To Tell the Truth?

How are you?

It’s a polite question to ask. It's a friendly way to start a conversation. It can be a complicated question for a cancer patient though. It’s the kind of normal question that makes us feel quite abnormal.

A difficult question to answer with honesty

After being diagnosed with leukemia in 2011, I have found that this question can be somewhat stressy to answer. I am hyper-aware of what response I might get if I tell the truth. There are a range of responses when I do tell the truth and not all of them are helpful. My answer can elicit a range of responses I might not be prepared for. That’s the rub. How will my answer affect the person I’m talking to?

The reaction isn't always appropriate

Some of us would rather not see pity in another person’s eyes, some of us have been given really strange cancer advice, and some of us receive, “Well, you look fine to me”. Then there are the times when the answer to that question results in oversharing when the other person highlights their own healthcare woes.

The worst response of all is what I call victim shaming and blaming. A kind of what-did-you-do-to deserve-this-because-you-must-have done-something-wrong! This response can make an already painful day so very much worse. For my part, I don’t believe that cancer is an indictable offense.

Do we have to respond truthfully?

I think these are some of the responses we try to avoid without being untruthful. I’ve noticed a debate among cancer patients. When we are asked, “How are you doing?” do we give the truth, the whole truth, and nothing but the truth? Or do we cite the Fifth Amendment, in fear of harsh judgment, and avoid commenting? I mean, is there truth in not telling the whole truth?

The difference between honesty and privacy

For decades I worked with people with disabilities. In my line of work, confidentiality was a big deal and we took it quite seriously. This is where I learned the difference between total honesty and the value of privacy. Through my work I learned that truthfulness is on a sliding scale between what is on a need-to-know basis and what is necessary to communicate.

Basically, through my work, I learned to adjust my communication with the need to communicate. In the interest of confidentiality, health concerns were shared with healthcare professionals, behavioral concerns were shared with support systems, and individual privacy was kept between client and their worker.

Basically, information was shared on a need-to-know basis. Confidentiality was taken very seriously and it was the basis of trust. The trick was knowing who needed to know and what information was most needed to share.

I’ve carried this experience with me and it has made communication a little easier. I break it up like this:

  1. Gritty fine details of my condition go to my healthcare providers,
  2. The emotional toll of this disease goes to my therapist,
  3. The struggle to understand them both comes to cancer care forums like this one. Here is where I feel I can share and receive, in a non judgmental way, what it is to be fighting an incurable disease.

Prioritizing based on what I need from the conversation

The more assistance I need, the more truth I tell. The less assistance I need, the less truth I tell. You get the gist.

If I say I am doing ok I really don’t think that I am lying. I mean, any day that I am not six feet under is a good day in my books. The rest is relative. The one person I never say I am ok to is my oncologist. He knows the difference.

Sometimes I try to sidestep the question by saying something like; I am better now that I am with you; I am better now that the shopping is done; or I am better now that I have the bills paid etc. It gives a decent spin on my answer and is usually something everyone can relate to.

These days I have become really proficient in choosing which truth I want to share. I feel like less of a liar when I sidestep an overwhelming question and I have my process for telling what to whom.

So I ask you, cancer patient to cancer patient, how do you decide what is worth sharing and what is not?

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