Should You Force Someone With Cancer to Talk About Death?

PJ Hamel Health Guide
  • Washington Post Style columnist Carolyn Hax writes an Ann Landers-type column, answering readers’ questions about relationships, sex, family issues, and the like. But in last Sunday’s Post, Hax examined a subject none of us is comfortable with: death. Here’s a synopsis of the column:

    “Dear Carolyn: I was recently diagnosed with an aggressive cancer and have been dutifully if miserably going through treatment… How do I get the people in my life to confess out loud that this could, and in all likelihood will, kill me? Everyone around me is insistent on being optimistic and denying the truth that this disease kills people every day, and I could be one of them. I try to talk to them about what will happen to my things, and what their plans are when and if I die of this, just as if I were hit by a bus, but they stick their heads in the sand and refuse to have the conversation with me… So why will no one discuss it with me? – V.”
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    Carolyn’s answer was blunt and to the point: “I am… sorry that your well-meaning but cowardly intimates have left you no choice but to suffer alone… You probably can't call people cowards as easily as I can–you want openness about your impending demise, after all, not enthusiasm. However, I do think you want to use almost that level of bluntness to get your point across…”

    Cowards? Carolyn, COME ON. When your best girlfriend is possibly dying, and you can’t unflinchingly look that fact in the face and have a dispassionate discussion with her about who gets the Cuisinart when she’s gone–are you a coward? When your wife may die, how much time do you spend discussing who’s going to take the kids to day care after the funeral? Maybe your daughter’s going through cancer treatment, and things are looking OK. But she’s determined to talk about the music for her funeral. If you don’t immediately start tabbing the pages in the hymnbook–are you a coward? No. I’d call all of these reactions just plain human.

    First of all, I’m struck by V.’s insistence that “this could, and in all likelihood will, kill me.” While I don’t pretend to know the details of her illness, many, MANY of us have been diagnosed with aggressive cancer. And thanks to “the wonders of modern medicine,” we’re around, years later, to recount our harrowing voyage through treatment and back to health.

    Yes, health. These days, even aggressive cancer is treatable, if not curable. Until you’re in the final throes, having exhausted every treatment—literally on your deathbed, breathing your last–dying is a possibility, maybe a probability; but not a certainty. None of us knows when we’re going to die. Miracles do happen. Carolyn referring to V.’s “impending demise” is making a big leap of (un)faith, in my opinion.

    It sounds like V. wants to examine the possibility of her own death thoroughly, and she’s approaching it by thinking practically of what will happen when she’s gone. Fine; that’s how she’s dealing with this scary situation that so many of us face. But if she dies, what difference does it make to V. “what will happen to my things, and what their plans are…”? Surely, with such close friends and family members, she trusts that they’ll honor her memory and act appropriately. The fact that they don’t want to work through her fears about death the way she wants them to is simply personal choice–not cowardice.

  • My advice to V. would have been far less aggressive. I would have suggested she find a good support group, and talk about death in a setting that doesn’t bring pain to those involved in the discussion. Then I would have suggested she write a detailed death plan–who gets the cat, who does what, who reads the eulogy–and leave it in a sealed envelope with someone close, “to be opened upon my death.”
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    And, Carolyn– I think it’s easy to talk about bringing pain to those around you when you haven’t been forced to. Just telling your family and friends you have cancer opens a whole world of hurt; wanting to discuss the details of death makes it worse. My advice? When you come home from the hospital, leave death at the door. Unless someone else brings it up, it’s a subject best examined in private–or in a group prepared and willing to address it.

    If you have a friend with cancer and WANT to talk about their possible death, how do you do it? Read my SharePost, When Friends Die.

Published On: March 03, 2008