Hand in Hand through the 'Land of the Sick'

March 3, 2014
Hand in Hand through the 'Land of the Sick'

In September 2009, a suspicious mass on a mammogram catapulted author, activist, and Ms. magazine founding editor Letty Cottin Pogrebin into "the land of the sick." Pogrebin's breast cancer diagnosis changed her relationship to her body—and her relationship to her friends.

"The reactions of my friends were astonishing to me," Pogrebin said. "Some friends blurted out 'Is it fatal?' Some disappeared completely. Others stayed suffocatingly close. I thought, 'I need a book to teach my friends how to be my friends during this period.' "

The result of Pogrebin's experience is How to Be a Friend to a Friend Who's Sick, a guide for people who love someone dealing with serious illness. She visited Harvard Divinity School February 7-9 to speak about the book at the National Leadership Conference (NLC) of the Women's Studies in Religion Program (WSRP). Ann Braude, Senior Lecturer on American Religious History and director of the WSRP, introduced the talk and noted that Pogrebin has been a friend of the program for decades.

"This is the only non-activist program she supports!" Braude said.

Pogrebin began the project on illness and friendship when she found herself sitting in the waiting room at Memorial Sloan Kettering Cancer Center in New York as long as three hours after she arrived for appointments.

"The sick have to wait," she said. "Our time becomes less important than anyone else's."

Looking around, she realized that her fellow patients were a perfect group to interview about the experience of illness. She began to talk to the people waiting with her, asking questions like, what's it like to have a chronic disease nobody sees? How do friends relate to people who are dying or to people whose parents have Alzheimer’s disease?

Patients come to Sloan Kettering from all over the country, and Pogrebin spoke to men and women from a variety of religious, ethnic, and geographical backgrounds. What she found from her many interviews and her own experience was simple: people don't know how to behave around their sick friends.

"[They say to the person who's ill], 'God only gives you what you can handle,' 'God wanted him,' 'It's part of God's plan.' Not helpful," Pogrebin said.

Pogrebin found that friends also often don't understand a sick person's physical needs. They bring yet another fruit basket or flowers to join those rotting and wilting in the hospital room, or visit after eating a pungent garlic pizza with strong-smelling breath that can trigger nausea, particularly for patients undergoing chemotherapy.

The cure for all this awkwardness, she said, is to concentrate on the individual. Friends start as equals, but when one becomes ill, the power relationship changes. The sick cannot control when they see their friends, or where, and have less power to steer the conversation than before.

"Ask yourself, 'Is what I'm about to say helpful?' " Pogrebin suggests. "Ask sick friends what they need. Don't bring the coffee cake. That makes you feel good," she said. Someone in a chilly hospital room might appreciate a warm wrap more than flowers and fruit.

Pogrebin recalled calling a friend whose Jewish family was sitting Shiva, hosting visitors who came to honor their dead relative. When Pogrebin asked what she needed, the friend replied, "We're running out of toilet paper." Few people would spontaneously think of bringing toilet paper to a family in mourning, but it was exactly what her friend needed.

Some friends who are sick may not want to talk about their condition at all—although Pogrebin found that only men kept their illnesses completely secret. That desire has to be respected, as do requests that visitors not pray for the sick. Pogrebin cited the case of the late author and critic Christopher Hitchens, an atheist who was afraid that if he recovered from his bout with cancer, the people who prayed might take credit for it.

Still, it depends on the friend. Some people who are dying want to talk. Pogrebin knew the late Geraldine Ferraro, the first woman to run for vice president of the United States, well enough to ask during her last illness, "How does it feel to be dying?" Ferraro replied, "Thank you. Everyone else keeps trying to jolly me."

Ferraro had made detailed plans for her death, from who would receive her jewelry to who would speak at her funeral, and wanted to discuss all of her work—but friends and family generally avoided the topic. Emboldened, Pogrebin asked, "How do you feel about death?" Ferraro answered, "Letty, you'll never understand. You're Jewish. I'm going to be with Jesus."

Pogrebin's cancer is now in remission. She was comforted during her treatment by the support of three close friends who helped her through the "cave"—the darkness of her illness. She suggests websites like CarePages.com and CaringBridge.org that make it easier for friends who are sick to communicate their needs, and for helpful friends to understand what the sick want, which may be to be left alone.

"It's work for the sick to see their friends," Pogregin said. "Sometimes it's best to just show your face, register your concern, and get out."

In the end, caring for sick friends is about continuing the relationship. One participant commented, "It's important to try not to be so wrapped up in physical disability [that you forget] to recognize the beauty of the intention [behind awkward actions]." Pogrebin responded, "That's why you end up forgiving them."

—by Meg Muckenhoupt