The first thing you need to know is that Dave had always been there for me.
When we became friends in fourth grade, he quickly opened his basement and backyard to me, never questioning why I didn't have anyplace else to hang out. Years later, when I asked him to be best man at my wedding, he was there, even though it required taking a red-eye flight to New York from Las Vegas, where he had performed the same role for his younger brother the night before. His attitude about that, and so many other favors over the years, was simply: That's easy; I'll be there.
But then life got harder.
In 2001, when we were in our mid-30s, Dave received a diagnosis of lymphoma. I was young enough not to be reflexively terrified of hearing he had cancer, but maybe too young to realize all that it meant, even in an age of advanced care. I did assume that, in the end, all would be fine. My friend was in for a stretch that would not be so easy, but he was smart, strong and otherwise healthy. I checked in with him periodically, but under normal circumstances, our relationship could survive indefinitely on four calls a year, and I didn't up the count by much.
As it happened, though, Dave's case was more complicated. With his immune system badly compromised, he eventually landed in a Boston hospital's "clean room" ward. To visit, I had to pass through an airlock and don gloves and a mask. Still, he didn't seem especially weak and his spirits appeared good, bolstered by his years-long habit of reading self-help books, which I once mocked.
And so there I sat, with my oldest friend – and, after the obligatory jokes about how he'd generated some "samples" to freeze in case he ever wanted to become a father, no idea what to say.
How to Be a Friend
You'd think it would come naturally, but some of us need advice on how to relate to seriously ill friends. Among the best resources available is Letty Cottin Pogrebin's new book, How to Be a Friend to a Friend Who's Sick. Conceived during her own bout with breast cancer, it addresses the discomfort she saw in those who visited her and the awkwardness she herself felt when calling on ill friends. She canvassed colleagues and fellow patients to compile the most direct, candid guidance for people struggling with what to say or do.
The result is a refreshingly down-to-earth handbook on the right time to visit; how to respect spouses' space; the length and mechanics of a hospital visit (don't stand above the bed; sit at eye level so as not to "flaunt your own strength") and what to bring ("don't give a tome the size of a car battery to a friend who's too frail to hold a porcelain teacup").
"Through no fault of their own, the unwell have a way of making the well uneasy, causing visitors who are unpracticed in the bedside arts to botch the encounter due to awkwardness, misinterpretation or ignorance," Pogrebin writes, accurately. "No one visits a sick room for the fun of it. Some of us just show our discomfort more overtly than others."
I've never been uncomfortable in hospitals. Both my parents had been in and out of them for years before their deaths. But it was different when it was a friend in the bed.
"Try not to stare," Pogrebin advises, "at the automated pen tracking the patient's brain waves in the skittery lines of an arthritic scribe, or the fluid that's drip-drip-dripping in a hypnotic, water-on-a-rock sort of way inside a plastic bag."
Finding the Words
A decade later, it's hard to remember much about the conversations Dave and I had in the clean room. I do remember the stress: Would talking about the Red Sox seem petty? Would discussing his health be a downer for me? Would chatting about my wife and kids be a downer for him? I think we ended up with some small talk about my driving in and out of Boston and maybe joking about how much his time away was costing the taxpayers of the city government he worked for.
(MORE: How to Stay Safe in the Hospital)
Distance made a difference. For the extended period my friend was seriously ill, I checked in on him every time I came to Boston, but I can't say that I made any special trips up, even when he was hospitalized. Pogrebin lists 15 common excuses for not visiting a sick friend, including, "I can't do anything for her and sitting there just makes me feel useless," "She told me I didn't have to come" and "If it was me, I'd want to be left alone."
That last one definitely applies to me, but Dave's no loner. He's probably the most naturally social person I know and he drew powerful support from other friends who lived closer to home, many of them women. Pogrebin quotes the advice of a friend who'd had his own experience with cancer: "Bachelors and widowers, if you don't have women friends, don't get sick!"
I finally decided to treat Dave as normally as possible when we got together during those months. At card games, when he was able to come, he would pass on the beer and leave the table early to get some sleep, and I'd joke that those behaviors were really no different than what he'd done when he was well. I hoped he appreciated that I felt confident enough about his recovery that I didn't shy from giving him a hard time. But when he left the table, the rest of us spoke with respect about how successfully he focused on his needs, keeping his eye on the prize of getting well.
Why It Matters
Eventually, he required a life-saving experimental bone marrow transplant from doctors at Boston's Dana-Farber Cancer Institute, who called the procedure "uncharted waters." Happily, it was a success. Dave got well, stayed well and a few years later, met a lovely, vivacious woman. Their wedding was a tiny affair, timed to the 10th anniversary of the transplant. Last month, at their baby daughter's Jewish naming ceremony, I was grateful to have been given a small, honorary role.
Dave made a speech at the event, addressed to his newborn, that touched on what it had taken for her to be there, the odds that had to be beaten. He also made a hilarious aside about trying to generate a sample of "my genes," as he put it, in a hospital clinic all those years ago while his own dad loudly fielded a business call just outside the door.
"The more people that you feel connected to," he told his daughter, "the more people you can ask questions of, the more people you can trust, the richer your growth will be. Mommy and Daddy are lucky to have great connections. Daddy still has his closest friends that he grew up with. Daddy has walked through all the stages of life with them so far and will continue to do so."
Moments like that remind us why friends matter. While some of us may never get the etiquette of hospital visits just right, we'll keep doing what we can because being there is important and the payoff can be extraordinary.