A friend is doing chemo. What should I say?

We're mostly online friends, and I'm kind of shy. I care but do not want to intrude.

Published February 15, 2008 11:49AM (EST)

Dear Cary,

I am in my late 20s and am what I guess you could consider a savvy Internet user in that I find many of my friends through it. I am not the most social person in the world and can be very shy, so I find it nice to be able to get to know people a little before hanging out. In this day and age it's pretty common, I think, and I don't feel weird or ashamed about it.

Recently I met a woman the same age as me (I am also female) on one of those Web 2.0 social networking sites. We've been following each other on it for almost a year after doing so randomly, and found we have tons in common. We live in the same state about four to five hours apart. Recently we decided to meet up over the weekend in a city between us with our significant others. It went really well -- we all had a lot of fun and got along great. They invited us to come up to their city for a visit sometime, and we plan to take them up on it.

Over the months we've known each other on the Web site, her writings have often involved doctor visits, bouts of feeling physically ill and exhausted for days on end, and occasional mentions of chemotherapy. Not sure what to say, I once made a comment in response to the chemo, but all she said was thanks for my well wishes. I decided not to pry. Once we were hanging out together I did not find out much more except about some side effects she's been dealing with, but she always laughs it off. I feel strange asking, "Hey, so what's wrong with you anyway?" I want to know and understand what's going on with her as I feel a connection with her; I feel we could become close friends despite being somewhat far away. If she does get very sick, I want to be able to be supportive and I feel like that would be difficult if I don't know any details of her illness. She was very upbeat and acted/appeared healthy when we met, but I know that may not actually be the case. She and her fiancé seem to be planning pretty far into the future. Is that supposed to tell me she's not terminal? Or is that just how optimistic people handle this sort of thing?

Fortunately, I have never had someone close to me suffer through cancer, or other health problems that are similarly devastating. One of my grandparents was riddled with prostate and bone cancer before he died, but we were not on the best terms and he lived across the country from me. So I don't know the etiquette with this -- is it inappropriate to come out and ask her about it at some point? Or should I just continue to offer my get-well thoughts whenever I hear she's not feeling so hot? I wanted to ask her in person but I was afraid it would make everything awkward. It does scare me that my new-ish friend may not be around for long and could be sick for a lot of it, but I refuse to let it keep me from being a good friend to her. Thanks for your help.

Trying Not to Be Too Nosy

Dear Trying Not to Be Too Nosy,

Sometimes the way to handle a situation like this is to tell rather than ask. You can tell a person what you yourself have perceived and are feeling without requiring her to disclose anything.

It is nice to sit on a park bench by a lake where there are ducks. The ducks can take your mind off. The way they waddle around makes it seem less serious. Bring something to feed them.

Sit on the bench with your friend and say, If you don't mind, there's something I need to tell you. Tell her what you have observed, and what you are thinking and feeling. In this way you reach across the divide and touch her shoulder and then withdraw, leaving her mystery undisturbed. Well, not completely undisturbed. But you are like a ripple of wind across the surface of her lake. You are not like a diver looking for old wrecks on the bottom.

You might say that you have heard her mention chemotherapy and your understanding is that chemo is most often mentioned in connection with cancer, and so you are aware she may be going through something quite serious. Tell her that whatever she is going through she seems to bear it with admirable cheerfulness and grace. Say that if she wants to talk about what she is going through you are there to listen, and if she doesn't, you respect her choice not to. Tell her that you are not blind to the effects chemotherapy could have, nor unmoved by the possibilities it represents. Tell her that you are not squeamish or afraid. Tell her that you respect the courage it takes to deal with illness. Tell her she may call you or e-mail you at any time of the day and night and you will be there.

Now, your purpose here is just to let her know you are there for her. This may be an emotional speech but don't go overboard. Keep it simple.

She may simply thank you for telling her this, or she may choose to talk about what she is going through. Either way is fine. You have done your part. You are not there to effect some change on her, but just to impart some information. We sometimes feel that if a person would talk about what they are going through, they would feel better, but that is not always the case. Sometimes it is we who would feel better. So however she responds is OK.

Now, having said that, and having gained more information from her, or seeing that she has nothing to say on the matter, you may find yourself with one final persistent worry: You do not want her to die.

That is put in fairly blunt terms because it is a fairly blunt fact. What if her disease were to take a sudden turn for the worse and she were to die without letting you know how grave it was? You might feel that you should have done more, that you should have pushed her to confide about her actual condition. It's not that you could prevent it, but that you want to prepare.

So also tell her one last thing: that your courtesy ends at death's door, that if she becomes extremely grave, you insist on knowing, regardless of the circumstances. Make her promise you only that.

And then feed the ducks.

Dealing with a friend's cancer? See pages 35-38

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