As the author of How to Be a Friend to a Friend Who's Sick, I've been invited to speak to community, health, and religious groups all over the country about what words and behaviors are most helpful or hurtful to people suffering from physical illness or agonies of the heart.

Here are a few examples of the complaints I heard from my audiences:

* The most well-meaning friends blithely utter cliches like, "I'm sure you'll be fine," or, "Everything's going to be okay," when they know no such thing.

* As soon as patients report their diagnosis, many of their friends respond with unwanted advice or self-referential remarks. They'll say, "My cousin had the same thing and she got through it." Or, "You think that's bad! I had it worse." Or, they'll insist that you go to see their psychiatrist, acupuncturist, or yoga trainer.

* Oblivious to the fact that chronic illnesses like diabetes, ALS, or Crone's Disease rarely get better, friends routinely bring to the sickroom helium balloons or greeting cards that say "Get Well Soon."

* To a breast cancer patient who had a double mastectomy, a friend quipped, "Well at least you're married."  To someone whose child died, a friend actually said, "Well at least you have two others." Any line that begins "Well at least..." is usually pretty offensive.

* Many patients resented hearing God cliches. For instance,  "God is testing you."  Or "God will only give you as much as you can handle." Or in the case of someone mourning the loss of a loved one,  "God wanted him." Or, "Don't worry, she's with God."  Unless you have a direct line to the Almighty, you might want to banish all the God lines from your friendship vocabulary.

* I kept hearing complaints about get-well gifts that made the giver feel good but didn't necessarily comfort or serve the patient. Relatives and friends, acting on the old etiquette, often send or bring flowers -- (we've all seen hospital rooms packed with floral bouquets, half of them dead, which makes the room even more depressing)-- or send fruit baskets wrapped in cellophane and filled with more fruits and fancy foodstuff than patients can eat.

In the question-and-answer periods following my talks, hundreds of formerly or currently sick people talked about how unhelpful these responses or offerings were, while others told of how awkward they felt in the presence of a sick friend and how unsure they were about what to say, bring, and do.

My book helps people navigate this bumpy terrain in great detail but a few general suggestions can start you off in the right direction.

First, try to establish a policy of absolute honesty with your sick friends by asking them to tell you:
-- what's helpful and what's not
-- when they want to be alone and when they want company
-- what to bring and when to leave

Second, filter your remarks before they leave your mouth. Ask yourself, "Is what I'm about to say going to be helpful and would I want to hear this if I were in my friend's situation?"

Third, consider what you might bring or buy that would be genuinely useful or would bring pleasure to the patient. Instead of flowers, maybe bring a gift certificate for a massage, or a gift card for a tank of gas to defray the extra cost of traveling to their multiple treatments. For the price of a fancy fruit basket, you could treat your sick friend to a pretty nightgown or warm flannel pajamas to wear in their overly-air conditioned hospital room.

Fourth, you could organize the patients' friends so that not everyone brings a tuna casserole on the same night. Or set up a schedule for different friends to accompany the sick person to her or his chemo lab on different days.

Five, always ask if it's a convenient time to visit—don't just drop in—and never overstay. Remember that it's an effort for the patient who's in pain or recovery to interact with visitors because they, too, were bred to make conversation and behave politely. Twenty minutes is optimal for the average visit; ten minutes if the person is fatigued or in extremis. (Unless you're there to help with household chores or child care in which case stay as long as you're needed.)

About the Author

Letty Cottin Pogrebin

Letty Cottin Pogrebin, a founding editor of Ms. magazine and past president of The Authors Guild, is an award-winning journalist, speaker, activist, and author of ten books.

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