I often hear my patients and their families talk about courage. They say that someone faced his illness courageously, for instance. Or that he wouldn't give up. Or that he's a fighter.
When they talk about courage, though, they're usually talking about a very specific kind of courage that has to do with the way that a patient is struggling with an illness. It's about the will to survive, or the desire to beat the odds. Sometimes it's about belief or faith, but often it's about plain stubbornness.
But an example of a very different sort of courage just made its way into the news. David Oliver is a 69-year-old educator, gerontology specialist, and former health care executive. He's also a man undergoing treatment for an aggressive cancer that is treatable, but not curable. And now he's a social media sensation and inspiration to many because of the videos he and his family have shared on Facebook and YouTube.
What's remarkable about Oliver's story isn't that he's making a private struggle with cancer very public, although that certainly is courageous. Instead, what struck me when I first saw his videos was why he is putting his life on display. When Oliver was first diagnosed with nasopharyngeal carcinoma in September of 2011, of course he wanted to fight the disease. But he also wanted to do something else. He wanted to help his friends, family members and colleagues deal with the news. At the same time that he was figuring out how to live with the diagnosis he'd been given, he also helped others to do the same.
What he realized very early on was that one of the worst things about having a serious illness is the way that other people treat us. When we're seriously ill, with cancer or heart disease or any one of a number of life-threatening diagnoses, our friends and families often find themselves at a loss for what to say and how to act. What if the person doesn't want sympathy? What if the person doesn't want to be reminded that they're sick? So maybe that person's friends and family members should act as if nothing were wrong? But that seems bizarre, cold and heartless.
What to do?
It turns out that Oliver's forthrightness about his illness is remarkably effective in cutting through a lot of that anxiety and uncertainty. By putting his diagnosis on the table, and by telling other people not to be afraid of it, he's giving them permission to bring it up, or not. Most importantly, he's telling them that he's still here.
It's not surprising that Oliver's story and his videos have received so much well-deserved attention. He's hit on something that is challenging to the friends and families of people facing a serious illness, and which is difficult for patients themselves. When my patients get a diagnosis that is life-threatening or terminal, all too often they find that diagnosis has isolated them. Colleagues, friends and even family members begin to pull away. It's not that they don't care. It's just that they don't know what to say, and they're afraid of saying the wrong thing.
Oliver's videos are one solution, but few of my patients have the motivation or resources to do what he's done. Fortunately, though, there are things that I counsel my patients and their friends and families to do that are easier than keeping a video blog.
For instance, when one of my patient's friends or family members ask me what to do, I tell them that if a diagnosis is uncomfortable or awkward for them, remember that it's doubly so for the person who's sick. So even if you feel uncomfortable and uncertain, get over it. Reach out to someone you know is struggling with a serious illness and let them know you heard about their situation and that they're in your thoughts. You could also add that you're there for them if they need it. That's all. Say your piece, break the ice and then let them decide what they want to say, and whether they need your support or not.
When my patients ask me for advice, what I say depends on who we're talking about. For their colleagues at work, sometimes the best approach is a realistic yet hopeful message, at least at first: "I've just gotten some very bad news and I'm not sure how things will turn out. But I'm still here and am going to try to work a reduced schedule at least until things are more certain."
For their close friends or family members, a more blunt appraisal can help set the tone more quickly, especially since these are the people we'll be relying on most for support: "I know this diagnosis is bad news and it's an awkward thing to have to talk about, but please don't let that scare you away. I'm going to need your support now more than ever."
Because for all of his courage and energy, that last point is one that David Oliver certainly understands. Fighting a serious illness like his isn't something that any of us wants to do alone. So although it may seem like Oliver's jokes about his chemotherapy are evidence of his fearlessness and independence, I suspect that the opposite is actually true. No matter how courageous he is, he has the good sense to realize that he needs his friends and family around him now more than ever. In order to keep them close, he has to be courageous enough, and even funny enough, to put them at their ease.
For more by David Casarett, M.D., click here.
For more on emotional intelligence, click here.