In Sickness And In Health

Syndicated columnist “Dear Amy” received a letter from a woman who said people were ignoring her sick friend because they found it too difficult to visit.

I ask you, who likes hospitals? Who likes contemplating mortality? Who enjoys seeing tubes and scans and overly-red Jell-O? No one I know. Visiting the sick is not about you.

Amy was sympathetic. She said if it is truly difficult, then do errands for the person in need. I thought she gave these “friends” a pass. A few weeks later a woman wrote back to say she was that sick friend. She did not want people in her life that did not have the decency to see her or even send a card. Resentment and anger is not healthy, so best to let go of people without the emotional fortitude to visit. “I’ve recovered. But I don’t think our friendships ever will.”

In Jewish law, we are obligated to visit the sick; it’s a commandment that has no limits, according to the Mishna. (But there is no specified time or duration for a visit. Rabbi Moses Feinstein was once asked if someone could fulfill this mitzvah via telephone. Today we might Skype or text instead. His answer: you must visit. Only when you see someone can you really pray for that person. Empathy begins with a look. A phone call will never communicate what a visual intake will about a person’s fragility and vulnerability.

According to Rabbi Moshe, you can visit a sick friend by phone if you live far away or if the friend does not want visitors while in a compromised physical state. Note: the choice is the patient’s not the visitor’s.

Since it’s not easy to befriend someone who is sick, we need good advice. I just finished Letty Cottin Pogrebin’s new book, “How to Be a Friend to a Friend Who’s Sick.” She opens with a chapter on the incredibly insensitive things well-meaning people often say to someone who is sick, collected largely from interviews she conducted at Memorial Sloane-Kettering hospital, a place she came to love when she herself had breast cancer.

In the verbal thoughtlessness category, we find, “You look great.” Art Buchwald tackled this when he went into hospice: “No one knows what to say to someone who is dying. … Here are some of the remarks I heard: ‘You look great!’ ‘You look really great!’” As Pogrebin’s friend remarked, this only works if you expect your friend to look dead so “anything short of rigor mortis was a relief.”

I finished the book and came to one conclusion: the best thing to do is to keep my mouth shut, which for me is a distinct challenge. She advises friends to ask and to act. Find out what your friend needs and provide it. Genuine words of comfort help. These include:

“I’m so sorry this happened to you.”

“Tell me how I can help.”

“I’m here if you want to talk.”

Expressions like these express empathy and availability or both. Friends should listen to how their sick friend is rather than tell her how she should be.

As easy as this sounds, it may be a cultural challenge in our own community. Jews love the Suffering Olympics, where your growth could not possibly be bigger than mine. Every tumor is “the size of grapefruit.” We are also very competitive when it comes to our doctors, who all manage to be “the very top specialists” in the field. Our acutely verbal dispositions and competition for victimhood can get in the way of profound listening and unobtrusive helping. But those who are ill should dictate the terms of the conversation or if there is a conversation at all.

Pogrebin wisely advises us to follow this course: “Tell me what’s helpful and what’s not. Tell me if you want to be alone and when you want company. Tell me what to bring and when to leave.”

There is another side to this: how to be a friend when you are sick. It is easy to make judgments from the kingdom of illness. No one can imagine your pain or the way in which sickness is self-absorbing. A friend who went through a serious illness said that sometimes you don’t want visitors because you are just tired of being sick and also talking about it. But where does that leave well-intentioned friends who just want you to know they care? It’s hard to get it right. Pogrebin’s call for candor is welcome.

Visiting the sick is a commandment because sometimes it goes against a narcissistic impulse to protect ourselves. We need, therefore, to work even harder at being better friends to friends who are not well. In sickness and in health does not mean only in health.

Erica Brown is scholar-in-residence at the Jewish Federation of Greater Washington. Her column appears the first week of the month.