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NEAL CONAN, host: When we find out that a close friend or a loved one faces a major health issue, it's often hard to know what to say. Writer Bruce Feiler encountered that situation firsthand when he found out he had bone cancer three years ago. Of course, he was grateful for the prayers, postcards, casseroles, but there were some things that friends and family did with the best intentions - well, they just didn't help. In a recent piece in The New York Times, Feiler laid out some ground rules for friends and family.

If you are or have been in this situation, what's helpful and what's not? Give us a call: 800-989-8255. Email us: talk@npr.org. You can also join the conversation on our website, that's at npr.org. Click on TALK OF THE NATION.

Bestselling author Bruce Feiler is a contributor to the Sunday Styles sections of The New York Times. His most recent piece is called "'You Look Great' and Other Lies." And he joins us from our bureau in New York. And Bruce Feiler, nice to have you back on the program.

BRUCE FEILER: Thank you, Neal. Nice to be with you.

CONAN: If I could see you, I could tell you, you look great.

FEILER: Thank you very much. And I would tell you that, oh, you're just saying that.

CONAN: Just saying that. You look great and other lies, you look great - that's something you should never say?

FEILER: Well, I think, you know, look, you set it up well. And let me just say that during the year that I was undergoing quite a lost year, as we called it in my family - five months of chemo, an elaborate 15-hour surgery to save my left leg and more chemo, we were inundated with warmth and loving gestures and incredible acts of generosity and kindness. But the ugly secret is, is that all of us who are patients kind of have this underground samizdat language of things that people say that annoy us.

And I would say particularly women, when I was kind of talking to people about this piece I was doing in Sunday Styles, did say when they hear "you look great," it just reminds them that they don't. And the truth is, when you are a patient, you know that your hair is falling out in clumps, and your colostomy bag needs emptying, and you're, in fact, quite yellow or pale or brown or whatever it may be at the time.

And I would say, though it wouldn't be my number one don't say, be careful about pointing out to people, reminding them, you know, that they may not look good. Vanity is perhaps the one part of the human anatomy that is immune from cancer.

CONAN: But you look great, I think the elided words there are "considering what you've been through."

FEILER: Yeah, exactly right. And it kind of reminds people where they are.

CONAN: And there are others that - my thoughts and prayers are with you.

FEILER: This to me, I really grew to feel strongly about this. In my opinion, there are people who think about you. And I think the expression I'm thinking about you is a wonderful thing to say to people. In my experience, some people think about you, it's great. Many people, as you know, you and I have talked many times over the years, and I write books about religion, right?

CONAN: Yeah.

FEILER: "Walking the Bible," "Abraham" - I know a lot of people who pray. And when they said to me, I pray for you, it's incredibly meaningful. But the particular phrase, my thoughts and prayers are with you, in most cases is a hollow expression. I mean, to me it really should be retired to that hackneyed place of "I'm stepping down to spend more time with my family" or, you know, "it's not me, it's you," or "it's not you, it's me" - sorry, I messed up the phrase.

(SOUNDBITE OF LAUGHTER)

CONAN: Well, you have to go back to cliche school. But as you go through that - what emotion does it - is there - the moment you hear it, that little flash of annoyance that crosses your face?

FEILER: There, you know, what happens is, I think people don't know what to say. And I'm sympathetic to this challenge. It's very difficult. And I think that what happens is people end up saying things that inevitably are designed to make themselves feel better often. And I just want to emphasize - I mean this piece has had a very big reaction, and a lot of people have said they are grateful for anything. But the number one thing that people say is probably the number one thing that patients don't like to hear, and that is, what can I do to help?

You think it's - I'll do whatever, call me whatever time, whatever I can do, please don't let, you know, please don't hesitate to let me know. The truth is, as Doug Ulman, the head of LIVESTRONG, said to me, who's a three-time cancer survivor, the patient will never tell you. You know, they don't want to feel vulnerable. And the truth is, I mean, why I said in this piece is, if you really want to do something, think of the most mundane thing that you have to do and come do that for the patient, right? Un-pot my dead plants, replace my light bulbs, change my oil. I mean, those things patients have to do.

I remember once, I was in the midst of chemo, and an old girlfriend of mine wrote me this very beautiful letter. And when you go through chemo, you have up cycles and down cycles. And, and I wrote about this in my book about this year called "The Council of Dads," in which I have these letters that I sent out. And she sent me this letter and she said, oh, in the up weeks, you must feel so wonderful. And the birds chirping is so fresh and the leaves must be so pretty. And I'm like, well, maybe, but I'm usually too busy unclogging my sink, because you have to live your daily life. And so, really, you want to do something to help? Come do the most mundane thing you got to do and then offer to do it for the person, the friend or the loved one who's sick.

CONAN: As you've said, this piece has gotten a lot of reaction, including the criticism. Well, how does your high school friend in the next town over remember or have the - know that your oil needs to be changing or, indeed, have access to your garage to do it?

FEILER: I think that my response to that and I think that what I found helpful, and obviously when you live what I've lived the last few years, I've met a lot of people who are patients - I think a really nice gesture is, I'm coming by. Can I take your dog for a walk? Or in my case I had very young children. That's the reason I formed this Council of Dads - a group of friends to offer to be supportive and be a team of loving voices for my daughters - is come take the kids to the playground or, you know, come and say, look, I'm in the neighborhood. Can I drop by some brownies? I'm not going to stay very long. And then, by the way, when you do drop by a fruitcake or when you come and take the kids for a walk, tidy up the bathroom, do the dishes before you leave and take the trash out when you go.

CONAN: It's interesting. In addition to six things that you have that you should never say to somebody who's seriously ill - and, by the way, if you've been in that situation, seriously ill, we'd like you to join the conversation. 800-989-8255. Email: talk@npr.org. You do have some things that you should say, and you just referred to one of them - I should be going now.

FEILER: You'll never go wrong with a patient with those five words. And the truth is, it's very nice to have visitors, but sometimes you really want to and need to be by yourself. I talked to a friend who had three brain surgeries in the last six months. And she was saying that she felt while she loved having her family around, one of the things that made her uncomfortable was this feeling that her room was a party all the time, and that she couldn't participate in the party. So there is kind of a - I talked to one writer who is collecting a book of these kinds of ideas. And she was saying, you know, 20 minutes, if the person is feeling good or if they're tired or, you know, really fatigued, sometimes even shorter will do. But, yes. Stop by. You've given the expression. Say something warm and genuine to the person and then goodbye. I'll be going now.

CONAN: Let's get some callers in. This is Mary Anne - Mary Anne with us from St. Louis.

MARY ANNE (Caller): Yeah. Hi. I just wanted to mention that we were - I was at the cancer support community today where I go every Tuesday for group, and we talked about your article for at length, I got to say. And we basically agreed with you that a thoughtless comment is just that - thoughtless. But any comment that is given sincerely should be accepted sincerely, whether you take it to heart or not. There are some, however, for - some thoughts for cancer patients, the cancer patients here, that are just to be trashed and never used again, like "it'll be OK."

(SOUNDBITE OF LAUGHTER)

MARY ANNE: We all agreed that one was not good, unless, of course, it's coming from your doctor.

(SOUNDBITE OF LAUGHTER)

FEILER: That's great. In fact, I mentioned "everything will be OK" in my list of things not to say in the...

MARY ANNE: Right.

FEILER: ...Times piece. And, by the way, if people wanted - if you go to - you can go to The Times and see. If you go to brucefeiler.com, I have a link.

CONAN: There's a link at our website. Just go to npr.org, click on TALK OF THE NATION, so...

FEILER: Everything - people have this instinct to say, everything will be OK or it's going to get better. One patient told me, and she said, really? Have you seen my scans? It's not what the doctor - it's not what the doctors are telling me. So, really, unless you're a medical professional, my advice is, you know, avoid being Nostradamus.

CONAN: Thanks very much...

MARY ANNE: Yeah, I got that from a taxi driver, so...

(SOUNDBITE OF LAUGHTER)

CONAN: It'll be OK.

MARY ANNE: OK. Yeah.

CONAN: The other one that I really - made me cringe as I read the story - and, Mary Anne, I wondered if your group had a reaction to this as well - is, well, how are we today?

FEILER: Oh. It sounds like she - is she gone?

CONAN: I think she left us, yeah.

FEILER: I was at - I'll tell you, I was at a - I gave a talk at a - about the Council of Dads at a cancer survivor group; last Sunday was Survivors Day. And I mentioned this one about "how are we today," right, which is basically infantilizing the adult patient. I was a 43-year-old man. And when I got sick - and I had - I was lucky enough to have four living parents, and it's very, very hard for parents when the person getting sick is an adult. And what happens is people kind of tend to fall back on behavior when that person is a child. My mother kept bringing me bologna sandwiches, and it was very genuine, but I haven't eaten bologna sandwiches since I was a kid.

(SOUNDBITE OF LAUGHTER)

FEILER: And so...

CONAN: And probably didn't like them then.

FEILER: Exactly. And so "how are we today?" And somebody raised their hand in this group in New Jersey and said, let's make a bowel movement, right? So there's this whole sort of way of

(SOUNDBITE OF LAUGHTER)

FEILER: ...this way of talking about illness, which is, you know, talking about - your engineer here in New York loved that one - about - talking about it like they're children, you know? It's like, sorry, we're adults, and it doesn't affect our brains even if it's affecting our bodies.

CONAN: Let's go next to Libby (ph), and Libby is on the line from Cedar Rapids.

LIBBY (Caller): Hi. Thanks for taking my call. I'm calling from the perspective of a caregiver. When my husband was dying of terminal brain cancer, frankly there were a lot of people who were taking care of him. And it was my friend Kate who said to me - she looked me in the eye and she said, OK, he's taken care of. I'm going to take care of you. I am your personal attendant. Anything that you need, I will do. You need me to stop and get you new pantyhose, I'll do that. You need the laundry done, I'll do that. Whatever you need, I will do for you.

And so each day, I would leave a note on my sliding glass door. She would drive by our apartment on her way to work. If she saw a note on the door, she knew it was from me to her. She would stop, get the note, do whatever I needed done that day. I couldn't have done it without my personal attendant, Kate.

FEILER: That's a beautiful story and, I mean, I had chills hearing it, and I'm sorry to hear about your loss. And I think this brings up a great point, and that is there are layers of people who have to support someone. And I think what we saw in my case - and especially because my wife and I had young daughters, it's like, my sister would come up from Philadelphia to help take care of the kids for a weekend, and then her friends would help her husband who was left behind with her kids.

And the same thing, my mother would come up, and then one of my mother's friends in Savannah, Georgia, would take dinner over to my father or take him out for dinner. And so, there are these layers. So one way to be helpful, you know, the patient is often overwhelmed because the patient has to talk to the nurses and to the doctors and to the insurance henchmen, like, the people around them.

And doing it - this echoes what we've been, you know, I think you're hearing a lot is sometimes it's the pantyhose that get - that need to be picked up. And somehow, you don't need to do a grand gesture. Maybe the small gesture is exactly what's needed.

LIBBY: Yep.

CONAN: Libby, thanks very much for the call.

LIBBY: You're welcome. Thank you.

CONAN: We're talking with Bruce Feiler about a piece he filed for the Sunday Style section for The New York Times. It was called "'You Look Great' and Other Lies." You're listening to TALK OF THE NATION from NPR News.

And this email from Linda in Arkansas. I have not been seriously ill but cared for my mother who was. My things not to say is, I know how you feel.

FEILER: Hmm.

CONAN: Do you? Is your mom going to die there, and there's nothing you can do about it?

FEILER: I think so. Since we've been talking about the no's a lot, why don't we talk about, you know, what is a great thing to say. And I had a couple here on my piece, and we've discussed one of them. But I would say the most important, maybe even the simplest, is just - and I think what you're - we just - we're hearing this consistently, is a simple direct expression of emotion. I love you. I'm sorry that you're going through this. I'm reaching out to you. I'm - you mean a lot to me. These simple gestures really echo so deeply in the ears and in the heart and the souls of the patient because it makes that human connection.

So you don't have to decorate it. You don't have to be florid. You don't have to say something you don't know, like it's going to get better or I know what you feel like or, oh, don't most people recover from this? You don't have to go there. Just talk about how you feel about the person simply and directly, and perhaps that's the best medicine you can give somebody.

CONAN: Let's see if can go next to - this is Chris, Chris with us from Wellfleet in Massachusetts.

CHRIS (Caller): Hello.

CONAN: Hi, Chris. You're on the air. Go ahead, please.

CHRIS: Yes. In my early 40s, I went overseas and I got a parasite, which they couldn't figure out what it was, and I came back and I spent two years in the hospital. And I had four or five major surgeries and was - spent four or five months actually near death. At one point, they actually called my wife up at two in the morning and said that I had died. And it was just so, you know, this awful experience, but the thing that I wanted to add to your list - I have not seen the article. I was just driving, and I heard the story, the show, and I wanted to call up.

The thing that I would add to the list, if it's not already there, is what people would come in - it shocked me how many people said this when they came in to my hospital room to visit me. They would say, how lucky you are. How - you're so lucky.

CONAN: So...

CHRIS: I guess they meant that I didn't die. And I said - and I thought to myself, no, no, no, no. Lucky is when you don't get sick.

FEILER: Mm-hmm.

(SOUNDBITE OF LAUGHTER)

CHRIS: And I just - I just - it shocked me. And then I said, you know, I just don't feel lucky.

CONAN: I can understand that. And I know they're trying to say something that's meaningful, but it can be taken the wrong way. It's...

CHRIS: And the other thing I noticed - briefly, I'll say another comment is that - is how much more difficult my ordeal seemed to be for other people. Your guest said - made the comment about how sometimes people say things that make them feel better. I would get people in my hotel - in my - excuse me, my hospital room who would have an emotional breakdown, and I would end up having to counsel them, you know? I'm lying on the bed, I've been near death for four months, I can barely talk, and I'm trying to help these people get through their day. And it was amazing to me how often it seems that the role of the comforter and the comfortee switched.

CONAN: Well, Chris, we're glad you make it and we won't tell you you were lucky.

CHRIS: Thank you.

FEILER: There is this thing, Neal. There is this - I - particularly in America, I think this is true, this desire to sort of happy your way through a situation. I mean, one of the things that I've heard a lot in response to this article in the Times, that patients don't like is this sort of idea that - how do I put it here? This idea that - oh, gosh, it's - that - it slipped my mind here as I was...

CONAN: Mm-hmm.

FEILER: So let me pivot then from the thing I can't remember to the thing I wanted to say, which is, I loved those moments when people came to me and talked about what they were going through. And one of the opportunities that comes from these miserable situations is you can be vulnerable, that my piece ends with this brain tumor patient who said that her advice to people is embrace the vulnerability of the situation. I was like a living ghost during the year that I was fighting this.

I have lost 30 pounds. I lost my hair. I was in bed recovering from my leg. And people would come and they would talk about the most intimate thing that was going on in their life, and I found that to be extremely wonderful. That's actually what prompted me to write the "Council of Dads." And I think that's an opportunity that you have. Direct emotion can be a great exchange. That's all you need to do.

CONAN: Bruce Feiler also recommends gossip, the starlet's affair, the ballgame that's coming up the next day - that will distract somebody from the situation that they are in. Bruce Feiler, thanks very much for your time today.

FEILER: Always a pleasure, Neal.

CONAN: And Bruce Feiler's piece in The New York Times Style - Sunday Style section was titled "'You Look Great' and Other Lies."

This is TALK OF THE NATION from NPR News. I'm Neal Conan in Washington.

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