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Guest Blog – Judy Bachrach

The Top 10 Things NOT to Say to the Terminally Ill

Dear Judy (one of my readers writes – a woman, I’m afraid), my husband’s mother has recently been diagnosed with Alzheimer’s, not in its last stages but bad enough. Her short-term memory is totally shot. My husband doesn’t want to reveal the diagnosis to his mother; he says it’s cruel. I’m tempted to tell her what she’s got right now, behind his back. After all, she needs to start making plans. Besides in my experience, secrets are toxic.

Of all the remarks I regularly read regarding how to deal with the terminally ill, it’s the secrets-are-toxic slogan that drives me totally nuts.. . .

It is also the only observation made exclusively by women (men seem to have a far greater affection for subterfuge and lies, borne perhaps out of habit). So let me start here with the obvious. Or what would be perfectly obvious if only people started relying more on common sense than on clichés.

Dying people are in a class by themselves. They are not going to mend their ways, get better or perk up. Some of them know they are dying, and want to make, as my reader suggests, plans. For others, strategizing is requires too much effort, and frank revelations about their diagnoses or long-term prospects senseless and vicious.  For one thing, if you’re dealing, say, with an Alzheimer’s victim, you’re going to have to repeat the death sentence to the patient time and again. For another – what are such patients supposed to do about their condition?

In fact, candor and dying are in many instances mutually exclusive. That doesn’t mean you have to be dishonest with the terminally ill. But it also doesn’t mean you invariably have to spell things out. The much-reviled coping mechanism known as denial is in fact a very effective form of consolation, allowing those who rely on it to absorb as much (or as little) information as will be helpful to them at any given minute. Who are the healthy to strip it away from those who need it most?

So whenever readers ask me what to say to the dying – usually right after they’ve told me what they intend to unload, no matter what — I tell them I have a better idea.  Maybe, I tell these well-wishers, they should on their visits to sickbeds fall silent for a few moments and let the patient do the talking. Then I offer them my favorite kind of list.

Ten Things Not To Tell A Dying Person

1) It’s probably because you’re a Type-A personality

2) I thought you were looking washed out, but I never wanted to say anything.

3) …If only you hadn’t smoked…

4) I had the exact same symptoms last year, but fortunately it turned out to be nothing.

5) Have you made your peace with Jesus?

6) You might want to enroll in an anger management course.

7) Don’t worry: my doorman (third husband/plumber) had the exact same type of cancer, but thanks to prayer (guided imagery/coffee grounds/juice fasts) is now in Hawaii competing in the Ironman Triathlon.

8) You want to be careful about getting hooked on those pain meds…

9) I know this great doctor with a clinic in Juarez…

10)  In a way, I envy you.

Judy Bachrach is a Vanity Fair contributing editor, and the founder of – an online advice column for friends and relatives of the dying.

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