It's hard to ask for help when you're dying. Ruth Terracini wrote this letter just months before she died to let people know how they could support people in their final days.
"Let me know if there's anything I can do". "If you need anything, just ask".
When I was healthy and strong these are words I could well have uttered to a friend who was experiencing illness or challenging circumstances. Or even worse, sometimes I did not even utter those words, paralysed by the person's plight, and not knowing what I could possibly do that would be helpful. I thought it best if I gave them space and did not pry. They would surely have closer friends and family who would be there for them. I felt that I didn't have anything to offer.
Now that I am two years down the track after a stage 4 cancer diagnosis, I have a new perspective. In 2012, I suddenly changed from being healthy and independent to being a powerless, weak and dependent person. I was very sick when I was diagnosed and there wasn't much that I could do but just let things happen around me, accept anything that people did for me with a very grateful heart, and only very occasionally ask for help when I was forced into it. It takes energy to ask for help, and it somehow makes the situation seem even more hard to bear … "not only am I sick, and a burden too, now I have to think of jobs for people to do!" I truly appreciated it when people took the initiative. When people offered specific help and followed through I could relax, be grateful, and feel loved.
It is hard to ask for help. Imagine for a moment, that a friend or acquaintance has said to you "Oh, that's terrible, let me know if there's anything I can do"…and you respond "Oh well, um, our front lawn is around knee height, and my husband is exhausted from taking me to the emergency department, worrying about me, cooking for me, caring for me … so if you could pop over and mow it or organise someone to, that would be great". I could never say that! It feels like an admission of not coping, of having to rely on other people. It feels awkward and wrong. It feels like I am being lazy and asking them to do something that I should be able to do myself (how hard is it to pick up the phone and call a gardener!). Maybe I'm too proud, but I'd rather settle for a garden that has the unkempt look.
In December 2012, I arrived home after a week in hospital, where I had been told the news that I had cancer spots all over my liver that were secondary, and not operable, and the primary cancer was not yet known. My husband and I were shell shocked and numb. Our world was turned completely on its head. I had been very unwell in the lead up to going into hospital, so things at home had become a little bit unravelled … in short, I knew I'd be coming home to a bit of a mess. Imagine our surprise when we approached the house, drove up the driveway and saw that things looked different … somehow unusually tidy. A quick look around revealed that the lawn had been mowed. It was a shock of kindness, and we looked at each other and I have to say that a few emotions welled up, number one being gratitude – that people cared. It was a simple action, but one that has stayed with me.
There have been many examples of people helping me since I was diagnosed. Reflecting on the thoughtfulness and kindness I have received shows me that there are so many good people in my life, and in the world. I have had family and friends make me meals, colleagues send flowers with kind thoughts, and a kind sister-in-law who cleaned my house every time I had chemo. An ex colleague who loves gardening spent a day in my front yard, trimming roses, attending to the vegie patch and making my garden happy. A friend of a friend even cleaned my oven while I was in hospital having major surgery! Sometimes, just feeling that people care and acknowledge my situation has provided emotional support that has sustained me more than they probably knew. One friend, who is part of a team that does the Relay for Life every year, sent me an email to say that in 2013, every step of hers in the relay would be a prayer for my recovery. An old school friend, who was raising money for cancer research, trained up and ran an ultra half marathon. During the marathon she wore a cap with the names of people she knew with cancer. I saw my name on the cap in a Facebook post. Another ex colleague, who I had not seen for at least 10 years, sent me a card containing lavender and heartfelt words of empathy. These thoughtful expressions of concern and love truly touched my heart and provided me with extra emotional resilience when I really needed it.
I know now that the phrase "Let me know if there's anything I can do" is well meant, but impossible (for me at least) to respond to. It is much easier to be grateful for something that somebody did without having to be asked. If you are thinking about how to help someone who is facing cancer or something challenging, my advice would be to:
- Understand that it is hard, and energy sapping, for the person to ask for specific help. Try not to put the person who is unwell in the position of thinking of jobs for you to do, and asking for help.
- Don't do anything out of a sense of obligation. Do it out of love, or not at all. Be truly happy to help.
- Understand that cancer can be an experience that is long and drawn out – and that help in various forms is just as much needed down the track as it is in the shock of the first few weeks after diagnosis.
- Realise that although a cancer patient may actually look well, they are, in reality, dealing with all sorts of things you may not be aware of. These can include regular blood tests and scans (and the nerve racking wait for results), pain, fatigue, appointments with the oncologist, bad news/good news (and what to tell people), medications (and their side effects), hospital visits, coming to terms with death, difficult decisions.
- Accept that doing something for someone does not have to be a grand gesture. You don't have to be a close friend or family member to reach out to someone that you know has been handed a desperate diagnosis or a very challenging situation.
- Remember the caregiver. They are bearing many burdens – working, as well as caring, housework and dealing with the incredible stress and worry of having a very ill partner. Much of what is written below could, and should, equally well be done for them.
If you are wondering what specific thing you can do, try walking a mile (or a minute even) in their shoes. Imagine, or investigate for yourself, what they need. A drive by their house may reveal a garden that resembles a jungle, or their Facebook posts might indicate that they are now eating organic food and would appreciate vegies from your garden, or that they have a dog that no doubt would love to be walked … and take action. Don't wait to be asked – as you are the only one who knows how much time and energy you have to spare, and if indeed you really mean it, or are just displaying a polite, yet empty, show of support. Do something, anything, that you yourself would like or find helpful if you were in a similar situation. If you are not close to the person, a card in the mail can be all it takes to make a positive difference to their day. I once checked the mail just as I was leaving home for the hospital, and there, in the bundle of mail, was a card from someone to let me know that I was in her thoughts.
My personal experience with cancer is feeling more like a marathon than a sprint. Although, amazingly, I have looked well for about the last 18 months, in reality my body is not well, and I am facing and dealing with the constancy of cancer and its treatment. There have been times along the way that I have needed help (of either the practical variety, or emotional support when my spirits are flagging) and have heard those words … "Let me know what I can do". Below is my answer. If I am feeling brave, I will send this list to the next person that utters the dreaded words and say "Take your pick" … (actually I would never give this list to anyone, who am I kidding, but it makes me feel better just to write it!)
- Mow our lawn
- Make me dinner
- Clean something around my house
- Invite me along to something fun or nice that you are doing
- Take me to a good movie
- Meet me for coffee
- Send me a card of encouragement
- Shop for some organic fruit for me
- Share something out of your vegie garden with me
- Plant something in my vegie garden
- Send me a text when you are doing your grocery shopping and ask me if I need anything
- Find out when I have to go to the hospital for treatment, a blood test or a port flush, and offer to come with me or visit me there
- Visit my elderly parent(s) when I am too tired or sick to go to see them
- Take my dog for a walk to tire her out and keep her happy
Kindnesses that take little effort but that can be powerfully uplifting:
- Tell me that you have said a prayer, or sent positive vibes into the universe for me
- Write me a note to tell me why I matter
- Send me an email or text every now and then just to say you are thinking of me…and don't expect an immediate response
- Share a memory that you have of me that is special to you
- Talk to me like I am a normal person, not a diagnosis or a problem to solve. Let me enjoy some time with you when cancer is not the main topic of conversation
- Let me know that you care – I don't need (or want) to talk about my disease or treatment all the time, or for it to be the first thing that you ask about, but I'd like you to acknowledge the reality of what I am going through, and not pretend it isn't happening
- Do something challenging and tell me that you were thinking of me when you were doing it (the Relay for Life, a long distance event, a hike up a mountain)
- Do something for my husband, who has been supporting me in every way since our ordeal began
- Give me a hug and tell me that you love me
The effects of emotional support for someone who is unwell, and their carer(s) cannot be understated. Feeling understood, acknowledged and loved goes a long way to creating a healing environment. You may even find that doing a good turn for someone has positive effects for you too. I am not sure where my story will go from here – treatment is ongoing. Perhaps I will have to practise asking for help. I hope though, that there will be a few people that are happy to lend a hand when we really need it.
Ruth Terracini, March 2015