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My husband, Bob, then coanchor of ABC's World News Tonight, was nearly killed by a roadside bomb while on assignment in Iraq. Thankfully, our family has come out the other side of the crisis, and Bob, who suffered a traumatic brain injury in the attack, is doing well. As the grateful recipient of oodles of love, goodwill, community support, and prayers during Bob's recovery, I've learned a lot about the practicalities of helping someone through a life-changing trauma -- what works and what doesn't -- and I have often been asked to share these lessons. The following tips, while not necessarily novel, seem to have a universal appeal -- because, yes, bad things do happen to good people.
Most people who haven't experienced a tragedy or serious illness at close range have no concrete idea of how to approach the person who is suffering. But it's crucial not to hang back: The bravest and most wonderful thing you can do is to be there for someone else, even if this takes you completely out of your comfort zone.
When something goes wrong in a friend's life, it's essential to acknowledge what is happening. Be sure to reach out. If the idea of calling is too uncomfortable for you, write a heartfelt note instead. Your friend may push you away at first. Take your cue from her, but don't give up -- come back later. We all need comfort and companionship. We just may need it at different times and in different doses during the journey.
When Bob was still in a coma and I was living in a hotel room in Bethesda, Maryland, one of the many fabulous gifts of help came from my friend Kitty, who lived in Washington, D.C. I was trying to convert family videos to DVD format to play in Bob's room so that he could hear our children's voices, but I was having trouble. Kitty showed up at my hotel, briefly entertained me with stories about her workplace and updates on her family, and took the tapes. She didn't ask any questions or demand information about Bob. Two days later the tapes arrived at the hotel desk, all transferred onto DVDs so we could play them for Bob and help his brain knit itself back together.
My friend's thoughtful gesture and her way of treating me as "normal" was exactly the tonic I needed. In the midst of the tornado raging around my family, I loved it when people talked to me about their aging parents or the fact that their child needed glasses. Sometimes when a person's life has changed so much, she wants to hear what normal sounds like; she wants you to treat her as if her world is just like it used to be.
Don't shy away from physical contact with a friend who's in the hospital. Most illnesses and injuries are not contagious. Touches and hugs are one of the most healing things one person can do for another. Overlook the tubes and machines your friend may be hooked up to and just focus on her as an individual.
I remember visiting Jose, a young marine who was in the hospital in Bethesda. Since Jose's arms and wrists were still raw with wounds and crisscrossed with tubes, I focused on his feet. I rubbed them as I talked to him, wanting just to give him that basic physical human contact. Jose's mother and sister said that they could see him relax instantly because someone was treating him like a person and not like a patient. Such simple acts can go a long way toward restoring a patient's dignity.
When you're visiting some one going through a difficult time, don't ask questions that make her recount the whole ordeal, the facts and statistics or the road ahead. She may not want to talk about the issue at all. Just take her lead when it comes to conversation. Resist the urge to share your own stories about similar illnesses or diseases and other people you know. Many people think that comparisons are comforting or hopeful, but these stories can actually be terrifying or even insulting. More general encouraging comments or expressions of support -- such as "I know how hard this is because I watched my mother struggle with cancer" -- may be a better way to let the person know that you understand some of what she is going through. Ultimately, the best thing you can do is to simply listen -- you don't always have to have a solution or good advice.
Do not repeatedly tell the caregiver to eat or sleep. She can't. She's operating on adrenaline, especially in the early stages. In a crisis the caregiver, as well as the patient, is damaged, and her brain may not be working the way it normally would. She may not ever want to leave her loved one's side, and that's just fine. But also remember that even if she says she doesn't need help with anything, she does. Don't be nervous about taking charge in non-threatening ways to ease her daily burdens.
While I was camped out during Bob's stay in the ICU, my friend Lauren knew that I liked decaf lattes, sushi, brownies, and the special corn and crab soup from the hotel room service. In the early days of the crisis I would return from the hospital, shattered and in shock, and find these foods waiting for me. She didn't nag me to eat or urge me to care for myself; she just took care of me quietly.
You should acknowledge the person's pain. It's okay to say: "This stinks, but I'm here every step of the way." The most helpful comments simply let the patient or friend know you hear them.
This is a delicate balance because you don't want to minimize things with a trite greeting-card philosophy, nor do you want to underscore the dire nature of the person's situation. Use your sixth sense and assess where that person is, emotionally, realizing it may seesaw from hour to hour. For example, there were times when I was tired of hearing about how incredibly strong I was and instead simply needed to hear that I could do it; that it was all possible. Take your lead from your friend. It's always comforting to hear, "Let's talk about you for a moment -- I'm here to listen."
Stuffed animals, balloons, and flowers in the hospital are cheery, but they may need to be moved from room to room or take up space in cramped quarters. Consider practical gifts instead, like pajamas, a luxury soap, a new toothbrush, or slippers. A box of thank-you notes is one of the most useful and helpful gifts.
Food, in any time of crisis, is also a great gift. People have to eat if they want to keep going. You can also use food to win friends among the medical professionals. The "Brownie Lady" in room 205 also has a much better chance of being on the radar at the nurses' station in those wee hours of the morning when she might need pain medication.
Whatever you do, don't tell the patient or caregiver to call you if she needs anything. That puts the burden of asking for help on her. Instead, suggest something specific you can do to help out: Invite the kids for a sleepover, bring dinner to the house (without dishes that need to be returned), mow the lawn, or walk the dog. Whatever you offer, decide on the details yourself, instead of asking your friend about her preferences. This includes whether or not she'd like chicken or fish. Just do it!
Don't expect the patient or caregiver to immediately return your phone call or e-mail. All of her energy right now is focused on herself (if she's the patient) or her loved one and other immediate family members. She is being interrupted about every 15 minutes by medical staff of all sorts, she's talking to doctors, undergoing procedures, perhaps worrying about her children or elderly parents, tending to the immediately critical tasks at home and, overall, being torn in many directions.
"Call me," well-meaning friends would plead into my answering machine. "I have to know what's happening." All that did was pile one more ounce of guilt on my shoulders. If you feel the need to reach out in the midst of the crisis, just leave a message that starts with "You don't need to call me back, I just wanted you to know I'm thinking of you."
Don't approach the family or patient with tears in your eyes or what I call the "sympathy face" (the hangdog look that says "You poor thing, bless your little heart"). If you can't keep your tears or overpowering empathy to yourself, come back when you can or write a note.
In our own journey, faith, family, and friends played a pivotal role in helping all of us to heal. But faith means different things to different people. Try not to say, "God doesn't give you more than you can handle," "Things happen for a reason," "What doesn't kill you makes you stronger," "There but for the grace of God go all of us," or "There's a special place in heaven for you." In fact, scrub these phrases entirely from your vocabulary. The patient or caregiver doesn't want to feel like Job or wonder why God chose her for this particularly rough assignment. Also, keep in mind that while spiritual comfort can be helpful to some, it may come off as irritating or too personal for others. Make sure you know where people stand on the issue of faith before you raise it.
In the first days and weeks of a crisis, people come out of the woodwork, flooding you with offers to help, with food and flowers and kind encouragement. This is wonderful, but it can also be overwhelming. And when all the neighbors have gone back to their own lives, the patient and family still need occasional support.
So perhaps you could hold off on sending that gorgeous bouquet for a few weeks, or even a month or two, and have it delivered to your friend's home. This simple gesture will make a big difference after the crush of the crisis and will let your friend and her family know they're still in your thoughts.
In the midst of our family's crisis, my friend Tom told me to subscribe to the "chit system." Immediately after a diagnosis or incident, everyone will rush in to ask what he or she can do. "Tell them they have one chit," he said. "And that you will use it. It may be the next day or even two months from now, but at some point in time you will call in that chit."
What was great about this concept was that when most people had gone back to their regular lives, I didn't end up feeling abandoned. Plus it made friends feel needed and gave them a task, even if it was months after they'd offered. Once I asked a friend's husband to come over and check our water heater. That used up his chit. Being there in a time of crisis is a sign of true friendship, and being needed is perhaps the greatest honor of being a friend.
The Internet is an amazing resource in a crisis -- for both the patient and friends who want to help.
- On CarePages.com and CaringBridge.com, patients or caregivers can post updates for friends instead of spending precious energy returning phone calls or sending mass e-mails. These sites also offer a place where friends can write messages of encouragement to the patient, so that she can check in when it's convenient.
- Friends can sign up to deliver meals or provide other specific types of help on sites like FoodTidings.com and LotsaHelpingHands.com. For the caregiver, this makes coordination a lot easier, and friends are even able to log on when they have time and get a very clear sense of what they can do to help.
- For caregivers and family members of the ill or injured, there are now Web sites with useful tools to help you stay organized.
- PartnersAgainstPain.com provides printable templates for pain diaries and medication schedules; Caregiver.org offers fact sheets to help you navigate a variety of difficult decisions and healthcare situations.
From Perfectly Imperfect, by Lee Woodruff. Copyright 2009 by Lee Woodruff. Published by arrangement with Random House, an imprint of Random House Publishing Group, a division of Random House, Inc.
Originally published in Ladies' Home Journal, May 2009.