Mia Freedman Sunday 7 August 2011 8:01am

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This week I sat down and wrote two letters I’ve been trying to avoid. One was to an old friend who has cancer, the other, a former colleague whose husband is ill. I’ve known about both situations for a while as the news has slowly seeped from their inner circles to their very outer ones, where I reside.

What to do when you hear someone you know is battling a serious illness? ‘Nothing’ is the answer most of us settle on. I did. These are not women I’d call. I don’t even have their email addresses. So I told myself they probably had lots of support and tried to put it out of my mind.

Until I couldn’t. It just didn’t sit right, especially when I imagined running into one of them in the street. What would I say then?

As a society, we’re lousy at bereavement and possibly worse with sickness. Perhaps it’s the uncertainty. Perhaps it’s an irrational fear of something like cancer being contagious, if not physically then energetically. Or perhaps we’re just more comfortable with our heads in the sand. But should our own comfort really be the priority?

Bruce Feiler author of “The Council of Dads: A Story of Family, Friendship and Learning How to Live”, recently shared an excerpt of his book in The New York Times. Bruce had bone cancer; he also had 3-year-old twins, a working wife, nine months of chemotherapy and 15 hours of reconstructive surgery to deal with. When someone asked his advice on how to handle a mutual friend’s brain tumour, he came up with a list of things not to say to someone battling a dire health situation:

1. “What can I do to help?” (Don’t ask, be proactive).
2. “My thoughts and prayers are with you” (A tired cliché)
3. “Did you try that mango colonic I recommended?” (Leave treatment advice to the doctors)
4. “Everything will be OK.” (You don’t know that)
5. “How are we today?” (Sick people aren’t mentally diminished infants)
6. “You look great.” (Don’t focus on externals).

On this last point, one of my friends had stomach cancer when she was younger and lost a lot of weight during treatment. She works in fashion and I vividly recall how colleagues would say, “You look fantastic”. Even when they knew why she was so thin. Maybe they thought it would cheer her up. It simply made her upset.

Meanwhile, Bruce Feiler’s list of things you should say includes:

1. “No need to write back” (Keeping up with correspondence can be overwhelming)
2. “I should be going now” (Short visits are best)
3. “Would you like some gossip?” (Distraction is helpful)
4. “I love you” or “I’m sorry you have to go through this” (Honest expression of emotions are a powerful gift).

I sent his article to several girlfriends at various stages of their health battles – some in the middle, others out the other side – and they agreed with every point. “Everyone wants to help but you feel powerless enough already, you don’t want to have to ask,” explains one friend who had cancer a few years ago. “I so appreciated the people who just quietly dropped food on my doorstep unprompted. With treatment, it can be hard enough to eat, let alone shop and cook. And I had a family to feed! Meals were a godsend.”

A single friend added that she appreciates being invited out or to someone’s house for a meal. “My illness can be so isolating. Everyone assumes you can’t go out and sometimes that’s true but I still want my friends to include me in social arrangements. At least then I have a choice.”

Distraction was another common theme. Bring it on. “People often feel guilty talking about themselves but I love it! I’m so tired of discussing my health,” said one friend. “Whether you talk to me about the jeans you found on sale or some outrageous bit of Hollywood gossip or your own problems, it’s a relief to shift the focus off me, even briefly.”

When it comes to addressing the illness itself, my friend Janet who recently beat breast cancer has this advice on dealing with the elephant in the room: “When I see a friend who’s going through a tough time, I always open with, ‘We can talk about it for as long as you want, or we can not talk about it at all. Your call!’ And it makes people instantly relax to know they’re not expected to go thru the whole spiel. Because when you’re going through cancer or a divorce or miscarriage, it can be exhausting to feel like you have to tell the same story again and again.”

She re-iterated Bruce Feiler’s point that honesty is never awkward and saying something is better than saying nothing. “The underlying message is that there is no “right” conversation…everyone feels awkward and helpless. Even just saying that is helpful. Tell me it’s crap and I’ll agree and we’ll move on. Also, the sick person understands that it’s all coming from a good place. You just have to emotionally show up!”

Emotionally show up. What a great phrase. I hope that’s what my letters conveyed…

What’s been your experience of serious illness? What do you say when faced with it? And if you’ve been through it yourself or are close to someone who has, what is the best way for people to express their concern?