Presence is everything, and by presence, I mean being fully present, fully engaged.

What do I say to a family member or friend who has been diagnosed with cancer? What are the right words? What do they want to talk about? What if I say something stupid or insensitive? What do I say to an 8-year-old child, a 16-year-old boy, a parent, or a grandparent?

These questions began to swirl around my mind and within my heart weeks before I first stepped foot onto the pediatric oncology floor at Johns Hopkins Children’s Center as a nursing student in 1995.

I knew nothing of having a loved one with cancer; I only knew what it was like to be the loved one with cancer.

Upon my first encounter with a family who had just received devastating news, I turned to the mom and said, “I understand how you feel.”

Sadly, once spoken, words can’t be taken back.

She abruptly told me I knew nothing about how she was feeling, and I should leave the room immediately.

I excused myself, and retreated into the ladies room so the tears could flow freely as my heart hurt for the insensitive words I had spoken. After beating myself up over my insensitivity,  I wiped my eyes and returned to the child’s room to ask if I might have a moment of her mother’s time.

She obliged me.

I apologized and asked her if she could forgive me for thinking that I knew how she felt given the circumstance. She was kind and gracious in forgiving me, but she was also curious. She said to me, “you really seemed to believe you knew how I was feeling: why is that?”

I shared with her that when I was about her child’s age, I had been diagnosed with cancer and was treated with chemotherapy and radiation. She put her hand on my shoulder and said, “sweet child, you understand how my daughter feels; you go be with her.”.

Here’s what I learned in clinical that evening:

It sucks to have cancer: this day, any day, and every day.

You’ve likely never walked in their shoes, so do not act or speak as if you have.

Extend compassion by simply being present with them amidst their shock and disbelief.

Your presence will communicate more than you could ever hope to say with words.

So, my response to the questions posed are as follows:

Say nothing; be present.

There are no right words.

Ask them what they want to talk about, and if they’d rather just be, then just be.

You will say some something stupid and insensitive at some point; everyone does, myself included, and it will be okay.

Persevere in coming back to visit again and again as they’re simply looking for you to consistently come alongside them, to be present with them, to listen, to be.

For other perspectives:

What Not to Say to a Cancer Patient

I’m Fine, Really I’m Fine: What Not to Say to Someone with Cancer

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