Bad Manners or Good Etiquette?

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Well, at least it’s not c-a-n-c-e-r! 

 

So many times I hear this pronouncement when someone shares the travails in their life or that of a person close to them.  What does this self-assuring phrase mean to the utterer? What does it mean to the hearer?

It harkens me back to the victorian age when C-A-N-C-E-R was hissed in hushed tones, as if saying it in polite conversation was unseemly, bad-form, or worse – made the disease communicable.

To the one sighing in relief, “well…at least it’s not cancer”, it is comforting as if this means the sufferer in question has somehow dodged a terminal bullet.

To the recipient of this sighed utterance, it can mean further isolation – especially if you yourself has C-A-N-C-E-R. Those of us with C-A-N-C-E-R do not have a red letter on our chests (or a pink, or a purple…but I digress).

It may mean that in the minds of the speaker anything is still better than c-a-n-c-e-r … that O-T-H-E-R disease. It may mean that C-A-N-C-E-R is still the feared death-sentence that it has historically been. It may mean that subconsciously people do not b-e-l-i-e-v-e the propaganda perpetuated by the C-A-N-C-E-R   I-N-D-U-S-T-R-Y. They may not believe the rhetoric that “awareness” is somehow a cure. They would accept anything but c-a-n-c-e-r.

I don’t buy into the billboards, TV commercials, print ads, direct-mail advertising, pop-up ads, runs, walks, retail-awareness. I do, however, understand the fear and the loneliness C-A-N-C-E-R can engender in a person. I would not wish C-A-N-C-E-R on my worst nemesis. Yet, I will not be hushed when I say C-A-N-C-E-R when speaking about myself, because it is part of life and reality.

What do I say in return when I am privy to the sighed utterance, well at least it’s not….     ?

Nothing.

I nod.

It would be unseemly and bad-form to do otherwise. One social faux-pas in a conversation is quite enough.

The "Cancer" Conversation

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The "cancer conversation" can be a focal point of stress for me, personally. It is not that I don't or won't converse. When specific, non-judgmental inquiry is initiated I do not have any qualms about answering. The open-ended "how are you feeling"? Or the blatant, expectation for me to "dish" - I can feel my emotional protective wall envelope me. Not because I am protecting myself from the inquiring person, but because I am protecting myself, from myself.  More so when family "expects" me to be the one to initiate the discussion. I also, selfishly, (and I do use that description quite a bit when trying to express how I am dealing with my chronic illness. Not because I am being self-deprecating, but because cancer is a "selfish" state of being) squirm at the thought of having to deal with the inquiring persons reactions.

Then there is the discomfort of the unknown. When presented with the open-ended query of: "how are you feeling [or doing]"; I am not sure just how much the inquisitor really wants to know. We live in a society where the perfunctory start to every conversation, whether it be with the SB Barrista, a client, an adversary, or a BFF, starts with "how are you"

In short, its complicated

The below synopsis, of a study conducted by The University of Texas' study on cancer communication, delves into the complexity of this "conversation."

Reprinted from "Navigating Cancer" - October 12, 2011

Some people choose to discuss their health concerns with those who are closest to them. Others prefer professional counselors, support group members, other survivors, or acquaintances made through the Internet. Not everyone finds the connection they need from the same source, and the depth of the conversation will vary as well.

Communication about an illness was the focus of a study conducted at The University of Texas which provided interesting results. Researchers specifically looked at patients asserting control over how they chose to discuss their illness, or chose not to discuss it. The overall findings suggest when patients assert control over communication it helps to overcome feelings of helplessness. In this way patients can determine an aspect of how they want to face the challenges of their diagnosis.
Erin Donovan-Kicken, assistant professor of communication, led the research to examine the strategies people with cancer use to communicate with family, friends, and colleagues. Donovan-Kicken and her team interviewed cancer survivors on how they approached the topic of their diagnosis with various audiences. The team gathered data regarding the advice patients received, the challenges they faced, and the recommendations they would make when talking about a disease. The participants were also asked to evaluate existing patient literature and how they managed information about their illness.

The study results indicate that asserting control over communication is an important factor for patients coping with the stress of cancer. Yet despite best efforts to control that communication, patients can’t control other people’s reaction. Patients will benefit from setting boundaries with family and friends when they need space to be ill or feel emotional in private. They should be allowed to focus on themselves without needing to support others, and to avoid people who are overly solicitous. Choosing not to engage in social discussions about an illness can prove to be an empowering decision for some patients.


Ultimately Donovan-Kicken’s research defined the difference between asking –
“Are you opening up to people?” and
“Do you have people you can talk to if you want to open up?”

The distinction is note-worthy for oncologists and survivor advocacy groups who counsel and provide support to patients. Patient literature could also be refined to emphasize what is meaningful about communication from patients’ perspectives. It could include suggestions on how to manage or withhold from personal health discussions, and establish boundaries allowing patients to experience their illness in a way that best suits them.