{"id":47358,"date":"2020-04-30T16:25:07","date_gmt":"2020-04-30T15:25:07","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=47358"},"modified":"2020-04-30T17:24:18","modified_gmt":"2020-04-30T16:24:18","slug":"richard-smith-how-to-talk-to-the-dying-a-lesson-from-a-novel","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/04\/30\/richard-smith-how-to-talk-to-the-dying-a-lesson-from-a-novel\/","title":{"rendered":"Richard Smith: How to talk to the dying\u2014a lesson from a novel"},"content":{"rendered":"<p><span style=\"font-weight: 400\">In one chapter of Elizabeth Strout\u2019s novel <\/span><i><span style=\"font-weight: 400\">Olive, Again<\/span><\/i><span style=\"font-weight: 400\"> Olive Kitteridge, a large, blunt-speaking, retired schoolmistress, encounters in a supermarket Cindy Coombs, who is being treated for cancer and has a fifty-fifty chance of dying. The chapter teaches something about talking to the dying, something that many people avoid.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Cindy, who is on the point of collapsing when Olive meets her, has been sent out to shop by her husband to show\u2014to him not her\u2014that she is strong. Cindy was taught by Olive and \u201chad not especially liked her.\u201d Olive looks Cindy \u201cstraight in the eye\u201d and says \u201cYou\u2019re having a hell of a time.\u201d The novel is set in a small town in Maine where everybody knows everything about everybody. Olive recognises Cindy\u2019s weakness and says \u201cWell, let\u2019s figure out what you need, and get you out of here.\u201d This is compassion\u2014caring and practical. (Sympathy is: \u201cI\u2019m sorry to hear that you have cancer.\u201d <a href=\"https:\/\/richardswsmith.wordpress.com\/2017\/03\/05\/sympathy-empathy-compassion\/\">Empathy is: \u201cI\u2019m sorry to hear that you have cancer. I couldn\u2019t sleep when I heard and haven\u2019t slept properly since<\/a>.\u201d<\/span><span style=\"font-weight: 400\">)<\/span><\/p>\n<p><span style=\"font-weight: 400\">A few days later Olive turns up at Cindy\u2019s house. \u201cOh Christ,\u201d says Cindy\u2019s husband Tom, \u201cIt\u2019s that old bag, Olive Kitteridge. What the hell is she doing here?\u201d Cindy tells him to let Olive in.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cI thought if I called you might say I shouldn\u2019t come over,\u201d says Olive.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Cindy\u2019s husband Tom can\u2019t accept that she might die. \u201cHe keeps talking like I\u2019ll get better. I can\u2019t believe it. I just can\u2019t believe it, it makes me so lonely, oh, dear God, I am so lonely.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">Olive replies: \u201cGod, Cindy, that sucks. As the kids used to say. That really sucks.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cThere\u2019s a nurse who comes in twice a week, and she told me Tom was acting like every man she\u2019s ever known in these situations. That men just can\u2019t <\/span><i><span style=\"font-weight: 400\">deal<\/span><\/i><span style=\"font-weight: 400\"> with it.\u201d [The italics are all Strout\u2019s.]<\/span><\/p>\n<p><span style=\"font-weight: 400\">Most of Cindy\u2019s friends don\u2019t come to see her.<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cI\u2019m awfully glad that you came over,\u201d Cindy said to Olive. \u201cYou wouldn\u2019t believe the people who don\u2019t come over to see me.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cYes, I would. Believe it.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cBut why don\u2019t they come to see me? I mean, Olive. Old <\/span><i><span style=\"font-weight: 400\">friends<\/span><\/i><span style=\"font-weight: 400\"> don\u2019t even come to see me.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cThey\u2019re scared.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cWell, too bad!\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cOh, I agree with you about that.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cBut you\u2019re not scared.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cNope.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cEven though you\u2019re scared of dying.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cThat\u2019s right,\u201d Olive said.<\/span><\/p>\n<p><span style=\"font-weight: 400\">In the mail during this time Cindy received a card from the librarians she had worked with. \u201cIt had a flower on it, and inside it said Get Well Soon! And everyone had signed their names. Cindy threw it into the wastebasket.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Olive talks about her regret that she wasn\u2019t better to her dead husband. She ends: \u201cI\u2019ve been trying not to talk about myself so much these days.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">Cindy replies: \u201cTalk about anything you want. I don\u2019t care.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cTake a turn,\u201d Olive said, \u201cI\u2019m sure I\u2019ll get back to myself.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">Cindy talks about crying in from of her sons on Christmas Day and feeling awful and then about being scared to die.<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cOh, I know, I know, of course you are. Everyone is scared to die.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">Olive comes again. In the meantime, Cindy has heard from her husband that Olive has remarried.<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cWell, congratulations, I guess. Is it weird?<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cOh it\u2019s weird. It\u2019s weird, yessiree\u2026But we\u2019re old enough to know things now, and that\u2019s good.<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cWhat things?<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cWhen to shut up mainly.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">This leads to a conversation about Cindy\u2019s worries of what will happen to Tom if she dies.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Olive comes again and observes in February that they still have a Christmas wreath on the front door. Cindy says she\u2019s asked Tom to take it down several times but he never has: \u201cOh, I <\/span><i><span style=\"font-weight: 400\">hate<\/span><\/i><span style=\"font-weight: 400\"> that.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cHe\u2019s upset, Cindy. He can\u2019t concentrate on anything these days.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">And it was strange, but Cindy saw then that Cindy was right. Such a simple statement, but it was completely true.<\/span><\/p>\n<p><span style=\"font-weight: 400\">These are the simple lessons that I draw from this chapter about talking to the dying.<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Turn up, even if you are not sure you\u2019ll be welcome<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Accept that the person may be (or is) dying and acknowledge that and be willing to talk about it<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Don\u2019t keep saying \u201cI\u2019m sure that you\u2019ll get better\u201d<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Talk as honestly as you can manage, including about your own fears<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Don\u2019t be worried to talk about yourself and your own problems<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">But be sure that you can shut up and let the dying person speak<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">You never know but you might say something very useful<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I\u2019m not sure that I can draw this lesson from this chapter, but I don\u2019t think that you should worry about saying \u201cthe wrong thing\u201d<\/span><\/li>\n<\/ol>\n<p><em><strong>Richard Smith<\/strong>\u00a0was the editor of\u00a0<\/em>The BMJ<em>\u00a0until 2004.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In one chapter of Elizabeth Strout\u2019s novel Olive, Again Olive Kitteridge, a large, blunt-speaking, retired schoolmistress, encounters in a supermarket Cindy Coombs, who is being treated for cancer and has [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/04\/30\/richard-smith-how-to-talk-to-the-dying-a-lesson-from-a-novel\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":42241,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[955],"tags":[],"class_list":["post-47358","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-smith"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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