Dear Wendy
Dear Wendy

“How Do I Ask My Friend Fighting Cancer If I Can Say Good-bye?”

One of my best friends since fifth grade (we are 32 now) was diagnosed with stage IV cancer two and a half years ago. We don’t live near each other anymore – she lives in Texas and I live in Florida, but we talk frequently and have visits as often as possible. In the past few months, she has been getting significantly worse, and chemo treatments haven’t been working. Up until now she has always been very positive about fighting cancer and her diagnosis, and obviously I have followed her lead anytime we talk. I let her share what she wants with me. Recently, she mentioned that doctors had started asking if she had end-of-life plans in place, and she said she isn’t ready to think about that.

My dilemma is that if it comes to it, I would really like to say goodbye in person. But I have no idea how to broach the subject. I am in contact with her mother, who is very involved in my friend’s care and treatment. I was thinking that I might send a handwritten letter to her mother asking about it. Assuming they would be comfortable with my presence at some point. I don’t know – is this an inappropriate request for a non-family member? I am at a loss for words. How are you supposed to ask a mother to please let you know if her daughter is about to die?

I don’t know what the right course of action is. I don’t want to cause any additional pain or stress to the family, especially since I really hope I am worrying for nothing. But my friend means so much to me, and I am afraid I will regret not asking if something does happen.

If you have any thoughts or suggestions I would very much appreciate it. — Worried About My Friend

I’m so sorry to hear about your friend’s cancer and the recent change in her prognosis. It must be a scary and stressful time for everyone, most of all your friend and her immediate family. One “benefit” of a long-term, serious illness is that the end is often drawn-out enough that there’s some warning for everyone involved to, essentially, make those “end-of-life” plans your friend isn’t ready to think about yet. Let’s hope it doesn’t get to that point, but if it does, there’s a strong likelihood that the signs would become clearer and more urgent, to the point that she would have no choice but to accept them and to reach out to those closest to her. If it comes to that point, there’s also a strong likelihood that she would be moved to hospice care, an end-of-life environment, often at a facility devoted solely to hospice or at one’s home, where life-saving treatments are halted and comfort for the patient is made a top priority. Another priority is giving loved ones the space — and the guidance — to say good-bye and begin letting go.

Obviously, these are not easy things to think about, let alone ask about. But I think you can let it be known you would appreciate being included in that end-of-life space, if it comes to that, without offending or needlessly hurting anyone. Since your friend has said she isn’t ready to think about it, you should respect that and not press her. And since you have been in regular touch with her mother, I would reach out to her. I would start by expressing your heartfelt feelings about the position she’s in and the gratitude you have that she’s spent time and energy remaining in contact with you. And then segue into how grateful you would be to be included should your friend’s courageous fight transition to the next phase and her comfort become a priority over treatment.

Here’s a sample template that you can personalize:

“Dear ‘Nancy’,

Over the last two and a half years, while attention has rightfully been on ‘Carol,’ your example of strength and grace has and continues to be an inspiration to me. I know only what it’s like to support a close friend from afar who is battling cancer, and I can’t begin to imagine how this has affected you, a mother, watching her daughter fight the battle of her life. Please know your example will always be a source of inspiration to me in the face of challenges. I also want you to know how much I appreciate your taking time to keep me updated and in the loop when you are already devoting so much time and energy to Carol’s care. It means so much to me.

Something else that would mean a lot to me — and this is difficult to ask, so I hope it is received in the way I intend — would be to to be included should, God forbid, Carol’s fight transition to another phase and loved ones are invited to help make her comfortable and surround her with love. It’s hard to think about that, and Carol has expressed to me that she isn’t ready to, and maybe you aren’t either. But I would regret it if I didn’t at least make it known that I would very much like the opportunity to be by her side and to lend and share any support and comfort I can with her, with you, and with everyone who loves her.”

Sending warm thoughts to your friend for healing and strength. Please keep us posted.

***************

Follow along on Facebook, and Instagram.

If you have a relationship/dating question I can help answer, you can send me your letters at wendy​(AT)​dearwendy.com.

33 comments… add one
  • avatar

    Kate November 21, 2017, 10:02 am

    I don’t know, I don’t think it’s appropriate to talk to either the friend or her mom about end of life eventualities if they’re not there yet in their minds. Mom probably isn’t either, maybe even less so than the daughter. I wouldn’t think she’d be happy to get a letter anticipating her daughter’s death if she hasn’t come to terms with it. A girl I went to HS with lost her young daughter a few years back and the sense I got from her blog was that she was NOT willing to think about that possibility until the very last days. I wouldn’t if I were you. Can’t you just have faith that you’ll know/hear when and if she’s transitioned to palliative care? And that if you don’t get to say goodbye in person, that might be all right if the alternative is bringing up the topic of her death prematurely and upsetting her and her mom?

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      Kate November 21, 2017, 10:05 am

      Especially if they’re Catholic or other Christian, I think, this wouldn’t be well received.

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      dinoceros November 21, 2017, 10:56 am

      Especially without knowing what the time frame is. My mom had a friend who had cancer and they’d been treating it for a while, and when the doctors asked her to consider ending treatment, she still lived for a year. It would have been strange (and probably upsetting) for someone to ask to say goodbye at that time.

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  • avatar

    Hannanas November 21, 2017, 10:31 am

    When my father was in the final stages of leukemia, a longtime friend of his that he hadn’t seen in a while, dropped by unexpectedly (he phoned beforehand but still). He said he just felt a strong urge to come. It was a major gesture, and my dad was thrilled to see him (as we were). He died shortly after. Still gives me goosebumps, I will never forget that.
    My point is that you don’t need a ‘reason’ to go – just go.

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    • avatar

      Kate November 21, 2017, 10:33 am

      Right, I’d just go. You don’t have to bring up the idea of her passing, or say goodbye, just visit and be with her.

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    • avatar

      Bree November 21, 2017, 10:38 am

      I definitely agree. The LW should go visit her friend soon. It doesn’t need to be when she thinks her friend is about to pass. Unfortunately, something unexpected could happen (like a heart attack, stroke, aneurysm, etc.), and her friend could pass away suddenly. If that happens, the LW would really regret not seeing her friend sooner.

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    • avatar

      LisforLeslie November 21, 2017, 11:58 am

      Agreed, just request to visit. Understand that your friend’s strength is likely severely diminished and she may not be able to have a long visit. You don’t need to have some emotionally wrought discussion, but you can say “You are a wonderful person and I’m glad you’re in my life.” It is unnecessary to talk about death because the whole point of the visit it to celebrate your friendship and the impact on one another’s lives.

      But just be aware, you may only get to see her for a very short time . So don’t expect to sit with her for hours, she may not be able to take it. You may end up travelling for hours to have 1/2 hour with her and you have to be ok about that because this is not about you (not that your letter is any indication of selfishness, I’m just putting out the reality).

      L

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      • avatar

        convexexed November 21, 2017, 8:19 pm

        This is very true. There were days my friend wanted me in the hospital room while she was getting treatment, and wanted me to help with bathing, etc, and there were days she was grumpy and was like, go away, I want to be alone, or I need to rest. So during my visits I spent a lot of hours wandering aimlessly around a local mall or watching TV in the hotel, only to have her suddenly call and want me back at the hospital immediately. It’s not inefficient or time wasted if you remember that time when people are sick or dying just plays by completely different rules, and you have to go with the flow. Time you aren’t with your loved one you can use to decompress, to self-care, to process your own feelings. It can even be a relief to get away from the bedside for a little bit and space things out because it can be exhausting and very emotional for you.

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      ktfran November 21, 2017, 2:06 pm

      This is what I was thinking too. Visit! Don’t make it about her eventual death, make it about her life and your close friendship. And do it now!

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      • avatar

        MBail November 22, 2017, 12:21 pm

        Exactly this. If you and your friend chat regularly, just tell her you were thinking of coming for a short visit or you’ll stop in to see her while in the area. Definitely don’t tell her it’s to say goodbye.. she likely realizes that, but if she’s not ready to think about that stage yet, then it’s best not to bring it up.
        My dad was diagnosed with stage 4 cancer at 54 in January and passed in May. He was staying with us in another city so his family and friends weren’t nearby. Most of them made a special trip to come see him at some point during those few months. Including a couple friends who hadn’t seen or spoken with in YEARS! Most of them just reached out and asked if it would be ok to stop by to visit (whether he was at our place or the hospital).
        As his daughter, it was very nice to see and it honestly made my dad’s day when someone would show up who he hadn’t seen in a long time.. brightened his spirits for a few hours.

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  • avatar

    Sara November 21, 2017, 10:43 am

    You say you are visiting and talking in between visits. Take the opportunity on one of those visits to tell your friend to tell her how much you love her and how much her friendship has meant to you. I think she already knows, though. I think this will come across better than a formal “goodbye.” If she isn’t ready to talk end of life, I can’t imagine she wants to hear a “goodbye.”

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  • Dear Wendy

    Dear Wendy November 21, 2017, 10:49 am

    Yeah, I think you guys are all right. LW, skip the letter — just go see your friend. Don’t say good-bye, but say whatever else you might want her to know, like “I love you” or whatever.

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    • Miel

      Miel November 21, 2017, 12:16 pm

      Wendy, I just wanted to say that your letter was compassionate and really well crafted. Not sure if the LW should send a letter or not, but I just wanted to say that on your end this was really well written.

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      • Dear Wendy

        Dear Wendy November 21, 2017, 2:25 pm

        Thanks! But thinking about it more, I agree with others that sending it isn’t necessarily and the lw should just go visit her friend and be there for her for whatever SHE needs (and not make it about what the LW needs).

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    • avatar

      Culture Correction November 21, 2017, 2:13 pm

      I totally agree. You should make plans to see her now, so you both can get the most out of the visit. Death doesn’t come on a timetable, and even if you did get word and made immediate plans, it could still be too late.

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  • avatar

    dinoceros November 21, 2017, 10:53 am

    LW, I’m so sorry to hear about your friend. You don’t need to (nor should you) frame it as needing to say goodbye. Just tell your friend that it’s been a long time and you’d like to come visit. See what she says. Don’t make it into a huge ordeal. Just a text or call or however you two communicate will be fine.

    If she accepts, then just enjoy spending time with her. Help out. Whatever feels right at the time. Don’t force her to talk about dying if she doesn’t want to. Even if she isn’t interested in verbally “saying goodbye,” a visit where you can reminisce or just enjoy each other’s company should be enough of a goodbye in your own heart.

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  • avatar

    Scattol November 21, 2017, 12:08 pm

    THIS!

    It’s been my experience that a visit and reminiscing is what your friend needs the most. She already knows she’s dying, she doesn’t need reminders. She will appreciate the fact the you spent your precious time to be with her.

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  • avatar

    ele4phant November 21, 2017, 12:22 pm

    I mean, can’t you just book a trip to visit her?

    You don’t need to tell her it’s to say goodbye, she’s going through an incredibly rough time, I assume she would appreciate seeing people she loves in person.

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    • avatar

      George Nagel November 22, 2017, 12:22 pm

      yes! Even if she lives for another 6 months, a year, 10 yeas.. she will always remember and be grateful that you came to see her during a very tough time.

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  • avatar

    Lurker kate November 21, 2017, 2:10 pm

    As someone with a close friend who died at 30, and who was in the end stage of an illness for months before that, just go visit your friend.

    Please don’t try to craft some sneaky “good bye” into that visit. Just go see your friend and spend time with her and let her say what she wants to say and tell her you love her. Follow her lead on this topic. This isn’t about how you want to experience her dying. This is about how SHE wants to die, how she wants experience the time leading up to it and how she wants to talk (or not talk) about it. Your presence as a friend is what she needs, she doesn’t need to accommodate your need for a conclusive “good bye visit”. If SHE needs a specific good bye, she will tell you.

    I hope all of that didn’t sound too harsh. Death is awful and I’m sorry that your friend is facing this. Just let her decide how she wants to face it. And go visit her and be there for her.

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  • avatar

    Emily November 21, 2017, 2:55 pm

    I agree with everyone else who says just go see your friend. Spend time with her NOW while she is still able to communicate and talk with you. Sometimes “the end” is fast and sometimes it is slow but the person can be drugged or unresponsive. Better to just do it then to wait until it is too late and regret not having gone. XO

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  • avatar

    MaggieB November 21, 2017, 4:00 pm

    I guess I’m reading this differently from a lot of people. I didn’t think that she didn’t plan on visiting until immediately before her friend’s passing. I thought that she’d continue to visit regularly as usual, but that she also wanted the opportunity to fly down immediately if her friend was nearing the end, so they could see each other one more time.

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      Kate November 21, 2017, 4:16 pm

      Right, but I don’t think it’s a good idea for her to ask that they alert her when the end is near. 1) if she’s a very close friend, and they’d want her to be there, I think they’d reach out, but 2) I just don’t think it’s appropriate in a situation like this to start talking about the eventuality of her passing. Her mom may not be ready to accept it and it could be upsetting.

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    • avatar

      dinoceros November 23, 2017, 11:37 am

      Hmm. I just read it as that she visits her friend from time to time, but wanted to have a special visit where they verbally said “goodbye.” I think that’s what people were responding to. I didn’t gather that most people thought she was going to fly down immediately, just that folks were concerned she was putting off a visit in order to gather courage to ask for a “goodbye.”

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      • avatar

        dinoceros November 23, 2017, 11:43 am

        Hmm. I re-read the letter, and I actually do read it like that. She says she wants to visit to say goodbye and wants to be alerted when it’s getting close. That doesn’t necessarily means that she wants to go right when she dies, but she presumably wants to visit sometime after it becomes somewhat imminent. Like Kate said, asking to be alert seems like a no-no. Additionally, I don’t think anyone should really place any sort of task on the family of a dying person. If they have the capacity to call a bunch of people when their loved one is dying, cool. If they are preoccupied with their own grief and calling the people they have to (family) and the practicalities of caring for the person/being with them and cannot call friends, even close ones, then they have no obligation to.

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    Essie November 21, 2017, 5:58 pm

    LW, just go. As soon as you can. Sometimes with terminal illnesses, it’s a slow, long progression to the final days, and sometimes it just happens, sooner than expected and without warning. People throw a clot and have a sudden, fatal stroke or a heart attack, or they just pass in their sleep.

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  • avatar

    convexexed November 21, 2017, 7:55 pm

    My best friend from high school lived across the country from me when she became sick; we were both just out of college. For the next six years, I visited, as she went through various transitions (chemo, remission, chemo, transplant, rejection, attempt to be approved for another transplant). Sometimes she (or her family) asked me to come, to be there for a specific transition, like in the weeks before her transplant, and sometimes I just went because I had vacation time/the budget to go, even if it wasn’t ‘urgent’. She and her family maintained a fighting mindset, and there were times I would sit there in the hospital with them as the doctor said, ‘It’s time to talk about the goals of care’, and they would disagree or just refuse to hear what he had said. They would ask me for my support, for me to agree with them that the doctors were wrong and she still had a fair shot at living a normal lifespan. That was very hard; I had to step back and say things like, ‘This choice belongs to [friend], and I really can’t weigh in, but I’m here for you no matter what’. Even though I knew the odds were terrible, I knew they were deep in denial, and I believed the aggressive, long-shot treatments were leaving her with no quality of life, it wasn’t my place to push or say. It would have been wrong of me to shove loss into their faces before they were ready. They have the rest of time to accept the reality of her death, after all.
    Finally, one summer the parents called me and said, ‘She won’t get approved for the transplant.’ I asked if she would like a visit, and they said that would be a good thing. I never said, a visit to say goodbye, and they didn’t either. It was like there was an unspoken rule where we had to talk around it—I was following their lead. I wish it wasn’t that way, and I’d rather be more direct, but you always have to just recognize the dynamic and go along with it. You can’t try to shape it. I barely had the money for that visit, and I had to jump through a million hoops at work, but I was sure this time was near the end. I also knew if I went to see her now, and she died, I couldn’t afford to go to her funeral, too. I went to see her and she was barely conscious the whole week I was there; I don’t know if she knew who I was. She’d been on a ventilator for a long time by then, and I remember sitting there and realizing I hadn’t heard her voice in years, and that I would never hear it again. When I finally had to leave the hospital to catch my flight home, it was the hardest thing to walk out of that room, knowing I would never see my friend again in this life. She went home that week to her parent’s house, and died a few days later.
    All that to say, I know how bittersweet it is to be the friend in that situation, to book the flights, to travel without knowing, to follow the family, to hope and to be afraid. I am so grateful for every visit I had with her. To be honest, the course of that illness was so rocky that I treated every visit like I was saying goodbye, like I might not get another chance. That’s what I would advise you to do, LW. Ask the family, ‘is it okay if I visit soon?’ and just visit. Book a hotel whenever you go unless they insist on hosting you to be sure you don’t add the strain of hospitality to the strain of caretaking. Every time you see your friend, which I hope is many more times and for many years to come, make sure you don’t leave without telling her how much you love her, how you hold her in your heart wherever you are, or whatever else you want her to know. Then even if you lose her and can’t get there in time, you won’t have regrets.

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  • avatar

    convexexed November 21, 2017, 8:09 pm

    To clarify, when I say to ‘say goodbye’ in each visit, I don’t mean in a way that is obvious to your friend or heavy-handed. Do not say, ‘In case you die…’ or ‘this is our last goodbye…’ or make a big production of it, or talk about how hard it will be for you when she dies.
    What I do mean is, don’t let your feelings go unspoken out of fear that ‘it’s not time yet’, don’t get back on the plane thinking, ‘I wish I had said how much she meant to me, oh well, I guess I’ll say it next time.’ Just say it. Every time.

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  • othy

    othy November 21, 2017, 9:03 pm

    If she’s nearing the end, she very likely won’t have much warning if she takes a downward turn. A friend of many of my friends recently passed away from cancer. She had switched to comfort care, and she and her husband flew to Florida for one last beach trip. Her doctors had given her the blessing to go, and estimated she had about 2 months left after she was supposed to come back. She had a great second honeymoon and as fine (for someone with stage IV cancer) the whole time.

    They had a layover in Atlanta on the way back when she suddenly started acting strange. She was rushed to a local hospital and sadly she passed a few hours later. None of her friends or family had the chance to say goodbye in person, since she was far from home. However, in the months leading up to her death, she had visitors from all over and truly cherished those times.

    Go now, and then again later if you have the opportunity. It doesn’t have to be a ‘goodbye visit’, even if it ends up being one. Just tell her you love her and spend time being there for her.

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  • FireStar

    FireStar November 21, 2017, 9:54 pm

    I’m with everyone else. All I kept thinking when I was reading this was “Go. go now”. Sometimes the decline is rapid at the very end. People aren’t conscious necessarily. Sometimes they just want family. What would mean more is a visit to tell her you love her and what she means to you while she can still enjoy your company. I can understand timing your visit specifically if she had no one and you didn’t want her to die alone. But that’s not the case. So go love on her now and anytime you can. If you aren’t there at the very end it’s okay… You are there for the important part…. when she is still here.

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  • avatar

    Tricia November 21, 2017, 10:40 pm

    Whatever you do, DO NOT say “Goodbye”. EVER. That tells her you have given up and it is going to bring her down. She deserves better. This is not about you and your feelings. This is about her and making her last moments the best possible.
    What you CAN and SHOULD do is make sure that each time you talk to her that you say “I love you.” I wasn’t able to say goodbye to my father when he passed away from cancer and we lived in the same house. However, the last words we said to each other was “I love you.” and those words have stuck to me more then saying “Goodbye” ever could.
    Please do this for her. That’s all she wants to hear.

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  • avatar

    DG620 November 22, 2017, 11:54 pm

    Having been through this last year, I would agree other commenters that I would simply ask to visit if possible. And definitely follow the lead of your friend and her family. Until the week she died, my sister continued to pray for total healing, and said “if I die…” instead “when” even though we knew time was limited.
    If there is an element/sentiment of your friendship that you really wish to share, you can do so without making it a “goodbye”.
    I can honestly say that the goodbye part felt like something that must be said when we got the devastating news, but when it came down to it, it’s really not what I was focused on. Just how much she was loved and how much she would be missed.

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  • avatar

    Kate November 23, 2017, 7:30 am

    You know what, “saying goodbye” is not a thing. People often die very suddenly. Other times it’s a process.

    You just spend the time with them that you want to spend and say what you want to say. YOU don’t get to decide when it’s time to say goodbye to them, like, goodbye, you’re leaving this world.

    That’s not up to you. Maybe if it’s your mom who’s passing, and you’ve sat by her side for days or weeks and it’s now her final moments and you’re holding her hand, and it comes to you to tell her it’s ok to let go, and you love her and you’ll see her again… ok, maybe that’s a goodbye. But most of the time, saying goodbye isn’t possible or appropriate. Again, just not a thing.

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