We are surrounded by people. Some we feel close to, others not. Although we don’t share everything with everyone, we do need one or more supporters with whom we can open up. Being too solitary feeds the trauma reaction and amplifies the urge to take flight or freeze.

When a medical challenge occurs, news spreads like the old childhood game of telephone. The information quickly makes the rounds as one person tells someone, that person tells another, and so forth. Sometimes the proper facts aren’t conveyed or facts are shared with people we would prefer not to know.

I think of our lives as consisting of three tiers of relationships.

• Tier 1 contains those to whom we are most close. This level may include a spouse, partner, best friends, and siblings. These are the folks with whom we share the most and want to keep aware of our experience.
• Tier 2 consists of people we consider friends, family (sometimes not), certain colleagues, and close neighbors.
• Tier 3 includes people we encounter but don’t feel particularly close to, or with whom we don’t share personal information. Many people at work fall into this category, as we want to keep a professional separation with some colleagues.

Being aware of whom you place on each level is helpful. Some people around us may think they are closer to us than we feel to them. While we can’t control that, we can prepare what we will and won’t share with each of the groups. That way, when you meet someone at the grocery store and they ask how you are doing, you can share as much or as little as you want based on what level the person is in. If someone is a Level 3 individual and says, “I heard you had heart surgery,” you can respond with “I’m doing fine now, thanks.” If you encounter someone who is on Level 2 and asks about your surgery, you might be more forthcoming. Preparing responses ahead of time can be helpful.

Workbook Chapter 13 Dealing with Others

Write who is on your different tiers. Decide what you want to share with each tier, and how. Have an idea of how you might respond to someone in each tier when they ask how you are or how they can help. (For ideas, see the section titled “How can I help?”)

Person	What to share
Example: A neighbor up the street I rarely see ( tier 3) says, “I heard you’re sick.”	“Yes, I’m going through treatment, but I’m doing well.”

Some people whom I am not well-acquainted with asked for details that I was not willing to share. For example, I did not want out-of-town relatives on my husband’s side of the family to know any details. I am not close to them and do not see them. Although well meaning, they would not be a comfort to me. There is sharing and there is gossip; there is a thin line between the two. I am very open with my friends,
but I like my privacy to be respected by more distant acquaintances. –MM

How to handle inquiries in work settings brings up different issues. Some of us are able to work during our treatment. For those with chronic conditions, our need to involve employers in conversations can wax and wane. Knowing what you want to say and to whom, just like with Tier 1, 2, and 3 relationships, can help reduce distress and uncertainty as to what to say in the workplace.

The hope is that all will receive fair treatment, but it may be helpful to review the American Disabilities Act. The American Disabilities Act has some provisions and protections for those with diagnosed medical diagnoses and treatments.

I had an extremely compassionate and supportive boss. She encouraged me to take all the time I needed. On my return to work, I had the practical challenge of being well enough to resume my job, but not healed sufficiently to twist and turn beneath a seatbelt. She arranged for a car service to ease the first weeks of my commute. This was a luxurious and unexpected kindness. –LO

People at work filled in for me on their own free time. –LL

My office was very helpful and understood that every third week, I needed to go for chemo.–KM

Concern for Our Loved Ones

Crisis is not experienced alone; there is a ripple effect. Our families and friends are impacted. While their reactions may be more delayed than ours, the impact is there. Those around us might not outwardly express their reactions directly to us, but the impact is there. A friend of mine with brain cancer said her husband never asked her how she was doing or seemed to understand her struggle, although she later found out that he talked to their daughter about his worries.

Two years after my diagnosis, my 31-year-old son called me in tears after listening to Taylor Swift’s song, “Soon You’ll Get Better.” Through his emotions and Taylor Swift’s words, he told me how proud he was of how I was coping with my experience. Some peoples’ words and emotions emerge on a different timeline than ours.

Just as they worry about us, we worry about them. A tumultuous time ensues for all when a crisis occurs. Routines change. Finances are impacted. Energy levels shift. Attention fluctuates. Above all else, no matter what happens, we want our family and friends to be okay.

It was so hard for me to see the effect it had on my preteen son. He was very frightened and freaked out. He acted out in school. It was a very emotional time for both of us.–RG

I was concerned about how my diagnosis would affect my husband, children, and grandchildren. I very much want to spend quality time with all of them. My oldest son and his family have moved to the area, and I treasure our frequent times together. I want to live to see my grandchildren grow up and thrive. –MM

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