Mind your words
‘How are you’ may not be appropriate in certain situations.
MY patient confided in me. “I have been living with metastatic breast cancer (the cancer has spread to the bone in this case) for two years. I feel well with the endocrine treatment you are giving me. I have no pain and my life’s activities are normal.
“But ever so often, I am asked ‘How are you?’ in a knowing, pitying manner. These three words make me depressed as I am reminded of my cancer, like an unwanted companion, a time bomb. I wish no one would ask me ‘How are you?’ as I would be much happier not to be reminded of my illness.
“Even worse is when they ask me ‘Are you ok?’. I try to avoid people who are always asking me about my illness.”
My patient is not the only one with this predicament. Not by a long shot.
I sauntered into my colleague’s waiting room and met a doctor friend of mine. I had no idea then that he had a very advanced incurable condition. Unknowingly and in a cheery fashion, I asked him “How are you?”
He gave me a wretched, deathly look and not a word escaped his lips. I at once knew that something was amiss and that he could not answer my question. He could not say “Fine”, as he wasn’t. He did not want to go into the gory and morose details of his illness.
I had unwittingly caused him consternation. I kept my peace and learnt a lesson.
My cousin lost her son who was in his mid-30’s to cancer. He was an investment banker who was not unhappily married and had a pair of twins. Her world collapsed. I met her at a Christmas party. It had been over three years and she wasn’t even a bit over it.
I had learnt my lesson. I did not say “How are you?”. It would have put her in a quandary. I silently embraced her and told her to get in touch with me in her own time and only if she were up to it.
If I know that your house has been burnt to a cinder or your car has been soaked in flood waters or that you have just been stripped of seven Tour de France titles, I will not ask you “How are YOU?” or “How ARE you?”. It would be insensitive of me. I would not ask you for details that led to your tragic circumstances if at all I feel you are discomfited by it. There are many things I can say to you, but I won’t say “How are you?”.
I could say “I am so sorry” and leave it at that. I could also say “Please call or text me if I can be of any help.”
“Let’s get together soon but only if you are up to it” is something else I would say. A sympathetic hug will do fine if religion and culture do not bar it.
While hugging you, I would whisper, “I would really like to help you. Please get in touch.”
“Hello, good to see you” and “Nice to see you are coping well” are welcome, neutral statements to someone in distress.
“How are you?”, especially said with a high inflection towards the end, almost always puts the person who is not fine or well in a difficult position. She doesn’t want to say she is well because that would be telling a lie and neither is she in the mood to tell you her woes.
I know it is difficult to refrain from saying “How are you?” when you see someone who is in dire straits. But, please try.
Your “How are you?” will most likely make a person feeling bad feel worse. If you are sick to the gills, hocked to the hilt, put on the mat by your boss or have just been diagnosed with a deadly African viral infection, and if someone asks you “How are you?”, how do you react?
If you wish to share your sorrow with her, by all means. Please remember you may have to repeat your depressing (to you and your listener) story 16 times a day. Like the Ancient Mariner who stoppeth one of three.
But if you want to cut the conversation short and still not appear abrupt or rude, you could say “I have seen better days”, “So-so, considering the circumstances”, “As well as can be”, “On an even keel”, “I am largely symptom free”, “Things could be worse”, “I am dealing with it well”, or “I have done all the things on my bucket list.”
Dr Albert Lim Kok Hooi is a consultant oncologist. For more information, email starhealth@thestar. com.my.