Clearing the Isms of Communication

Just before starting chemotherapy, for T-cell lymphoma, I needed a biopsy of an enlarged lymph node. When I met with the surgeon who would be performing the procedure, she told me everything I needed to know, was reassuring, and I was comforted by her kind and professional demeanor. On the day of the procedure, just before it was to begin, she came into my room to greet me. While looking at her, I was suddenly stunned to see how young she was. Why hadn’t I noticed this before? It also made me wonder, Just when did I get so old? It seems as if everyone I meet is so young. As these thoughts raced through my mind, she understandably interpreted my pause to mean that I didn’t remember her, so she reintroduced herself. This exchange still makes me smile because, as I was thinking of how young she was, she was probably thinking that, because I’m older, I must have been having memory issues.

It continues to make me smile for several reasons, mostly because age appears to be a very big deal in our society. So many products promise to keep us young, but as we age there are many jokes and anxieties about memory loss, and often the first thing we worry about is getting Alzheimer’s disease. When my surgeon saw the paused expression on my face, it must have been on her mind as well; or, at least, something to be ruled out. I was taking a class recently to learn about reiki, and though I wasn’t surprised or uncomfortable to be the oldest student, I was surprised to hear how many agist jokes the instructor made throughout the course! She was clearly uncomfortable with my age, and I had to remind her that learning and growing continue even as we get older, and maybe especially because the desire to “keep as is” remains blessedly strong for many of us.

I’m discovering that when we communicate, we seem to have a filter that  assesses what we have seen and heard, and we unconsciously react; sometimes it could be just noticing differences, like age, or perhaps we have a flash of judgment or maybe a bit of discomfort. It’s a natural reaction to notice all the differences that exist among us, but if we are uncomfortable with differences, it can affect the way we interact. That, I believe, is an ism. It is clearer to see with racism, sexism, or agism, but when it comes to talking to someone who has an illness like cancer, the difference can be more subtle because our reactions tend to be tinged with emotions: love, compassion, sadness, or fear. Even though it might not have the negative judgment attached to other isms, it affects the quality of communication, nevertheless.

I have begun to notice the ism of cancer since starting treatment, as I have been talking to family, friends, neighbors, and many health-care providers. I have been wondering about what we hear when we communicate with others, with both new and familiar people. How do we react to what we have just heard? Are our reactions based on the facts of what we see and hear, or are they based on our own attitudes, reactions, opinions, and preconceived notions? Can we put all that aside and listen openly or do our own reactions interfere with the quality of our communication? There are a few neighbors in my apartment building whom I have always enjoyed chatting with. Our conversations were always very casual and light, but when I was diagnosed and started going through treatment they started to interact with me differently. Our conversations changed from light banter to their eagerness to help in any way possible, which I appreciated, but eventually that changed again. One woman looked at me with sympathy but still shared kind words. A nice gentleman’s expression shifted from a casual smile to an extreme sweet kindness, which was pleasant but also made me uncomfortable. Did my new appearance scare him? As he put his hand up in prayer for me, I immediately missed the casual banter that used to be, and then my own reaction interfered with our communication because suddenly I felt like I was being looked at with sympathy and pity. But then I wondered: Is that what they are projecting or what I am experiencing? It stems from my own issue about not wanting pity because it makes me feel uncomfortable and weak. Then again, perhaps I am seeing it as pity when it is instead love, concern, and compassion? Either way, it still interferes with true and open communication. There are also well-meaning people whom I will always love who try to encourage me with such phrases as, “You got this,” and, “You will beat this.” Even though I believe I will, and love their faith in me, those comments always come off as a reflection of their own fears and anxieties, so eventually I agree with them because it makes them feel better, but the difficulty I am experiencing at the moment somehow gets minimized.

The many health-care providers who treat me all chose to work with cancer patients. Some are attentive but quiet and reserved while others are curious about who I am, my career, what I have gone through, and where I am headed. Because it is their chosen profession to work with cancer patients, their demeanor is different. The stigma of cancer doesn’t seem to be as present. They look beyond it to the person who I am. It is the same with the support groups that I once facilitated as a social worker and now experience as a cancer patient and participant myself; there is a freedom of expression and therefore a connection with others that is less awkward. We listen to one another with compassion, without trying to fix anything. We can say scary things to each other with ease. We express our understanding without explanation, so the ability to truly listen becomes clear.

The anxiety that exists around the word “cancer” makes us all afraid; the fear becomes paralyzing as it brings us closer to the topic of death, our own mortality, as well as possibly losing someone we love. It’s as if our fear builds a wall between the healthy and the sick and it can make us feel uncomfortable, not knowing how to discuss such delicate topics. We want to be supportive but not upset a person who has an illness, so we don’t know how to approach the subject. When I first began experiencing symptoms and suspected I had cancer, I would talk about them with my sister, who listened sympathetically. Once, in a helpless way, she said, “I don’t know what to say.” It was the most important thing I could have heard because I felt her concern and knew she wanted to help but was uncomfortable with the helpless feeling she was experiencing. At that moment the helplessness didn’t bother me because that is exactly what we were both feeling. We connected beautifully on that emotion alone. What was wonderful was that she honestly expressed her concern and love for me. The connection was precious. I have come to understand from that exchange that we often aim to control life and situations but the basic fact is that not everything is controllable. 

Sometimes, it should be said, the patient might even perpetuate the uneasiness. In conversations where I am asked about my health and recuperation, I will often deflect and ask about the other person. If the other person also has a health issue, I will almost always hear them dismiss what they are going through because what I am going through is much more serious. It can feel like I’m setting the bar for human suffering, when in reality it is not a contest. It is yet another filter that we use. One of the most helpful tools I know for good listening came to me from my training in the school of social work, which was to be mindful when listening to others. As social workers, we learned to ask ourselves, Are we reacting to our agenda, or theirs? If we all do this we can learn to acknowledge the feelings that arise when we hear of someone else’s misfortune. Acknowledging the helplessness without trying to fix it is the key to breaking down the wall of uneasy dialogue. It is honest and real and if we can just observe the helplessness, fear, or insecurity without reacting to it, it can bring us closer to compassionate communication. We don’t have to aim for perfect moments, just real ones. And that can lead to the helpful ism: realism.