Couples should never—not ever—make major life decisions while awaiting results of biopsies, tests, scans, or other medical oracles.
—Dan Shapiro, PhD
David sits at his desk, tapping angrily. He’s tired of his abusive, ignorant boss, the VP for regional sales. The man’s sales targets are absurdly high, he’s impossible to reach on the phone, his “motivational” speeches evoke the stress of Glengarry Glen Ross, and even his fake all-light-brown hair color is irritating. No one’s hair is that consistent a color! As the senior salesperson, David knows it’s his job to protect the team.
Now he considers bolting past Thomas, his boss’s secretary, and rushing the door. He rehearses how the conversation will go. David will clap his fist into his hand and announce that things have to change. No, things are going to change. No more bullying.
He stands. The office door is only 20 yards away. He’s taking his first steps when his cell phone buzzes. Huh? It’s his wife. Should he answer? It will only delay him a few moments. He taps the glass, answering. After he whispers his plan into the phone, there’s a long pause. “Are you still there?” he asks her, more aggressively than he intends.
“Uh, Davy, are you sure that’s a good idea? What happens if he lets you go?” his wife asks.
He swallows. Uh, no, he suddenly realizes. Maybe I haven’t thought this through….
His wife knew that only a few days before, he’d had a biopsy for possible prostate cancer and they were still awaiting results. Since then, he’d gotten angry at the trash collectors who routinely service their complex at 5:30 AM, he’d sworn at two drivers who moved too slowly after a light change or forgot to signal a turn, and, of course, he’d blown up at her for mailing a donation to the Red Cross that was $50 larger than he’d had in mind, after ravaging tornadoes erased a town a few states over. Yet she knew he was typically a cheerful, generous, soft-spoken man.
And, in fact, David was violating a simple marital rule that applies to all patients visiting the “cancer world” (see Tip 1 below).
Tip 1. Couples should never—not ever—make major life decisions while awaiting results of biopsies, tests, scans, or other medical oracles. Do not purchase or sell property, do not change jobs, and especially do not adopt a ferret with a tricky thyroid. Do not discuss one’s relationship or any other important issues with a spouse.
Unfortunately, David’s results were not what he’d hoped. But after the knee-buckling bad news, a decision on a treatment plan, and a brief conversation with a clinic social worker, he recognized the dark alchemy that turned his fear into anger, and he stopped taking it out on his wife, his coworkers, and even the sanitation workers.
This is the first of a number of tips I’ve accumulated after personally being a cancer patient and then the spouse of a patient. As a psychologist, I thought I’d be inoculated from needing this advice, but I was not. When our patients visit cancer world, they probably aren’t, either.
Two years ago, with my wife’s breast cancer adventure still fresh in my mind, I interviewed 40 couples from around the country and worked to distill what I learned into a number of key lessons. Here are a few more.
Tip 2. Cancer is a new experience. Couples may need to learn to tolerate not being great at it at first. It’s normal to lose one’s keys, park in the wrong place, and forget to bring one’s insurance card to chemotherapy. But like any new skill, we get better at it. Successful couples have patience with one another and quickly forgive rookie mistakes.
Tip 3. It’s happening to both members of the couple. When I had cancer, it felt like I was driving into an intersection too quickly. But I had my foot on the brake and my hands on the wheel. I had some semblance of control, even if it was illusory. But when my wife was diagnosed, it felt like I was 200 yards away, watching her drive too quickly into an intersection, her windows rolled up, too far away to hear me.
When I was a patient I was self-centered and had little appreciation for how my illness impacted my loved ones. It took being the spouse to understand how difficult life is on both sides of the bed. Oncology professionals do couples a service when they alert them that it is painful on both sides of the bed.
Tip 4. Couples who are willing to be flexible with household jobs and roles do better than those who rigidly try to cling to the way things have always been. Sometimes cancer prevents us from doing our typical tasks. This means our partner or someone else has to do those jobs.
Yet we are often kinder to our pets than we are to our loved ones when trying to teach them new things. Flexibility means being willing to calmly encourage our spouse, even when they are backing up a boat trailer for the first time or laundering our delicates.
Tip 5. Spouses may need to learn to advocate for their partners. Some physicians are brilliant, organized, and kind. Some are overworked, tired, or even sloppy. And some clinics and medical systems are still designed more for the convenience of health professionals (or billers) than patients. It often falls to spouses to ask questions and assertively speak up.
Medical systems do not award popularity prizes. While I’m not suggesting we antagonize well-intentioned health professionals unnecessarily, I am urging that spouses must sometimes learn to speak up and insist that the patient’s needs are met.
Tip 6. Couples need to stop fighting over how a spouse is thinking about cancer. The popular culture is rife with notions of thinking one’s way to better health. It is painful to accept that horrible things happen to good people, and there is no one magic way to cope with the experience. That said, if a member of a couple is depressed, get treatment!
Tip 7. Be generous with one’s spouse. It’s hard for both of you. Even if you can do little else to combat the illness beyond what you are already doing, you can be kind to one another. A soft word, the gentle touch, an off-color joke—these can be a soothing balm when you feel that your lives are ablaze. ■
Dr. Shapiro is a clinical psychologist and Chair of the Humanities Department at the Penn State College of Medicine, Hershey, Pennsylvania. He is a cancer survivor and the spouse of a survivor. His tips are adapted from his book, And in Health: A Guide for Couples Facing Cancer Together (Trumpeter, 2013), which won a national book award in May 2014.