. I’m thankful for the few people who do want the details. I think every cancer person needs at least one person like that! Great post! Thanks

  17. kasey fox said,

    Oh you made me smile. I loved it. Keep up with the writing. It was a crazy fluke thing that I found you or found this website, since I refuse to sign up for Facebook, but I am so happy I did Sarah. Send me an email and we can trade digits. I work from home a few days a week and would love to have a cup of coffee with you over the phone.

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