How to have a friend who is ill

Sally N.
Sally N.
Dec 4, 2018 · 10 min read

When I was first diagnosed with cancer, I was pretty flattened by the news, and disoriented. I had no idea how to ask for help or where to turn, but luckily I did have a bit of an instinct to find older friends who had been through a health crisis before. I think in my heart I knew that I would have been totally unprepared to help a friend through a situation like this, and suspected that those in my social circle who were closer to my age also wouldn’t really know what to do, especially those who are not involved in a church or other established community that cares for its ill.

I was right! And I don’t say that as a complaint, because I’ve been SO well tended and fussed over and cared for. I just think it’s sometimes useful to acknowledge the gaps in our understanding prior to tackling them. And we should all be so lucky as to be healthy and stable enough to be able to care for our friends and family when the chips are down. We don’t know what we don’t know till we start learning.

Disclaimer, though: I’m a very social introvert, and I’m not sure how much that informs these preferences. For example, a bunch of people offered to be there if I needed to talk, and I am generally just not the kind of person who needs to talk beyond what’s absolutely necessary, especially if I’m feeling crappy. If you’re not sure what applies to your other friends, just ask them! Articles like this are a good way to open the conversation — just send them something you thought was interesting and ask if it resonates with them. That said, here are some thoughts from my experience:

1. If you want to offer assistance, have a conversation with yourself before you have one with your friend. Look into ways of being supportive (I’ll link some great resources at the end here), and think about ways you’ll be more or less helpful. Your friend might not know whether you like cooking, whether you have a car, whether you’re in their neighborhood regularly, what your financial situation is, etc. I once sent out a plea to my New York friends for weight-gain smoothies, not realizing that half of them don’t really cook, not even smoothies, and that it’s not necessarily practical to be hauling extra smoothies around on their commutes (not a big deal — I just got lots of store bought ones, but it goes to show asking for what you need sometimes requires more information about how it can be provided). Is your work schedule flexible? Do you have a gym membership that allows guest passes? Do you enjoy walking, meditation, saunas, or other activities that they probably should be doing regularly? Are you an excellent researcher who can figure out dietary needs, medication options, clinical trials, etc.? Do you have money? A good stash of cat gifs? A tolerance for hospitals? On the flip side, are you broke? Would witnessing a blood transfusion make you sick? Are you sharing a car with your spouse and already struggling to run your own errands? That’s ok! Once you have an idea of the energy and resources you have available, you’ll be able to make more specific offers, and it will mean a lot to your friend that you did more than fire off a “let me know if I can do anything!” And if your resource right now is your ability to send a couple texts or postcards, that 100% counts as being supportive.

2. It’s not rude to ask your friend to create a list of needs. A lot of people don’t think to do this (I didn’t), but once they get started there will likely be a number of things they could use help with, and once they create a list, it can be shared and updated easily, and managed by caregivers. Encourage your friend to include things that are just for fun as well as all the practical needs.

3. Your friend doesn’t want to be the most important thing in your life, but if you are or were inner-circle close, she probably wants to know she’s a priority. Have you considered how this illness affects your life? Are you willing to change things about your plans and daily habits in order to accommodate the new reality, like an activity or commitment that can be put on hold for a bit to free up time?

4. Small, consistent (or inconsistent :) efforts are often more meaningful than one large one. One of my friends has texted me every single day for the last six or seven months to tell me he loves me, and telling people that makes me cry every time. The texts give little updates on what he’s up to that day, and encouragement to face whatever my challenge happens to be that day. They don’t ask lots of questions about how I’m doing, so I’m free to share as much or as little as I’m up to. It would have never occurred to me to ask for that but it’s absolutely been one of the most life-affirming things in my life recently.

5. At the same time, if you are able to do more, it may be worth talking to your friend (or their caregivers) about the big picture. How is their financial situation? Do they have a surgery coming up? Is everything in place for that? Are they happy with their medical team? Are they set for transportation to appointments? Do they have a therapist? An exercise plan that is realistic and achievable? In other words, are all the large necessary components of care in place and running smoothly? If there’s a glitch, is it something you can help with without needing a lot of training and explanation to get started? If their close caregivers are getting worn out, is there something you can take off their plate, or something kind you can do for them directly?

6. This isn’t a requirement at all, but if you happen to be a curious sort and inclined to ask lots of medical question, it’s a nice touch to do some of your own research on their condition. I guarantee your friend has spent hours and hours educating people on their disease, how it progresses, what its effects are, what medications they’re on, at what stage in treatment they are, etc., so they may be tuckered out with explaining what they’re going through. If you do ask questions, use the information to learn more on your own. You don’t want to be trying to lecture your person on their experience, but when you see your bald friend they will definitely appreciate hearing “I’ve been reading about your chemo drugs and it sounds pretty tough, how are your counts doing?” as opposed to “sooo what is chemotherapy exactly?” Plus, your person has been forced to spend massive amounts of time researching all the lousy elements of their situation, which is itself pretty isolating, so feeling like other people are on Team Learn Scary Things is nice. Googling “natural cancer cures” or some such and sending them the results does NOT count, in that it will not help you understand and empathize with their lived experience, it will just make you feel qualified to tell them to eat more broccoli.

Relatedly, if you want to skip the medical conversations and talk about TV and politics, your friend is probably more than fine with that.

7. If you’re interested and able to help in sort of drudgy ways, say so. As in normal life, if you say “let me know if you need anything!” your friend will probably not feel comfortable asking you to spend a night grocery shopping and cooking you a meal that’ll mostly go in the trash. They also won’t feel comfortable asking you to help clean their house, take out the recycling, sit on the phone with the pharmacy for an hour, scoop their cat’s litter box (which you’re not supposed to do with a suppressed immune system), etc. I’m going to be really honest and specific here: my sister would not turn you down if you offered to scoop the litter box. She’s very tired of it.

8. Ease up on the “I’m busy.” I know you’re busy. You know you’re busy. Nonetheless, it makes your sick friend feel shitty when your offers to spend time with them come sandwiched in texts about how you’ll be getting off work late and will need to leave promptly after an hour to pick your guppy up from daycare. Just say when you’re available and that you’re excited to see them. Similarly, don’t be difficult to plan with. I guarantee your girl/boy doesn’t have the energy for this.

9. Your friend is now simultaneously a high risk for flaky behavior and quite hurt by flakiness. It’s so annoying, I know, but energy levels are such a moving target that your friend is likely to bail out on plans. At the same time, if you are one of the precious two or three people who they’ve prioritized to spend time this week, probably mustering the energy all day to do it, if you’re the one to bail it does suck. :/ Keep in mind that while you have about 16 hours in each day of awake functional time, your friend might be working with just a few, which is really limiting for trying to reschedule. (See the spoon theory, below, for more on this topic.) Don’t change plans from something at their house (easy, pajama-friendly, medications close at hand) to going somewhere else, for example, because it may just add an insurmountable number of tasks for your friend (getting dressed, packing water/snacks/medicine, coordinating transportation).

10. Probably don’t bring your new boyfriend/friend/coworker along to lunch. It’s really challenging as a cancer patient to strike up new relationships with people; we’re particularly sensitive, traumatized, tired, and always nervous about what’s going to come up in conversation. Especially if you yourself haven’t seen your friend recently, the two of you are probably needing a chance to re-connect and find a new groove of communicating and understanding one another. Don’t throw an unknown person into the mix without at least checking.

11. It’s OK to rotate out. You have a life too! This doesn’t really apply to me at the moment because my main caregivers are stuck with me and I don’t require much in community support. But if you’re part of a meal train, are tending to an ill friend in person a lot, have picked up housekeeping duties for them, etc., it’s not a lifetime position. I think this goes back to suggestion #1, in terms of knowing what you can offer and what you can’t. Committing to a month or two of helping with XYZ is no less of a help because it comes with a limit!

And finally, for one last bonus round… I avoided specifics because everyone’s different, but just to give a few more ideas of some of the gifts that I’ve been really grateful for this year: fuzzy socks, heating pads, hypnotherapy sessions, food, paintings, video messages, TV, housekeeping services, tea, books, plants, lightweight but warm blankets and scarves, anything cashmere, slip on shoes, essential oils, and pot. You may notice a trend of things that can be enjoyed while lying on a couch. A couple things I got myself that I’ve really enjoyed are a nice expensive pair of gold threader earrings (hypoallergenic for sensitive bodies, comfortable to sleep in, looks nice with a bald head, I literally wore them for months) and a necklace engraved “keep fucking going” that I got myself as a pre-radiation gift.

The amazing thing about living here in this world in this time with unlimited communication and information is that it has never been easier to take care of one another. And on that note, here are a few other folks who have covered this topic better than I have and have such useful things to say:

A More or Less Definitive Guide to Showing Up for Friends — I wish I’d read this a long time ago! This is like the bible of how to be a good friend, there are so many fantastic ideas, both for times of sickness and health.

The Ring Theory — The Buzzfeed article links to this one, and it’s genius. The basic idea is that when someone is facing a crisis, you comfort in (toward them and people close to them) and you kvetch out (toward people who are less close to the trauma). I don’t think you have to abide by this 100% of the time (I’m not made of glass and it’s ok for people to express sadness to me) but it’s a great rule of thumb. Unrelatedly, shouldn’t there be a non-domestic violence-related phrase to replace “rule of thumb” by now?

The Spoon Theory — This article is actually really helpful in helping me calm down a little and accept my limitations a bit more. It’s a visualization of the way a chronically ill person has to manage their energy and physical resources throughout the day, and it helps explain why a friend might cook the whole house dinner and then collapse in a heap without touching the dirty dishes, or get dressed, showered, and fed, and then spend all day in bed.

Finally, here is a model google doc for preparing for surgery and a model google doc for a “how to help” letter. These are both great for surgery situations but I also found them eye opening in terms of examples of communication and clarity in difficult times.

I’m actually a bit hesitant to post this because I would never, ever, ever want to make anyone feel they’ve said the wrong thing or done something wrong. For myself, if a communication doesn’t quite hit the mark, I just say to myself “it’s all love” and focus on the kind intention of the person behind their action or words. But I do think as a society we need more tending-one-another skills and less panic in the face of difficulty, and I hope this is a little bit helpful in that way. As always, I am full to bursting with gratitude and love for everyone who has done so much for me. It’s stunning how fortunate I am to be so well cared for and I can only hope to pay it forward.