What do you say to a man who knows he's going to die soon?

Where I work, there’s a guy who has had mysteriously declining health in the five years I’ve known him. He’s early 50s. He’s had a condition with the nerves in his back and down his leg. Then, one day as he stood out front of the building, hanging onto the steel railing, the place was struck by lightning. It knocked him back onto the ground, but he was otherwise OK.

I didn’t see him outside smoking for awhile, and then there he was today. He told me he’d stopped smoking in February, because he was experiencing shortness of breath. He figured it was from smoking, so he quit, but the problem didn’t go away. Now he’s been to five specialists and had several types of scans, and there is a problem he didn’t know about. I didn’t catch the last word of it, but it’s called “ideopathic pulmonary ________” which means there is scar tissue growing on his lungs. They don’t know why it happens; there is no cure and no treatment. The specialists told him he has between two and four years to live.

He had a mini-stroke on Sunday, due no doubt to the stress of knowing he is going to die, soon, but not when. And that’s why he was out having taken up smoking again.

I was completely at a loss for what to say to him. “I’m sorry” didn’t seem appropriate, and other responses seemed like the answers would be none of my business. You can’t reply with anything trite or cheerful. He must be disguising an enormous amount of emotional agony. So, is there an appropriate response?

That’s probably idiopathic pulmonary fibrosis. It’s what my first husband died of, at age 47.

Is your friend still working? How much contact do you have with him? Does he have family, or a support system? How close are you to him?

It’s hard. You can say “I’m sorry this has happened to you. Is there anything I can do?”

Anything else depends on your relationship with him, and what he needs, and what he’s willing to accept from you.

Like you said, it’s incurable. My husband was waiting to get on a transplant list when he died. That was the only option the doctors had for him.

Thanks for your response, AuntiePam. I don’t really know him very well at all, you couldn’t say that we were friends. We work in different departments, and I pass him in the hallway sometimes, or see him out back. So yes, he’s still working, and he has a family, in fact he recently became a grandfather. So there isn’t really much that I can offer him. I’ll see him up until he stops working. I don’t gather he’d much like to talk about it, and I don’t want to pretend like he didn’t tell me, while at the same time I don’t want to offend him by trying to come up with something meaningful and having it come across as insensitive, or worse. Know what I mean?

Yeah, sometimes it’s easier if you’re close, because then you have to talk about it.

All anyone can say, really, is “I’m sorry.” I don’t think it sounds trite, and it’s definitely better than (like you said) trying to be upbeat.

When you do see him, I don’t think there’s anything wrong with asking how things are going. He might want to talk about things with someone who’s not emotionally invested.

I think it’d be hard for him not to talk about it. What else can he be thinking of? I can’t even imagine. I had a breast cancer scare a few years ago, and it’s all I thought about until all the tests came back negative.

Your co-worker really has a hard row here, healthwise. Without the “I’m sorry” wish, maybe you can say “I know you’re having a hard time of it now, I see that, can I help at all?”

It’s really hard to say those words, our society is really inept in teaching how to deal with those situations. One of my side-jobs is helping a man (very brilliant in his profession, so it’s an apprenticeship for me) who is in very frail health; told he had “six months to live” five years ago. I’ve wrestled with talking about his health, how to approach it, but have found the best thing to say is “What can I do, Now?”

When someone is given a sad prognosis, it leads to isolation. Lend a hand out of that isolation. Ask him how he’s doing, and listen. Just stand there with him and listen. Ask him what it felt like to be “struck by lightning”.

I hope he stops smoking again and gets on a transplant list. I’m guessing that a current smoker would be ineligible.

I second elelle’s comments. My husband passed away a couple of years ago from lung cancer (and, yes, he continued to smoke). I think we really appreciated the people who said, “I’m sorry,” and “Let me know if there’s anything I can do.” (and meant it).

I don’t know what kind of treatment he is receiving or how much his wife is doing (is she working and caring for him?) I know it was really hard for me to be working and caring for my husband. One of the nicest things that was done was some co-workers made casseroles for us during the rough times (e.g., chemo treatments). It was awesome and made us feel like people really cared. Maybe you could organize something with your office. Possibly a co-worker who is a friend of the family could get more information about their needs. Does anyone have any extra sick leave they can donate (assuming your employer offers that)? I know one of our concerns was yard work and household stuff that just didn’t seem to get done because we were either at the hospital, chemo treatments or working. Maybe your co-workers could offer to do some of those things.

I’m not saying to go overboard with help, but just little random acts of kindness can go a long way. I know my husband would not have wanted to be treated as an invalid. He wanted to maintain some control over his own life (even if he was faking it at times). At first our lives were turned upside down with the initial diagnosis, but later we got our equilibrium back and lived an abnormally normal life with new challenges. I am sure your co-worker will come to terms with the knowledge of his terminal illness and make the right choices for himself.

I agree with the folks who recommend an acknowledgment of the condition, and offer of assistance. If appropriate, you also might want to touch bases with their supervisor to offer to cover for him on any occasions when it is needed.

But IME one of the best things you can do for a terminally ill person is to treat them like normal. So much of their existence is tied up with the process of dying. Nearly everyone treats them differently - one way or another. Depending on the situation, you may be doing them a real favor by not making their illness the main focus of your relationship.

Since you weren’t really close before, the fact that he is dying doesn’t mean that you should be best friends now. Most terminally ill folks get plenty of sympathy. Which often makes the folks who treat them with respect and professionalism stand out.

Thanks everyone, for your points of view. I will continue to treat him as normal. It was a good suggestion to see about covering for him, but he’s a company accountant and I’m in a totally different department with different skill requirements. None of us on our side of the building could even hope to understand his job- nor could he do ours. I guess he reports directly to the CEO, so his position will be taken care of when he can no longer come in.

So many good responses in this thread. So much depends upon the individual, which can’t always be accurately ascertained. A comparison comes to mind: some people who are physically handicapped* (recently or otherwise) appreciate their condition being at least acknowleged, since that means you’re not ignoring/marginalizing it. Some others do NOT feel comfortable having it acknowleged, since it sort of rubs their face in it and reminds them again of being different. Others probably feel differently in a different way. Predicting is dicey.

I don’t think there’s anything wrong with mentioning that you know about it (since it’s recent, and probably common knowlege at work), and a (however paraphrased) “Is there anything I can do that would help?” would at least communicate good intentions.

On the other hand, I would NOT advise my first response to the title of the thread (think the most famous catch-phrase of Larry the Cable Guy). It may be funny in a gallows-humor sort of way, but I’m not anticipating major odds on it going over well (on the other other hand, it might just be the sort of chuckle to counteract all the sombreness of everyone else’s responses/lack thereof).

I cannot be the judge here, so my post is probably worthless. Good luck.

[sub]*Is that word even PC anymore? Sorry if it isn’t, but I’ve suddenly realized that I don’t keep up on PC as much as is expected.[/sub]