How to Know What to Say

I thought this was brilliant. So simple, but so brilliant.

I've written a lot about "what to Say/What Not to Say to Cancer Patients" posts. They come up a lot online. They don't usually say much that's new, but they come up a lot anyway, because it's such a raw subject for cancer patients. I think lots of us feel like writing about these experiences will help us work through some emotions.

The LA Times published a piece a few days ago on this topic, but with what I thought was a unique twist: it offered some advice not just on what to say, but also on who can say what to a cancer patient. It was prompted by an experience that one of the authors had with a colleague, who insisted that she come to visit the author after the author's breast cancer surgery. When the author declined, the colleague said, "This isn't just about you."

Of course, cancer isn't ever just about the patient -- it effects family, friends, work colleagues, etc. But, really, as we all know, it's mostly about the patient. We  the Cancerous should really be at the center of things.

And that's what the authors of this article do -- quite literally put the patient in the center of things.

The author with the needy colleague came up with what she calls "The Ring Theory." In their words, here's how it works:

Draw a circle. This is the center ring. In it, put the name of the person at the center of the current trauma. For Katie's aneurysm, that's Katie. Now draw a larger circle around the first one. In that ring put the name of the person next closest to the trauma. In the case of Katie's aneurysm, that was Katie's husband, Pat. Repeat the process as many times as you need to. In each larger ring put the next closest people. Parents and children before more distant relatives. Intimate friends in smaller rings, less intimate friends in larger ones. When you are done you have a Kvetching Order. One of Susan's patients found it useful to tape it to her refrigerator.

Here are the rules. The person in the center ring can say anything she wants to anyone, anywhere. She can kvetch and complain and whine and moan and curse the heavens and say, "Life is unfair" and "Why me?" That's the one payoff for being in the center ring.

Everyone else can say those things too, but only to people in larger rings.

When you are talking to a person in a ring smaller than yours, someone closer to the center of the crisis, the goal is to help. Listening is often more helpful than talking. But if you're going to open your mouth, ask yourself if what you are about to say is likely to provide comfort and support. If it isn't, don't say it. Don't, for example, give advice. People who are suffering from trauma don't need advice. They need comfort and support. So say, "I'm sorry" or "This must really be hard for you" or "Can I bring you a pot roast?" Don't say, "You should hear what happened to me" or "Here's what I would do if I were you." And don't say, "This is really bringing me down."

So simple, but so brilliant. And it can even go on the refrigerator.

As I've said, when discussing this topic, I always try to give people the benefit of the doubt in situations like this. I think people are basically good, and want to be helpful, but sometimes just don't know what to say or how to say it.

Wouldn't a nice schematic be really helpful?