I happened to run into an old friend whom I hadn’t seen for a while. After asking about each other’s families, work, etc., she blurted out, “Did you know that I’ve been diagnosed with Parkinson’s Disease?” I was stunned by her news because, of course, she looked fine (Do people judge your book by it’s cover?) . And then I felt sad, because I’ve worked with people with Parkinson’s and know how difficult it can be.
I suddenly felt a little anxious because I knew I had to say something but all I could dig up was, “I’m so sorry.” Ugh. Immediately, I wished I could suck those words back into mouth. They sounded flat and meaningless.
The thing is that I should know what to say. Having been on her end of the conversation too many times to count in my own life and spending so much of my time with clients discussing the issues of talking about illness. But when I’m on the other end of the conversation, the one who who is the witness or is being given difficult news, I’m stuck. Her response, “It’s o.k., really. We’re coping and just getting on with our lives for now.” was what I’d said myself so many times. With those words, she was telling me not to worry about her. She was taking care of me. It could be that she preferred that to probing questions. But my response had left her without a choice. “I’m sorry” doesn’t encourage conversation, it closes it.
Shortly after, I was speaking with a client who had just been diagnosed with a second,, even more difficult to treat chronic disease. Again I found myself replying, “I’m so sorry.” But she didn’t accept that. “Really?” she said. ” To tell you the truth, after working with you, I’ve learned to recognize how uncomfortable I am when people say that to me. This wasn’t your doing and you can’t fix it Why say you’re sorry? “
Great question! We’d worked on how she talks about illness to other people. But she understood that this was different and she called me on it. This was a teaching moment for me. I told her I was grateful to hear this and explained that I ‘get’ that this is a poor response, both for the person in pain and the person who is trying to comfort. But, when I asked her what would be a more helpful, empathetic response, she was as clueless as I.
And. then I read Atul Gwande’s book, Being Mortal, and found the words I’ve been looking for. Dr. Gwande learned about difficult conversations while working with a palliative care nurse. In the world of palliative care, conversations like the ones I’m describing (as well as those that are fraught with much more complexity) start with: “I wish things were different.”
Wow. These five words say volumes to me. The statement doesn’t patronize with a meaningless apology. Instead it shows empathy and opens the space for the other person to move around and decide how to respond. Most importantly, I think that unlike “I’m sorry”, “I wish things were different” opens the door for meaningful conversation. Try it sometime. Let me know what you think.
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