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Dear Joseph,
How do you best help a friend that has only days to live? I assume being a good listener is important, but is there anything helpful that I should say?
Signed,
Hoping to Help
Dear Hoping,
For purposes of my response, I’m going to assume this is a close friend not simply an acquaintance. If your relationship is weak, they may find stress rather than comfort in your presumption of intimacy. But if they feel safe with you, if you’ve earned their trust, you should assume nothing less than that. This is when true friends show up. Here are some thoughts about how to show up.
First, you ask: Can you say anything useful? I don’t know. But what I do know is that they probably want your companionship more than your advice. They are unlikely to want someone who attempts to beguile them from their obvious predicament with magical homilies. Don’t pressure yourself by assuming you need to fix something. What they will want most from you is for you to sit with them in their predicament. Experience it with them. Love them in it.
Second, my experience is that in situations like this, we fault more often on being too tentative than on being too intrusive. It is often the case that more intimate is more appropriate. We often act as though we believe not talking about the fire-breathing dragon in the room is safer/kinder/better than taking a person’s hand, sitting beside them, and staring at the dragon together.
Third, spend less time telling them how you feel about their impending death and more time asking them how they feel. Ask about their beliefs. Ask about fears. Ask about regrets. Ask about their legacy. Ask about their proudest life moments. These are perspective questions—ones that invite connection around larger issues of life. Beginnings and endings are moments of perspective. These are the kinds of thoughts that are naturally occurring to them anyway. So, go there with them. If they inquire, feel free to share your perspective on these questions, but don’t cross the line into coercion. Never take advantage of your psychological advantage of being the healthy one to impose your nostrums.
Finally, relieve their stress. My father taught me once that stress is like arithmetic. Everyone has a certain tolerance threshold. Mine might be 40. Yours might be 45. But we all have a number. The amount of stress we feel at any time is equal to the sum of all the stressors acting on us. Some might be 3s (I have a chip in my windshield that might spread). Some are 5s (my water heater is leaking now). And some are 10s (I’m dying). Thinking about stress this way helps point out two things:
1. Everyone has a tolerance limit. Everyone begins to crumble when the sum of all their current stressors exceeds their tolerance limit. Everyone. Even if your tolerance level is 327. If your stress sum is 600, you will break down.
2. You don’t have to remove the big stressors to help someone get below their limit. If your friend is dying, you can’t fix that. You can’t take away the 10. You may not even be able to do much with their 9s and 8s. But if you take away enough 2s, 3s and 4s, you might help them get back to manageability.
Once I learned this, it changed the way I talk with loved ones who are suffering. I no longer make vague offers like, “Please let me know if there is anything I can do to help.” This is a worthless offer. Basically, it says, “Here’s one more thing for you to think about—think about helping me feel helpful!”
Instead, I teach them about the arithmetic of stress, then I hand them a pen and paper, and I say, “Write down EVERYTHING that’s on your stress list right now.” I sit with them and encourage them to work all the way down to the nit-picky 1s and 2s. When the list seems complete, I go to work. I don’t ask for permission. I take charge of all the fixable things on the list.
I hope these ideas help. And I hope the sacred last moments you share with your friend are filled with the real intimacy.
With love,
Joseph
