July 8, 2010 | 
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Facing severe illness, Part 2
As I write this column my sister-in-law is nearing death. Last week I wrote about my battle with cancer and having come so close to death, and this week we are losing a relative who is coming to the end of her battle with the same type of cancer. As I explored in the last column, this mystery of who lives and who dies confronts us, and confounds us, on a constant basis. Most of us contemplate the “why me?” question at some point. Whether it’s asked when bad things happen or when good things happen to you depends upon your psychological make-up. As to whether the universe runs by some plan, intelligence, or just random chaos, this has been a question that humans have wrestled with for thousands of years.
Since I’m not about to solve the mysteries of the universe in this column, I’d like to share some suggestions on coping with a serious illness, or supporting a friend who gets sick. A primary thing to understand is that everybody gets sick in their own way. Not only is the illness unique in each body, but each person’s reaction to a disease, and their coping skills, are different. There are no hard and fast rules about how you should feel, what you should say, or how to handle a serious illness. Everybody wants to do and say the “right thing” but most people struggle under the weight of this difficult situation. Because illness and end of life issues are so complex and so personal, a good time to think and talk about them is before they happen. When things actually happen your feelings may change, and you certainly can alter your plans then, but it is easier to adapt a plan to the circumstances than to try and formulate a plan from scratch when you are under the pressure of actual crisis.
There are several questions you will want to consider for yourself, and talk about with family members and doctors in advance. The one most of us are familiar with is end of life care. Each of us must try to decide how much we are willing to endure to extend our life. Of course, looking at that in a theoretical fashion may look much different than when we are actually facing death, but making a clear directive now to your doctors and family is the only way to ensure your right to decide when the time comes. Doctors and hospitals may tend to want extend your life in any way possible, as this is their orientation. If you wish to limit care you must make it clear, in writing, beforehand.
But even before the end of life there are care decisions to be made. For instance, how aggressive do you wish to be with therapies to treat your illness? In cases such as cancer for example, chemotherapy, surgeries and other medical interventions can be extremely painful, debilitating, and costly. You may well be faced with decisions about the quality of your life, not just its length. How much pain and suffering you are willing to face will determine your course of action. You may not want to think about these things until you are facing them, but I think it is worth some discussion with your loved ones in advance. You may have very different views on these questions, and it is good to air them out before choices must be made.
When you are dealing with an illness, many additional questions will arise, and I advise dealing with them as honestly as possible. Tell your friends and family how they can best support you. People often want to help, but they don’t know how, or they don’t want to intrude. Tell people if you need help or if you need solitary rest time. Ask if they are willing to be called so you know who to call when you need help or are just feeling lonely. Do you like people to ask about your condition or to offer suggestions about possible treatments? Let them know. If you don’t want to talk about it let them know that, too. You may want to create a phone network or an e-mail list so that you can inform your whole network of changes in your condition without having to repeat it over and over.
It is important to remember that there are many people that care about you. Probably more than you realize. I have been amazed at the number of people who have stepped up to give me support during my illness. We are all part of a larger community than we may see on a daily basis, but that doesn’t mean it’s not there. Being ill is a great time for realizing just how loved you truly are.
Dr. Jeffrey Low has been a therapist since 1978. He currently works with individual and couples in Sonoma, California. You can contact him, ask questions, and find out more about his work, at www.themarriagepath.com
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