When facing a cancer diagnosis, you quickly learn who shows up and who retreats. The impact of illness on relationships was one of the topics discussed with four cancer patients in the Center for Communication in Medicine’s video “Voices from the Lived World of Illness.” As producers of the video, psychologist Dr. Bernard Bandman and I were invited to appear on The Health Show, a public radio program. We asked oncologist Dr. Lidia Schapira, an advisor on the project, to join us on the phone from Boston.
As we sat at the studio desk, the host chose to introduce the topic of relationships by airing an exchange between the patients about their personal experiences. First, we hear George telling us, “It sorts out who your friends are very quickly.”
Adrienne adds, “And, who you want to spend time with.”
Without hesitation, George responds, “and who wants to spend time with you.”
Then, we hear Pete say, “Yes, they were friends but where do they stand when the going gets tough? A lot of them have been there that I wouldn’t have expected.”
Looking across the studio desk the host asked Dr. Bandman for his thoughts. He said, “There can be wonderful surprises and deep disappointments. You see family, friends and medical providers who are there and those who pull away. Illness redefines the nature of relationships in one’s life.”
I described my role of medical humanist and explained that I would ask patients how they and their loved ones were coping with illness, which I documented in a note for the cancer care team. Then, I referenced what a patient described as “The experience of being embraced…feeling their arms around you…and then the sudden realization that they have fallen into your arms and you are holding them up.”
Dr. Schapira, calling from her office at Massachusetts General Hospital, noted, “Patients describe moments of exquisite kindness, which can change them forever for good… or bad, if a relationship shifts. A person with metastatic cancer experiences multiple losses at different levels: loss of future, sometimes career and so many more.”
For me, it’s inevitable that illness will impact the relationship between patients and loved ones, which speaks to the importance of communicating openly about one another’s needs and concerns. In my work, I have observed that clearly articulated expectations can reduce the chances of misunderstandings, disappointments and regrets. For that reason, there’s a chapter titled “Speaking With Family and Friends” in SpeakSooner: A Patient’s Guide to Difficult Conversations, a tool I developed to help identify issues and concerns in facing serious illness.
Frankly, it really doesn’t matter who opens these conversations as long as there’s thoughtful communication about the kind of support needed for both patients and loved ones to “hold one another up” during trying times.