How to Say the Wrong Thing


Kate Riener Boyd

I’ve heard so many unbelievably wrong things throughout my cancer career, I’m no longer shocked. Some comments are so wrong they aren’t worth noting here—they’re not likely to occur to most people. Would you tell a cancer patient you wish you could have chemotherapy because you need to lose weight? No? Because you know that’s a totally boneheaded thing to say? Good, let’s move on.

It’s easy to say the wrong thing. We do it all the time. What’s harder is noticing we said the wrong thing and recognizing why what we said was—inadvertently or not—inappropriate. There are many seemingly innocuous remarks that can upset, irritate or hurt. I’ve heard most of them, and I’ve said some doozies. We speak too quickly, not giving our brains the chance to review word choice, examine our intentions, assess implications and hidden meanings, anticipate how it’s going to sound to the cancer patient.

Here are some of the comments that inspired internal rants.

I’M PRAYING THAT ALL THIS IS A MISTAKE/THE DOCTORS ARE WRONG!

Yeah, if you’re going to pray about me, let’s not make my medical care sub-par, OK? Because if I’m getting pumped full of the Red Devil every couple weeks for no reason, I’m gonna be PISSED. Maybe you shouldn’t be the leader of my prayer chain, I’m not sure I trust your thought process here.

Aside from the ridiculous premise that an incorrect diagnosis is a worthy goal, sharing your prayers is tenuous—your patient may not hold similar religious beliefs. Telling an atheist you’re praying for them is as meaningful as saying you’re enjoying the crackling repartée with the new co-host on Live with Kelly Ripa. Or you found a new Greek yogurt brand with all the taste at half the price. Oh, okay. How neat for you.

Even if you share the same core beliefs, your patient has their own relationship, their own conversation with their own God. Communion with a higher power is personal, and sharing your conversation disregards the personal struggles the patient may be having. Some feel abandoned or lost, angry and alone; they may be internally yelling at God on the daily and think their prayers aren’t being heard. Your prayer doesn’t account for their experience.

I know praying for someone comes from a place of love and compassion. You do it because you want to help in the face of helplessness, and you find solace in reaching out to your God. You feel better by praying. That’s lovely—for YOU, but it may not help your patient. Unless you’re certain your patient finds comfort in your prayer, then you’re really just showing off, cupcake. Who does your comment benefit? Be sure it ain’t you.

I KNOW SOMEONE WHO HAD YOUR CANCER. THEY DIED.

Seriously? Are you the person who sits in economy class and informs your seat mate that this same flight number crashed into the ocean last year? Do you cite highway accident statistics to your strapped-in carpool? Satan, is that you?

I wasn’t raised in a bunker. I know stuff. People die every day; people die from my particular cancer all the time. I knew some of those people too, by the way.

It might be that you were planning to pivot at the end and say something positive like “But I know you’re going to make it!” I bet other super smart folks told your dead friend the same thing at some point. Not helpful, not necessary, not welcome.

WHAT CAN I DO FOR YOU?

Do I really have to figure that out for you? I don’t know your life. I don’t know what you’re good at, what you’re willing to do, how much time you have. Can you make a home-cooked meal that spans four diverse, picky palates and won’t die a slow death in my freezer? Will you pick up my kids and run them around town, even if it’s out of your way and you have to reconfigure your afternoon? Are you silently cringing after asking this question because I might ask you for something you hate doing and can’t afford during a time that’s inconvenient?

Now I have to come up with just the right task for you. But I have my own shit to figure out—like whether or not the spigot of a bloody nose is starting again or if my kid is really as okay as he says he is when I’m sick in bed. I don’t know what you can do for me. F- it, NOTHING.

I know, I know, it seems so thoughtful, so giving, so I’m There For You. I believe that’s how it’s intended. You’re asking the question because you want to give, help, support. You don’t know how to be most helpful, so you ask.

It may come from the right place, but you need to do the heavy lifting. Think of ways you’d like to help, times you have available, skills you count on, resources you have. Offer your services, among options you can live with, and let your patient choose.

“I’ll drop off a stack of magazines this afternoon around 4. I’ll be going to the store on the way so if you need any groceries, let me know. And I’m free Saturday afternoon if you need kid rides or errands.”

Yes, okay, thank you. That’s what you can do for me.

If you really don’t know what would be most welcome, most patients have a sidekick in the know—husband, best friend, parent or adult child—whom you can ask. Find that person.

YOU THINK YOU’RE HAVING A BAD YEAR? JACK’S HAVING A BAD YEAR!

Ah yes, you’re right, the man who died might be described as having a worse year than me. Then again, he could be dancing jigs on a cloud with Jimi Hendrix. How are we to know how his year turned out? If you must use Jack’s death as a yardstick for all human experience, then I wager his widow might be worse off than me. But guess what, jackass? It’s not a competition.

My illness does not trump anyone else’s, nor does someone else’s extreme strife mean mine isn’t challenging. Not a competition, not a zero-sum game. Jack’s world can be devastated by his death, and I can still be going through shitty cancer and shitty recovery. Both things still happen. It also means people around me can still have their own shitty days and need to complain. Don’t apologize or diminish your own experience, and don’t do it to mine.

CHECK OUT YOUR BOOBS! THEY LOOK SO NATURAL! BOUNCE UP AND DOWN!

Are you freaking kidding me?

Watch your step, bub. It’s such a short little hop over the line. Let’s clarify what is appropriate here.

In some settings, using Boobs, The Girls, Tits, or—heaven forfend—Tatas is record-scratch wrong. We all know a bawdy babe who’s offended by anatomically correct words (her vagina has been a snatch since she was 16) but we’re not talking about her. We’re talking about run-of-the-mill women who sometimes say Vagina, sometimes say Hoo-Hoo, and sometimes can’t think about her vagina without thinking of the overdue need for a pap smear. Regular gals.

Regular gals get bawdy too, maybe when feeling tipsy and flirty. And you may be technically tipsy and feeling a flirty air when you see our newly reconstructed gal, but I don’t care. There’s no flirt in a mastectomy. It’s hard and emotional and complicated. When you choose light words to describe something so deeply personal, I feel lost and diminished. Best not to mention my breasts unless I bring them up. Let my language dictate how you talk about my experience.

Staring at my chest in appreciation, especially moving your eyes back and forth as if to study their individual qualities, is also wrong. I’ve had surgeons and oncologists studying me for months, medical students have crowded into a room to examine my naked breasts. I’m not here for your clinical assessment. Unless I’m wearing a crisp light aqua gown that ties in the back, you don’t get to investigate my reconstruction.

And for f’s sake don’t order me to bounce and up down to see how natural they look.

“You look fantastic” is a winner, all the time, every time. You can’t lose. If you need to, glancing down at my new breasts while you say it will lasso in the breast appearance that you are intending to convey. I’ll get it, and it will sound good. Make it a super quick glance, though.

Still not sure how to say the wrong thing to a cancer patient? Follow these quick steps:

  • Talk to her how YOU want to talk about things. You’re feeling optimistic and gung-ho, let’s go kick some cancer ass! You fail to notice that right now she feels fragile and blue; you blow right past her and control the tone of the conversation. Might as well have this chat on your own; why bother including her if you’re not going to let her contribute?
  • Tell the patient how you’re feeling. I don’t mean how you’re feeling in general: a catching up on your life is a welcome and normal distraction. My favorite exchanges during treatment were run-of-the-mill emails with my cousin Amy. She told stories of her kids, complained about her commute, shared pictures from family excursions: regular chatter. The wrongness comes when you burden your patient with your feelings about her being a patient. Is it dredging up your own trauma? Does it pain you to see her in pain? Are you terrified of losing her? You patient does not need to hear it. She shouldn’t have to attend to your emotional needs. Save it for your therapist.
  • Tell the patient how she’s feeling. Always a great way to annoy.
    Samples: You must be so scared. You have to be relieved that part is over. You don’t mind when I try to finish your sentences and get it completely wrong. It’s a much better idea to ask her how she’s feeling. And then listen.

Kate Riener Boyd is a writer, graphic/web designer, mom, wife, theater enthusiast, and two-time cancer survivor living in Northern California. She launched her blog How to Cancer to help other patients, caregivers and loved ones navigate cancer treatment and its aftermath with humor and honesty.

This is the first of a series of guest blogs from Kate! Visit How to Cancer to read more of Kate’s take on everything cancer has to offer.