Many of us have been through illnesses that require operations, risky procedures or recurring downtime that can change our lives, even if we fully recover. Any of this makes us face our death.
Our imaginations race toward finality. No matter how elevated or sublime our thoughts become, this state of mind adds to our pain and brings despair.
How our friends talk to us as we are going through this and recovering can be a source of further pain.
I have been catheterized for clogged arteries in my heart two times in the last 10 years, once with an angioplasty and once with a stent.
For a recent angiogram to see what might be causing some new arrhythmia, I found myself in the hospital on the same day that my son was being operated on for a severely broken collarbone.
We were greeted by all kinds of comments from friends and associates that prompted these reflections on what people say to those who are ill.
I offer them as a guide to those who want to talk in a helpful way to those who are ill and also to reveal some painful aspects of our current culture.
And they may empower the ill to speak up for what we need.
Connecting with sympathy
These comments focus on the patient and what he or she needs -- sympathy, not advice.
* How are you feeling?
* Is there anything I can do to comfort you?
* I'm really sorry you have to go through this.
* I missed your friendship and warmth while you were down.
* I'm very glad to have you back.
* I want to support you through your recovery. I'll call you in a day or so.
* And later: Would you tell me the story of your illness, and what happened to you?
This critical approach shifts focus away from the patient and features the advice-giver as a knowledgeable exemplar of good habits.
* You should lose weight, exercise, stop your unhealthy behaviors, etc.
* You should follow my health example to avoid future problems. Do what I do. I'll e-mail you my list.
* I had a similar problem and here's what I did. All my tests are now great, and I take the following vitamins, supplements and teas.
* Maybe you shouldn't take all those pills. I don't take any pills. I'm as healthy as a horse.
* There is none of that in my family. You should get some genetic counseling.
* I've read articles about things you should do to fix your problem. Would you read them?
* I can recommend a great doctor/healer/therapist who can fix your problem.
This hurtful approach is an all-out assault on the patient and reveals the underlying disgust, anger and fear one's illness can provoke in others.
* I could see you were headed for this by the way you behaved but I didn't say anything because you won't take any advice.
* I could see you would come out fine; I can see such things, really. And see, I was right. Your worries were groundless. Trust your future to my clairvoyance. You're fine.
* You need to change your way of thinking. Think positive thoughts, which can actually shape what comes your way. Read "The Secret."
* I interpret what happened to you as a sign of your avoidance of your life purpose, your archetype.
* If you believe as I do, this would never have happened.
* Deep down it's your fault; and you have only yourself to blame. Your whole life is wrong.
Our society seems unable to accept illness as a normal part of life. We don't think it's "natural," despite its potentially transformative and ennobling power and, of course, its inevitability.
Some would give all the credit to our genes; others would make illness our personal, conscious responsibility. Whatever the correct ratio of genetic factors to personal behavior, we're likely to blame people for their diseases.
A character in Tolstoy's great story of disease, "The Death of Ivan Ilych," signals the meaning of Ivan's death to his fellow worker: "He has made a mess of things -- not like you and me." We are a culture of blame and we can persecute the sick as deserving victims.
Compassion and sympathy are tough. They require us to express how we feel about one another. They expose our inner life. They reveal the depth and character of our being.
When you open yourself to another, especially one who is sick, it heals you too. And that may be the most powerful medicine we both give and receive.
Robert Louis Chianese is a professor of English at Cal State Northridge and a coronary heart patient.Copyright © 2014, Los Angeles Times