Don't say "Everything happens for a reason": What patients and caregivers want friends to know about helping them through the horrors of cancer

By Keith T. Hardeman

“My friend has cancer. What can I do to best help them?” A cancer diagnosis of a friend, acquaintance, or co-worker will often leave us wondering about the most appropriate things to say to someone suffering from this dreadful disease. In general, cancer fighters much prefer aid and comfort during their agonizing treatment over being subjected to empty clichés and annoyingly dismissive “you need to stay positive” lectures. Keith Hardeman’s, "Don’t say 'Everything happens for a reason'" is an easy-to-read, how-to guide that provides constructive, no-nonsense lessons on empathy, communication, and practical help for anyone wishing to support their friends coping with cancer. 

"This book is for those who experience the shock of learning about a friend’s cancer diagnosis and don’t quite know what to do or say to help them. Keith Hardeman, a caregiver during his wife’s trauma with breast cancer, enlightens us with credible guidance on the dos and don’ts of supporting a friend with cancer. He offers his readers insightful, concrete advice for helping members of the cancer community along with suggestions for effective communication strategies. You want to help your cancer friend in the best way possible? Read this book!"

-Dr. Barri L. Bumgarner, author of "Fifty cents for a Dr Pepper"

"We all want to help a friend or acquaintance fighting cancer. To do so, effectively, it’s important to understand the perspectives of those who have already 'been there and done that.' For better or worse, being a cancer caregiver has taught Professor Hardeman many lessons about how to help cancer friends that he shares in this book. It is written with understanding, compassion, and is rich with sage advice."

-Dr. Robert Cowles, Professor Emeritus, Westminster College

• Language: English
• Publisher: Outskirts Press
• Release date: May 11, 2023
• ISBN: 9781977264893

Keith T. Hardeman

Keith T. Hardeman is the author of The Shadow of Trepidation, a compelling book on cancer caregiving. He is professor emeritus at Westminster College and has also published several articles about the cancer experience in Coping® with Cancer magazine and Cancer on The Mighty. 

Book preview

Don’t say Everything happens for a reason

What patients and caregivers want friends to know about helping them through the horrors of cancer

All Rights Reserved.

Copyright © 2023 Keith T. Hardeman

v2.0

The opinions expressed in this manuscript are solely the opinions of the author and do not represent the opinions or thoughts of the publisher. The author has represented and warranted full ownership and/or legal right to publish all the materials in this book.

This book may not be reproduced, transmitted, or stored in whole or in part by any means, including graphic, electronic, or mechanical without the express written consent of the publisher except in the case of brief quotations embodied in critical articles and reviews.

Outskirts Press, Inc.

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Cover Photo © 2023 Keith T. Hardeman. All rights reserved - used with permission.

Outskirts Press and the OP logo are trademarks belonging to Outskirts Press, Inc.

PRINTED IN THE UNITED STATES OF AMERICA

To Shelley

In the words of singer/songwriter Ben E. King, I won’t be afraid,

just as long as you stand by me

Table of Contents

Preface

Lesson 1 The art of empathy – meeting us in our cancer world

Lesson 2 Others’ cancer is not about you, but their recovery just might be

Lesson 3 The perils of toxic positivity

Lesson 4 When it comes to describing our cancer, avoid clichés like the plague

Lesson 5 Don’t say Everything happens for a reason

Lesson 6 Cancer fighters don’t need (or want) unsolicited medical advice

Lesson 7 The pragmatics of helping your friend with cancer

Lesson 8 Listening – The key to effective communication with cancer fighters

Lesson 9 When the storm is over

Conclusion

Endnotes

About the Author

Preface

I’m in a different frame of mind this time around.

My first book on our cancer experience, The Shadow of Trepidation, was extremely difficult to write. The work was a synthesis of my memoir as a caregiver along with my attempt to provide practical, how-to strategies for other spousal or family caregivers. I composed much of it during the rigors of my wife’s treatment. Just watching the pain and agony Shelley underwent throughout her seemingly never-ending cancer story provided plenty of emotional distress for both of us. And, like her, I was forever changed by the experience.

A bestseller my book definitely was not. But I would like to think it has a legitimate place among publications designed to support caregivers enduring the dread of a loved-one’s cancer nightmare. And I feel humbled to still receive occasional praises on how it has helped many overcome some of the emotionally charged aspects of coping with a new diagnosis. Chapter 11 in particular, some said, was beneficial in offering general guidelines for effectively communicating with cancer fighters. One reviewer noted that this section presented great advice for … what to say and not to say with clear explanations of why some comments are not helpful or appropriate. My goal for that chapter was to provide a few useful and specific examples of unintentionally insensitive things we should avoid saying to cancer fighters. I did so in the hope that readers might be able to steer clear of similar communication pitfalls with their own friends.

And then I realized there was so much more on that front that needed to be said.

Thankfully, there are already a number of books available on the important subject of helping our friends who have cancer. I’ve read four of them (so far) and found each to be worthwhile but completely different in perspective and approach. Yet they were all quite beneficial in the information they conveyed. Still, I feel my suggestions in this area might be unique. Not only am I a spousal caregiver, I’m also a professor emeritus who taught various college classes in interpersonal communication and relationships. Teaching about productive communication strategies is what I did for a living for more than 40 years. My hope and purpose is to add a new wrinkle toward outlining useful interactional tools and guidelines for those wishing to help their friends cope with cancer.

For purposes of clarity and word-efficiency, I’ve used the term cancer friend throughout this book. Our relationship webs can be wide and extensive. In addition to our spouses and closest friends, many of us have living parents, children, siblings, co-workers, colleagues, trusted service-professionals we know and frequent, extended family, neighbors, acquaintances, and social-media friends (including some we may never have met in person). Whether we have daily interaction with them or only exchange holiday cards once a year, we would certainly feel at least some level of pain and grief for them upon learning the news of any cancer diagnosis. Therefore, as I refer to a cancer friend, I mean anyone you know – who does not live with you – who is braving a cancer fight at some level. I mean anyone who is a member of the cancer-fighting or surviving community, including the patient’s spousal or live-in caregiver.

Since much of my professional life was spent as a classroom teacher, my decision to use the label lesson instead of chapter to denote book segments really shouldn’t surprise anyone. Course structure and organization is normally based on the notion of needing to understand previously-taught class material in order to fully grasp subsequent information. In this book, empathy is the subject of the first lesson and is the foundational premise for each one I cover thereafter.

I do spend significant time addressing my recommendations of what not to say. Semantic implications often play a large role in how those living with cancer might perceive our messages. And though it’s unquestionably inadvertent when we do it, the one thing we should all want to steer clear of is negligently minimizing the difficult experiences of the patient and caregiver. So I’ve tried not only to alert readers to statements that are best avoided, but also why saying them might sound so dismissive and even hurtful to members of the cancer community in the first place.

Nonetheless, the last thing I want is for goodhearted readers, who’ve already successfully helped their friends or loved ones with cancer experiences, to feel any sort of retroactive discomfort – or even guilt – should they reassess some of their own past communication methods. When we see pain and suffering in our friends’ lives, it is a perfectly natural thing to want to soothe the hurts and alleviate the anguish. My suggestions in the following pages will hopefully provide ideas to keep in mind toward making semantic adjustments and improvements in future interactions with patients and caregivers. Perhaps this book can enlighten readers so they may understand there are some situations they simply cannot fix. But it doesn’t mean they can’t help.

As of this writing, we’re about four years beyond the completion of Shelley’s primary treatment. Each stress-producing scan we’ve had since then (at least two per year) has, thankfully, been clear. While we obviously hope for the continuation of similar results in the future, we’re all too mindful of cancer’s propensity to return. We take nothing for granted. And though there’s never really a complete exit from the cancer world, both Shelley and I are currently more hopeful of her living a normal lifespan than we were five years ago. As a result, I now have a slightly more objective (and less emotional) perspective when it comes to revisiting our experiences. Still, writing this manuscript on how to help cancer friends has involved the reopening and resurfacing of some painful memories that the passage of time had previously helped to suppress.

Regarding a complete to-do list for helping your friends with cancer, no one has all the answers. Therefore, a book on this difficult subject couldn’t possibly float only on Shelley’s and my memories and opinions. Though I’ve most certainly included them, it would be silly for us to offer any of our viewpoints as fully representative of the entire cancer community, as we’re both still learning and evolving in our ideas of best practices in retrospect. Therefore, to supplement our thoughts, I needed to research others’ narratives for inclusion, even from those whose perceptions differed from my own. I interviewed a number of cancer survivors and explored scores of articles published by survivors and caregivers. And quite often, there was additional information in reactive feedback from others in the cancer community to the content of these pieces. The blunt intensity within many of those responding comments was a genuine (and sometimes even shocking) eye-opener. Though some patients and caregivers may leverage their experiences to help others, few ever see a cancer journey as anything positive, even when nudged to focus on some sort of mystical bright side that doesn’t exist for most of us. So in spite of perceptual differences, many affected by cancer, it seems, do share a number of similar views with Shelley and me.

Not all quotes and perspectives I’ve provided in this book will be fully attributed. Some came from cancer survivors who either preferred not to be recognized or were not identifiable as they resulted from response comments to online articles.

I wish to acknowledge several individuals for their help and support in my completing this book. The feedback I received from those who read and gave helpful comments on the manuscript was invaluable. To my good friends Heather Gehlert, Bob Cowles, Karen Hay-Steuer, Barri Bumgarner, along with my wife, Shelley, and our daughter, Karen Duckworth, words cannot begin to describe the depth of my gratitude for your time, effort, suggestions, and especially your candor when it truly was needed. Heather, in particular, went far above and beyond the call of duty in providing substantive commentary and suggestions in more than a few key passages.

I was also fortunate to have received particularly honest, comprehensive, and blunt descriptions from a number of cancer survivors. In addition to Heather and Shelley mentioned previously, Heather McRae, Hank Ottinger, David Robinson, and Rebecca Johnson stood out as they were exceptionally thorough and frank in describing their experiences to me.

I’m grateful to my brother, Jim, a retired pulmonology, internal medicine, and critical care physician. As he did with The Shadow of Trepidation, he provided much needed semantic advice and clarification for my medical explanations in this work to ensure as much accuracy as possible.

A strong thank-you must be extended to my son, Nick. Upon learning that I was about to begin writing this manuscript, he surprised me (shocked me, actually) with a gift of a brand new computer. It was a state-of-the-art upgrade that was astonishingly fast when compared to my previous 12-year-old dinosaur of a machine and made the typing and research far easier.

I also need to give a shoutout to my former college president and longtime friend Benjamin Ola Akande. His profound and well-timed Facebook memes provided much-needed breakthrough inspiration during many of my bouts with writer’s block.

And, finally, our continued thanks go out to members of our oncology team at Missouri Cancer Associates and other medical partners in Columbia, Missouri. If not for Dr. Makarian, Dr. Peterson, Dr. Johnson, Dr. Bryer, and our nurses and nurse practitioners Ashley, Gloria, Lindsay, Danny, Susan, Gretchen, TC, Piper, Mung, Rhonda, and many others, Shelley might not be with us today.

LESSON 1

The art of empathy – meeting us in our cancer world

The [cancer] tragedy another person is facing is not yours to own or comment on. [It’s not about] your beliefs. Or what you think is right. Or how you handled an experience you think is similar. True empathy is to co-grieve without imposing yourself. It is to own the hurt as a shared human experience, with selflessness and humility. More often than not, a genuine expression of love and shared sadness is all that is needed.

-Susan, in a CaringBridge.org comment

People don’t get it. They just don’t. They don’t know what to say. They’ll inevitably say the wrong things most of the time. [Most of] my friends have never had a friend with cancer, so I mostly get toxic positivity whenever I try to vent. All I need is a You’re right. That really sucks. I can’t even imagine. Because they can’t. Until you’ve been through it, you really can’t imagine what it’s like. And feeding me, Everything happens for a reason! or Just keep a positive mindset and you’ll be OK! isn’t helpful. If everything happens for a reason, please tell me why I have an incurable cancer diagnosis at 26 years old. If I just need to keep a positive mindset, why won’t my symptoms go away?¹

As a caregiver for my wife, I’ve certainly lived my share of the frustration described in the previous quote from cancer survivor Mel Hebert. But on the other hand, expecting friends and coworkers – who’ve never before had a cancer experience – to intuitively know precisely what to say, what to do, and how best to help any cancer family is a rather tall order.

So to the reader of this book, thank you. The fact that you’ve begun reading says a lot about your desire to help those saddled with one of the most physically and emotionally charged medical diagnoses anyone could receive. Though tremendous strides have been made in survival rates over the last several decades, cancer remains the number two killer in the U.S. and the world.² To learn of their own malignancy – in almost any form – is no small task for the patient and family to cope with. That is something my wife, Shelley, and I were faced with when she got her breast cancer diagnosis. And having to be the bearers of our bad news – and to watch and hear others’ emotional reactions – only adds to the ordeal before the true test of grit begins.

When it comes to my suggestions and ideas on how to better help your friends battling cancer, the only thing for certain is that I don’t have all the answers.