I try to forget for a few minutes,
I stare at a spot on the wall.
I lose myself.
No clue how long it has been.

The clock says it’s been six minutes,
I am glad that they’ve gone by.
But then I realize I have wasted them:
Six minutes of my life.

I want them back,
Feel I should use them for something better,
Something constructive.

I am mad at myself:
That was a waste of time.
I want days of suffering to pass,
But I also know that this is the only time I have.

I take a trip inside my head
I don’t know where I go.
Somewhere else,
Anywhere else,
Far away from here.

If you’d let me, I would run away,
I would go find a way
To keep you safe from this,
Safely far from this.

Some days I long to tell you how I truly feel,
But there’s no room for that in this,
No room for that in this.

It is not a choice.
That I know.
And when I finally do go
It won’t be for lack of want, or heart, or strength.

When I die it will be because that is what cancer is,
This is what cancer does.

And when it comes to being fair,
There is no room for that in this,
No room for that in this.

Mom and I have reacted very differently to the news of my stage IV cancer. I was online within days writing posts about the steps I was taking. I wrote immediately about how to help children in the days following a diagnosis like mine. As my readers know, I’m very open about this part of my life.

My mother, on the other hand, is much more private. She would never write a blog the way I do. She didn’t want to share this news with people; she wasn’t ready to talk about it. I respect her decision but that approach doesn’t work for me. Sometimes our different ways of thinking lead to disagreements. Despite our differences we always support each other.

I thought it might be helpful for readers to hear what she has to say about reading my posts. Some of us with cancer choose to be very public with our daily lives but our parents are often forgotten in the discussion. I think the timing of Mother’s Day weekend is perfect to share this piece. I love you, Mom (photo at left: 1970).

…………………………………….

I am Lisa’s proud mother and I have followed her blog from its first day. As her mother, I read her blog from a unique point of view, and I want to share my perspective with you.

Those of you who are reading this blog follow Lisa and her incredible writing. It is her understanding of human behavior, her expression of feelings of her heart and thoughts of her mind that make so many people want another blog from her as soon as the one being read is finished.

Yet, as the mother of this outstanding-in-all-aspects daughter, my reading of Lisa’s blogposts is complicated because each piece contains an extra layer of heart-wrenching pain for me. Lisa’s blog is a precious sharing of her everyday life, of medical explanation and analysis of each and every test result, of measured consideration of her hopes, fears, etc. Parents rarely get the opportunity to get “up close and personal” to this extent with a child. As Lisa’s mother, knowing her innermost thoughts is a gift and a curse.

If you (or anyone else but Lisa) were writing about a life journey with a cancer diagnosis, I could handle reading about the physical assaults on your body and the emotional assaults on your psyche because I would be more objective and not involved in your everyday life. I could read your blog, feel empathy and sorrow for the diagnosis, but step away from it. However, I am enmeshed in Lisa’s writing.

Lisa’s father stopped having the blogposts sent directly to his e-mail because he was often caught unaware with heavy emotional subject matter arriving at inappropriate times. He now accesses the blogposts only when he feels emotionally prepared for whatever he may find.

While this would also be a very reasonable decision for me to make, I have the ambivalent feelings of wanting to be close and share every moment of what Lisa thinks and feels at that moment versus retreating from the declarations of how her life is now and her fears for the future for her and the family – her family and my family.

Lisa and I share the personality trait of always wanting to know the truth so we are as well prepared for the worst as we can be. Lisa and I promised each other that we would never withhold any information to protect each other. The honesty Lisa promised me is the honesty she has promised to all of you, her readers.

On one level, her blog reveals to me everything I want to know, but on another level what I unconsciously don’t want to know. This emotional see-saw of wanting to read it but not wanting to read it is a decision that I must make each time a new blog-post appears in my inbox.

Why is this “to know or not to know” decision so difficult for me? When I read Lisa’s writings, I imagine the sub-text that she does not reveal: how she is managing to keep her family’s lives as “normal” (whatever that means) as possible.

Lisa is, as most mothers are, the hub of her family’s life. When Lisa writes in a blog-post that she was very tired and rested for hours, I know that her closed bedroom door makes every family member who sees that closed door go into overdrive with founded or unfounded concern and fear.

Lisa and I share the goals to make the most of each day and to cherish and to love one another. These are life affirmations within our control when so much of life is out of our control. Share our goals as you and I, Lisa’s readers, benefit from Lisa’s greatest gift to us: who she is and how she lives her life, in sickness and in health.

I can’t yet see myself in my children,
I wonder if it is always that way.

I remember as a teen the day I actually could match my father stride-for-stride,
My smaller feet dwarfed by his size 13 shoes.
I remember thinking I was a grownup then.

I was wrong, of course.
I had no clue what being an adult was.

I learned.
Yes, I did.
I yearn to go back to those days,
Perhaps I was not carefree but I was taken care of.
Knowing my parents were in charge,
I felt safe, protected.

Now I am a parent in charge,
I must be ready.

My children try to match my steps, still unable to.
I yearn for the day they can.
I hope I will be beside them when they are old enough to mirror my stride.

Not just beside them in spirit.
That’s not enough.
I want more.

When they think they are grownups
I want to be there too.

People love to casually say,
“Enjoy every moment” or
“We all die some day anyway” or
“Life is fleeting.”

I know this already.

And I know it in a different way.

I don’t need to be told to
fight the good fight to beat it
or the key is to just stay strong
or that it’s mind over matter
or that I should pray for a miracle
or that I will be cured.
That’s nonsense.
Scientifically impossible in my case.

And so, when you say,
“No, that can’t be true.
There must be something that will cure you,
If you want it/pray for it/think it will be so,
You can be healed,”
What you do is force me to assert my knowledge,
Insist upon my diagnosis,
Explain the desperate nature of my disease,
Spend my time defending my sentence.

I know it’s what you wish.
I know you insist because you want it to be the case.
I know you’re grasping at straws,
Wanting to reassure yourself that bad things won’t happen to you,
That bad things don’t happen to good people,
That something awful won’t happen to me.

Trust me, I wish for it too.
But these things do happen.
It has happened to me.

The truth is that wishes don’t count for anything when you’re placing them against cell biology.

I know many healthy people who say the passage of time is bittersweet.
It isn’t a competition but I can tell you that this passage of time is different.
If you could feel it for just a moment you would know.

There is a difference between
Distant,
Hypothetical,
Potential,
Maybe…
and reality.

I have learned that being nervous about test results,
Worrying,
Wondering,
are not the same as the reality.
Reality is having your oncologist walk in the room
and when you say to him, “How are you?”
and he says, “Not good,”
you naïvely think it must be a problem with him,
or his family and
instead he ducks his head,
takes a breath,
looks at you, and says,
“Your test results were not good.
Your tumor markers are up.”
He knows I know what this means.
He waits for a moment and says,
“I think you have a metastasis.”

A few minutes later he says,
“You need to go get a chest x-ray right now.
Go across the street,
I will come over to the hospital and look at it immediately.
Wait for me there.
Then you need to schedule a PET scan as soon as possible.
Have you had any other unusual pain?
A cough perhaps?”

The room spins, the world stops.
My life didn’t end in that moment, but life as I knew it ended for sure.

No turning back.
Reeling, processing, shock.

All you can do is let your jaw drop,
the tears fall,
your body shake,
crumple.

Slowly,
deliberately,
as I looked at him
in a way that I never had in the six years he had been my doctor,
the only words that came to my lips in response
were to repeat over
and
over
and
over
and
over
again:
“Fuck. Fuck. Fuck. Fuck.”

Because that’s the only word that could capture how angry
and scared
and angry
and surprised
and angry
and shocked
and angry
I was.

I never have liked the term “to expire” rather than “to die.”
I started thinking about these words though.

We all have an expiration date.

I’ve never thought of it like that before.

We all have one.

It is as if I’ve grabbed a carton of milk without looking.
I took the one in front I guess,
The one with the rapidly approaching date they put conveniently at the shelf’s edge for people to grab when they’re not paying attention.
Except I did pay attention.
I did.
I was always paying attention.
No one was more vigilant than I.

I want to put this carton back,
I want to say it’s not mine.
I want to scream it.
This must be for someone else.
The date is too soon but I can’t trade it in for a new one.
No givebacks.

The problem is
I don’t know exactly what the date says.

I wrote three pieces while I was in Florida. I was planning to take time off from writing, to focus on the trip, the family time together, the joy. And I did. For most of it. The truth of the matter is that even joy right now is twinged with sadness. The writing I did was on my phone and was explosive and emotional.

That’s just the way it is. What I’m doing is grieving.

It’s been six months since the diagnosis of metastatic cancer. I’ve already run through one chemo regimen, wrung its effectiveness dry, and now have had to move on to something else. It will be at least one month before we know if it is working. There is no way to know if it will, and if it does, for how long. I’ll then be leapfrogging on to the next thing.

The loss of control is hard. It eats at me. I always wanted to believe that if I played by the rules, took the most aggressive route I could with my cancer the first time (more than 6 years ago), that I’d at least be NED for a decade or two.¹ I was told my chance of recurrence was in the single digits. But cancer doesn’t listen to statistics– good or bad. The features of each person’s cancer are different. How aggressive it is, its resistance to certain treatments, its mutations.

I am not a risk-taker by most definitions of risk. I always felt that playing it safe would somehow benefit me.

I have come to believe that what I did actually did matter. I have come to believe it’s that not that it didn’t work. My surgeries, chemo, prophylacic oophorectomy… maybe, just maybe, those things bought me a few years. It’s possible I’d be dead already if I hadn’t done them.

I digress. But I want to reiterate that just because I am writing heavy pieces here, this isn’t the way you will find me if you see me in my daily life. There is joy, happiness, living. Please know that. I’ve always explored the darker emotions, the harder subjects.

Perhaps I feel the written land of the upbeat is for others. My niche is here, in the agony of this disease. There is so much emphasis on “being positive” and all of that; I feel the compulsion to show the flip side, too. I do not want to show the nitty gritty details of what the cancer is doing to me, what my side effects are, what appointments I go to; while important, they are a laundry list. Instead I choose to do what I have been doing all along here: writing my way through the forest of my emotions.

…………………………………
Sometimes as I’m drifting off to sleep I make a sound.
A sudden hmmmmm or a series of loud breaths.

If my child did this as I watched her sleep I’d furrow my brow,
stroke her hair,
pull up the blanket and tuck it under her chin.

But who will do that for me today?
I push them away, it is not time yet.

I do not yet need to be cared for like that.
And yet, I know it will come.
I must fight these demons.
I brave the fear.

I agonize with the decisions.
I push harder than I should.
They are watching.

Always watching for a chink in the armor, a sign of weakness.
No one else can truly understand what each of us with this disease must balance.

Even those of us who have chosen to publicly share our lives with cancer still manage to keep much of it to ourselves.
I do.
I must balance privacy and pain and catharsis.

Many people say they still can’t believe my stage 4 diagnosis.
That denial is a luxury afforded to those who are not compelled to live it.

You must believe it.
We must believe it.
I must believe it.
I have no choice.

It’s my life now.
It’s my death someday.

That noise I make as I fall asleep?
It is the sound of startled agony.

1. I never have used the term “cancer-free” since it isn’t necessarily accurate. Some like to say they are cancer-free after they finish treatment for breast cancer. This is not always the case. In some cases there are residual cells, as there obviously were in me. These cells stay dormant in some people for decades– maybe the rest of your life–  and hardly dormant for any time at all in other people. 30% of those who’ve had breast cancer that isn’t diagnosed orginally as stage IV will ultimately have a metastasis where the breast cancer cells leave the breast and travel to other sites in the body. Only metastatic breast cancer can kill you. Rather than “cancer-free” I have always preferred the aforementioned term NED. This stands for “no evidence of disease.” The difference is that this term acknowledges that there may be still be cancer cells in the body, but they are not currently detectable on any tests. Maybe there aren’t any. Or maybe there just aren’t enough to show up on the tests

I sit on the beach, feel the sand’s angry texture rub my chemo feet in a way I wish it wouldn’t.

I watch my family in the ocean, turquoise and calm and vast.

My husband flips over, face in the water, takes some strokes out to sea. His movement is graceful, effortless, just as it was the when I met him 22 years ago.

He was a sprinter on the college team then, and while he laughs and says it doesn’t feel effortless anymore, nor perhaps fast, it does not matter. In my mind’s eye he is that young man, swimming fast, joking with his team, coming over to the stands to talk to me while chewing on the strap of his racing goggles. I fall in love with him again every time I see him swim.

My three children float, bobbing in the ocean water.
I can feel the distance between us, it feels like a lifetime.
It is my family in the ocean floating away from me.

I see the quartet, I watch as an outsider.
I do this a lot lately. I watch them from afar and think how it will be without me. A new family unit. Behind the big black sunglasses my tears stream down.

Suddenly Tristan is running from the water to me, across the sand. He stands, dripping, face beaming. “I just wanted to tell you I love you, Mama.” I take his picture. I capture the sweetness. I grab him, hug him, feeling the cold ocean water on him, melding it to my hot skin. I murmur to him what a sweet boy he is, that he must never lose that. I send him back to the ocean, away, so I can cry harder.

By the time they return to shore I’ll have myself composed. But my oldest immediately senses something amiss. She mouths to me, “Are you okay?” And pantomimes tears rolling down her cheeks.

Yes, I nod.
I walk to the water’s edge to prove it.

Mine, however, falls into the other camp: it did work for a period of time. It did what it was supposed to, just for not as long as we’d hoped. That is, it did reduce the amount of cancer in my body for a while, it did hold progression at bay.

It’s no longer doing that, my counts are very slowly rising, but that doesn’t mean it “didn’t work.” It just means it didn’t work for as long as I would have liked.

Most people with advanced disease will be leapfrogging around all sorts of agents (chemo, anti-hormonals, etc.) to try to see what works. The cancer mutates and becomes resistant to most treatments that will get used. That’s when it’s time to move on to a different one. I know people that have been on at least ten different agents. That leapfrogging is just the nature of the path many others and I are on. A small percentage find one that works and it continues to work for a long, long time. Research is needed to find out why these particular cancers are more easily tamed. We do not know now why that is the case but researchers are learning more and more about the subtypes.

So while the stability was not as long as we’d liked, in this particular case it doesn’t mean it didn’t work. It did. For six months. But now we’re moving on.

In my case, because my cancer is estrogen-receptor positive, we’re trying anti-hormonal agents. Although I don’t have ovaries to produce estrogen, the fat cells and adrenal glands in my body still produce estrogen. I will be taking two drugs every day now, Aromasin and Afinitor. The plan is in place and I’m already starting taking them, slowly on the Afinitor because it has a side effect of bad mouth sores if started at a full dose. I won’t go into other side effects here because I don’t know yet what my particular response will be.

Thanks for all of the notes of support and concern over the last 48 hours during the PET scan and this new adjustment. As always, I can’t respond to every message but I do appreciate them all.

I’ve got a PET scan early this morning (Thursday). It is being used as much to see how much progression there is as to be used as a baseline before starting the next treatment.

I’m still talking with my oncologists about what the next treatment should be (options include oral anti-hormonals and various IV chemotherapies). Whatever I choose will be ripe with new side effects and demand monitoring. My hands will improve; much as I am happy about that, I am truly sorry to see the Xeloda go. I think you always want to hope that the first thing you throw at this disease will keep you stable for longer than this. But, the Xeloda did good work for six months. But we knew this day would come: on to the next.

I am glad there are still things to try. But of course, for now, I’m sad.

I’m still grieving and angry and all of those emotions. But I’m also learning new skills of compartmentalization and recovery. I move forward, I move on, I live. There is no choice. I change treatments and see what I can get from it. My life has become a puzzle shifting pieces; we move and mix them around until they fit.  That fit won’t last, but hopefully it lasts for a while.

Do not be concerned if you don’t see a post for a bit. I’m going into research and decision-making mode. I appreciate all of the support from everyone. I know that if hopes and wishes and hugs could cure my cancer I’d be healthy for sure. I can’t acknowledge all of the messages right now and even the thank you notes for Tristan’s birthday party are sitting half-done. For now this is what I am focusing on and being every bit the mom and wife that I can be at every other moment.

In the still of the evening I hear a car,
A train,
A neighbor calling his own dog home for the night.

In the still of the evening my mind wanders again.
Back.
Always back.

I finished my 13th round of chemo 48 hours ago.
I wonder what is going on inside my body.
I wish I could see.
I wish I knew.

Is it working?
Is this round the one that will show evidence of chemo failure?
Will I move on to a new treatment?
One step closer to the end?

Every time I bang against something,
Every time I feel a twinge,
Every time that fractured bone aches,
I pause.

The pauses add up to moments.
The moments add up to minutes.

I reel them back in like fishing line, I show them who’s boss.

Just listen, I say.
Listen to the frogs. The creaks. The murmuring. The train.

Just listen.
Just hear the quiet,
Hear the house going to sleep for the night.
Feel the love.
Be grateful you can.

……………………………..

I always get some heat about posting essays about the stupid things people say to those with cancer.

I know people come here expecting to learn. That’s what I’m trying to do: educate. People inevitably vary in their responses to what people say. After all, responses to books, movies, and comedians are all over the place.

Occasionally people will get defensive and say, “Well, I have said one of those ‘stupid’ things and I meant well.” I am going to take an unpopular stance and say that meaning well isn’t always enough.

Maybe the listener is scared. Maybe they’ve had cancer or a family member with it. Maybe they are just uncomfortable talking about illness and death. It’s important to remember: it’s not about you. It’s about the person with the illness. If you are a friend you will need to get over your discomfort or get out of the way. What you don’t want is for the ill person to have to be consoling the listener or trying to minimize the seriousness of what they’re feeling.

Do not turn it back on you, or when you had cancer, or when your child or mother or 2nd grade teacher did. It’s not necessarily the same. Types of cancer are not the same. Even subtypes of cancer are not the same. Now, I’m not saying you should always avoid interjecting something to let the other person know that you’ve had experience with cancer. But the first thing out of your mouth shouldn’t be to connect it to someone else and what their outcome was, good or bad.

Different diseases cannot be compared. Different cases of the same disease cannot necessarily be compared, either. Chiming in with, “Oh, my second cousin’s boyfriend’s dog walker had breast cancer” doesn’t help a person, especially if it’s followed by “She suffered in pain for a long time and died” (yes, this gets said more often than you can imagine). The other end of the spectrum is, “Oh I know someone who had that. They’re fine now.” (Okay, but some people are not fine… should they be jealous? Feel inadequate?) Someone told me in response to learning I had metastatic breast cancer that his wife “had a bit of that last year.”

If you had a coworker who worked the entire time she had treatment, that’s great. We are happy for her, truly. But that bears no relation to how someone else can handle their surgeries, treatments, and side effects. So while you might think it’s supportive (in your mind you’re saying, “See, I’m being supportive and reassuring her that it might not be as bad as she thinks”) what that person may reasonably hear is, “Wow, if you have to take time off work you are weak, or at least not as strong as my coworker was.”

What would be something better to say to a coworker? How about “Please tell me how I can help you during this time. Is there something at work I can do to make it easier for you? I hope you know I would like to help if I can. If you can’t think of anything now, that’s okay. Just let me know if/when you do. I’ll ask again to make sure you’re getting the help you might need.”

Asking “Has this been a good week or bad week for you?” seems like a good bet to ask someone you might not be best friends with. It shows concern and they can be as detailed as they want in their response.

…………………………..

A few weeks ago someone tweeted to me, “As a cancer survivor myself, I know that half the battle is the mindset. Be determined to defeat cancer and you will!” Then followed that one up with “I meant that if we believe we can win against it, we will.”

Comments about someone’s attitude are definite don’ts. Does that mean those who die every day are responsible for their deaths because they are weak-minded? If it were as easy to defeat cancer as mindset, people would not die of it by the thousands every day.

Similarly, comments about appearance while rampant, can strike the wrong chord. I can’t tell you how many times people find out about my stage 4 diagnosis and say, “But you LOOK just fine!” The two are not always correlated, most especially at the time of diagnosis. This is why many people don’t know they have cancer and are completely taken by surprise. When people tell me “You look great!” I know they mean something nice by it. But the rest of that comment, the dark underbelly, is “You don’t look like you’re dying” or in some ways more insidious, “If you look that good you can’t possibly be that sick/it can’t be that serious.”

Don’t say you know exactly how someone feels if you don’t have evidence to back that up. Being a compassionate person and caring friend does not require personal experience that is identical to what the person is going through. Let me say that again, a different way: in my opinion you don’t need to have had cancer to be a caring friend. It might help you to be a good friend if you have had cancer, but it’s no guarantee. People “do” cancer differently. While the experience does make us members of the club, it doesn’t mean we will necessarily agree on how to deal with it. Part of what I try to do here is level the playing field. I try to bring you information and advice you can use so that you will know more about helping than you did before.

Don’t tell them that their science-based treatments are bunk and what they really need to be doing is just changing their diet, breathing pure oxygen, or relieving their constipation to be cured of cancer. Do not tell someone who is in the middle of treatment that chemotherapy is a waste of time. You may think your suggestions of supplements/vitamins/tea are harmless, however, there are serious interactions that can dull the effectiveness of chemotherapy and other treatments. Not all lotions are good to use during radiation treatment. Not all vitamins are good additions.

………………………….

I like what @travisbhartwell tweeted to me: “Mindset changes the days you have, not the number of days you have.”

The worst thing that can happen is that friends disappear. This is happening to me in spades. It may be that they are afraid they’ll say the “wrong” thing and end up being written about. But I think it also has to do with the fact that death and illness make people uncomfortable. I represent their fears. People who should be in touch with me at least every week or two (because that is how often we saw each other before) have just dropped away.

That said, there are so many people in my life who are so wonderful. Who offer to help, who make it easy to accept it. Who send notes or emails of support months after the initial shock. Who keep asking what they can do. Who pointedly give ways they can help and ask if I could use it.

………………………………..

One thing I think is very important is to always say to someone who is ill or has experienced a death in the family: do not write me a thank you note for this. Do not feel the need to answer this email. Do not feel the need to call me back.

If you live near the person ask them, “Would it be helpful if I texted you before I run errands so that I can pick something up for you?” Texting and email help because talking on the phone is almost always too much of an ordeal and/or inconvenient. I have friends who email me at the beginning of the week to say, “I’ll be at the grocery store, the drugstore, and the post office this week. Can I do anything there for you?” Some will text on the spur of the moment, “Running to Costco. Need anything?” These are invaluable offers.

If you have no knowledge of what information you are being told, admit it. People with serious illnesses do not expect you to know everything about their new diagnosis. They are probably learning a lot of information in a short period of time and may not even know the details of their diagnosis and treatment. They don’t expect you to have the knowledge but you need a way to connect. I recommend when someone tells you about a diagnosis you don’t know much/anything about you say, “I don’t know anything about what that diagnosis means. Would you mind telling me about it, and what it means for you?”

How is it impacting your day-to-day life and what part of that can I help you with?

I’m so sorry to hear that.

What is the worst part of this for you and how can I help make that a bit easier for you?

If your friend is dying or has a relative who is, and they refer to the death or how difficult treatment/daily life is, don’t brush it off, dismiss it, or say, “Oh, you’re not going to die. You’ll be fine. It will all be okay. Things will work out.” Saying this to someone with stage 4 cancer comes across as dismissive of the seriousness of their diagnosis.

If the listener says, “Oh, that’s depressing, let’s not talk about dying,” it can isolate the person who is ill, making them feel they should not be thinking about what is a very real concern or outcome. As Julie Klam points out in her book Friendkeeping, acknowledging someone’s wishes should be paramount. She tells the story of her mother and her mother’s friend Patty who was dying of cancer. Patty wanted to give Julie’s mom a pendant. Rather than gratefully accepting it, Julie’s mom insisted Patty would wear it again, that she would get better. Instead, she died a few days later. Years later when recounting the story with regret, Julie’s mom said, “She knew she was dying. It probably would’ve been comforting to her for me to acknowledge that… I was just afraid that she had some small glimmer of hope. I just didn’t know.” I would bet that if that same scenario happened again, Julie’s mom would act differently.

Later in the chapter Julie recounts being a friend to someone who had to terminate a pregnancy. She asks Julie a question that continues to haunt me: “Will anything ever be good again?”  It echoes in my mind now: Will anything ever be good again? Will anything ever be good again? 

The truth of the matter is that for some it will. For some people, it won’t.

Check in with your friend intermittently. Give her reminders that she is not forgotten even if she is not out in public. I love getting cards or texts or emails that tell me what my friends are up to. As I write this my friend Kathleen texted me to say she was eating at one of our favorite places. “I miss your company” she said. How can you not love that?

I love written notes. I save my favorites. When I’m having a bad day there is something about pulling out a card, seeing handwriting, reading a message. It’s just more personal than seeing it on a screen. Of course texts and emails are great for frequent check-ins, but for a special message? Real paper can’t be beat.

Other winners to me are notes that remind me of a funny experience a friend and I had, a favorite memory. Many people know I love my garden and flowers. They will send me a pretty card and tell me what they saw at the farmer’s market or in their own garden or what they’re looking forward to about Spring. Sometimes they will tell me about being on vacation and how they thought of me when they saw the water or the tropical plants and they remembered a trip I’d blogged about.

Some send a favorite poem or story or memory. I like those. I don’t like religious quotations or cards that focus on people praying for me or hoping for a miracle. That assumes I am a religious person (I am not and I don’t believe in miracles). I think cards should focus on the person— the connection to that person, your friendship, not what types of religious comfort or explanation the writer endorses.

One Twitter friend, Neil Shurley, wrote me a song titled “We Love You, Lisa,” and then made a video with people holding up signs that say those same words. I still watch it. I always cry. It’s one of my favorite things anyone has ever done for me. This, from what most people would term a stranger. Another friend, Nichole, took photographs that people sent her, combined them with poems and sayings and turned them into a photo book for me. When I’m down it’s another thing I reach for to feel support.

Does the person who is ill have children? If so, you can do what one room mom did for me this year: For school events Lizzie always asked if I felt well enough to join on any party or field trip. She offered rides to school performances. When I could not attend, she (and other moms) took photos and videos and sent them to me… without being asked. My friend Zerlina put together a playdate calendar and a dozen moms signed up in rotation to have Tristan over three times a week for playdates for the past six months. This was especially helpful. Sometimes I’ve been well enough to say we would host the playdate here. But knowing there was fun built in with his friends was a relief to me.

Finally, I always love my mother’s suggestion for one of the best questions you can ask in any situation whether it be posed to a friend, a spouse, a child, a coworker. When someone comes to you with a complaint, a problem, or a rant asking the simple question, “Do you just want me to listen or do you want my advice?” is a wonderful way to be supportive. Sometimes a friend just needs to cry and vent, no advice wanted. By asking you will show sensitivity to the distinction. This is what I mean by not needing to have had the same experience to be a good friend. Listening matters. It’s free, and all you have to do is offer (and follow through).

And if you have a serious illness how do you respond when someone asks you how you are? If you don’t want to answer in detail, one suggestion is to say, “There are good days and bad days. Today is a … day.” This response is also a good one after the death of a loved one. If you are having a good day it allows you to acknowledge they’re not all like that. If you’re having a bad day it expresses that you know they won’t all be like that, either.

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I think we all like to hear that we matter, that we make a difference, that we are loved. In the end, you can never go wrong by telling (or writing) someone what they mean to you, what you like about them, and what you enjoy most about being with them. This is the essence of friendship to me. Some days you need a serious chat. Some days you need a friend to be silly with. Some days you need a friend to go shopping and have a gossip session with and try to put cancer in the back seat for a few hours. There are many ways to be supportive.

My dear friend Cathy texts me every morning to wish me a good day and asks, “How can I help you today?” I most certainly don’t expect that every friend should do this. But boy, it means a lot that she does. I rarely need something these days. But I will someday. And when I do, I know she’ll be there for me.

I have so many people in my world who care. I know how fortunate I am. I hope that some of these suggestions will be helpful and I am sure you will find others as readers comment on the post. You don’t need to have many things to say… a few good options will do.

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I hope you all have a good weekend, we are starting to feel Spring here and boy, does it feel good!