I get that question a lot these days. It happens when someone finds out I have lung cancer. Their face goes a blank for a second, and I can see their eyes searching the air around me for the right words. “Did you smoke?” they blurt out, or some version of that question. Sometimes it’s just one word: “Smoker?”
I wish the whole world could read this and understand. Unless you are a healthcare professional assigned with a patient’s treatment, this is a really, really horrible thing to ask someone who has lung cancer. In case that didn’t sink in, this is an outrageously small-minded, insensitive, shitty thing to ask someone who has just told you he or she has lung cancer.
You might as well ask, “Is it your fault?” That’s what the question means, right? Did you smoke? Is it all your fault? Are you the one to blame? Did you do something stupid and now you’re paying the price?
Somehow the question always takes me by surprise, so I’m seldom prepared to say the things I’ll later fantasize having said. Things like, “No, but say, is this the kind of sensitivity you reserve for all those special occasions when someone tells you they have a potentially fatal disease? You know: Heart disease – cheeseburgers? Cirrhosis – drink a lot? Hepatitis – dirty needles? Goodness me, have you thought about a career in pastoral counseling?”
“Just crack,” I said once. I was tired that day. Tired and annoyed at the prospect of comforting yet another person innocently but heartlessly looking to propagate the lie that everything in our world makes sense. For if I smoked like a chimney, even for a few years, then perhaps the universe could still be fair.
I think that’s what people are looking for (and afraid of not finding) when they ask me the question. Fairness and sense and the ability to stave off the gnawing fear that awful things happen with no rhyme or reason – that at any moment, reality can dangle your life over the abyss and it has nothing to do with who you are or what you’ve done.
In that light, I put, “Did you smoke?” in the same category as other ridiculous things to say to someone who has cancer. Things like “It’s all part of God’s plan,” “God won’t give you more than you can handle,” and “Everything happens for a reason.” They’re all attempts to name order in the chaos and, failing that, to squeeze meaning out of the inexplicable. I didn’t smoke, my cancer isn’t part of God’s plan, sometimes we get way more than we can handle, and shit happens. I’m sorry if that’s upsetting to you, but trust me, it’s not nearly as upsetting as finding out you have stage 4 lung cancer.
And I get it. It would be great if the universe lined up a little more nicely sometimes and we didn’t have to fend off thoughts of life’s terrible fragility. But welcome to the club of cancer patients, Rohingya Muslims, Syrian war refugees, children born with AIDS, and millions of others who don’t have the luxury of pretending that life is remotely fair. With me at least, it’s ok for you to admit what I already know.
So here’s a list of things I’d suggest you say to someone who tells you they have cancer:
“Oh [insert name]. No.”
“Dammit I’m sorry.”
“I’m honored that you would share that with me.”
And when in doubt:
“Wow. I don’t know what to say.”
Trust me on that last one. It’s ok. A lot of the time, I don’t either. Whatever you do, resist the temptation to bring order to chaos. Don’t try to rationalize, theologize, or explain my cancer. Instead, join me in conversation (preferably one that doesn’t begin with the question, “Did you smoke?”) and I’ll let you in on a little secret that I’m surprised to keep learning: God doesn’t seem to be in the business of making chaos “fair.” But God is summoning life out of it and calling it “good.” Lung cancer and a hundred dreadful questions looming around me… God hovers over even these chaotic waters, and somehow I believe that the goodness is coming.
I have stage IV lung cancer and I write about that here. If you're out there and you're fighting cancer, solidarity. If you read "lung cancer" and you wonder if I was a smoker, read this. Living with cancer is a daily, death-defying reality - one that pushes me to not simply defy death, but to affirm life, bless goodness, cheer for wonder, celebrate beauty... you get the idea. I hope I do that here.