One of the first of these blog entries was about things not to say to a person living with cancer.  (I'm just going to use PLWC after this, an abbreviation [not an acronym, he said fussily] similar to one used for People Living with AIDS.  Somehow it sounds cleaner than the alternatives.)  The examples in the earlier blog were egregious (my dentist's "Do we even need to make another appointment?") and meant to have a sort of black humor to them.  Today I'm going to do a second installment of well-intentioned but infelicitous comments that friends have made over the last two years.  I'm a little reluctant to do this because someone may recognize him- or herself.  I know that my friends care about me and are sincere in their concern.  We all say things that aren't as happily phrased as they might be.

Don't say nothing.  I don't mean this for people I see regularly, but when I meet friends I haven't seen for some time and they don't ask about the cancer, I'm always rather baffled.  My conclusion is usually that they feel embarrassed or don't know what to say.  But saying something as simple as "How ya doing?" is better than saying nothing.  And then take your cue from how the PLWC responds: if there's a one sentence, "I'm doing okay, thanks," that probably means that the PLWC would rather not continue the discussion.  If you get a fuller response, feel free to ask more specific questions.

Whatever you say, don't play Ann Curry (it didn't work all that well for her): the furrowed brow, the tremulous, halting voice, the leaning forward.  I know you're sincere and that you're honestly concerned; you're my friend after all.  But this attitude too often comes across as pitying.

Matter-of-fact is good.  I can't speak for all PLWC, but I'm perfectly happy to talk about the results of the latest tests, possible alternative treatments, my current state of mind; if not, I wouldn't be doing the blog.  And the best tone, for me at least, is factual and relatively neutral.  Don't dwell on those things that haven't changed.   Prolific pooping is a persistent problem.  Nausea, cramps, and loss of appetite are less frequent, but common.  But nothing has changed over the last 22 months, and there's really no point in long discussions.  There's nothing new to say, so let's just pass over the subject.

Don't be falsely cheerful:  "Oh, you'll be back in Paris is no time."  No, I won't.  "I know exactly what you're feeling.  [No, you don't.]  I don't have as much energy as I used to; it's just getting older.  [No, it's not.]  Of course, I don't have cancer so it's probably more severe with you.  [Indeed.]"  It comes across as dismissive.

I seem to have done a poor job of describing what the fatigue is like; my metaphors of a "black curtain" or a "black wave" haven't done the job.  I need a novelist's help here.  Several people have said, "Why are you so worried about sleeping a lot.  I love a long nap."  What happens isn't a leisurely 'nap.'  I know that every morning, I'll have a burst of energy.  I write the blog and some e-mails after I take the chemo.  An hour later, I can eat something.  But suddenly, three to four hours later, the black curtain descends.  I'll go upstairs to take a shower, but I literally don't have the energy to pass the bed.  I fall immediately asleep and am out of it for an hour.  Waking up is an ordeal, but I finally manage to shower and put on clean clothes.  By then, it's time for lunch and my daily dose of "The Bold and the Beautiful" (cancer doesn't necessarily give you deepened taste).  And then suddenly, I can't stay awake any longer.  I feel guilty because it's been only a couple of hours since I woke up.  I stagger up the stairs, always optimistically carrying my Kindle or a New Yorker, but in 22 months, I've never read a single page.  It's as if I pass out, and this time it's at least a two-hour sleep.  That's a big chunk of the day given over to sleep.  It comes on all at once, and there's no resisting it.  There's usually one more shorter sleep when I prop a pillow against Mohamed and stretch out on the couch.  That one might qualify as a 'nap.' 

After I did the first entry of what not to say, someone e-mailed me to say that what I needed was what to say.  That's harder, but I'll work on it.