I’ve been overwhelmed with the support I’ve received from friends, family, colleagues, social media, etc…; that being said, although I know that everyone means well, cancer is shocking to many people, and your first instinct isn’t necessarily the right one.  Sadly, given the grim statistics, we’ll all probably have to send a supportive note to someone with cancer again, and in the interest of making these notes as valuable as possible, I thought it would be useful to present my thoughts regarding the key features of an effective or ineffective letter.

The things to DO:

1. Follow the formula –

I. “I was shocked to hear about your diagnosis...”

II. (Something complimentary), followed by: “I know you can handle this...”

III. (OPTIONAL) Anecdote about a survivor you know.  Bonus points if they’ve gone on to do something exceptional, like finish a marathon, or publish a book, win the Kentucky Derby, etc…  I don’t care if these stories are about your sister-in-law’s aunt’s neighbor; I never get tired of hearing stories about survivors.

IV. (OPTIONAL) An inside joke, if you’re certain it’s actually funny.

V. “Anything you need, please let me know…

VI. “We’re praying for you...”  I don’t know that anyonTreee tangling with cancer will say no to your prayers, even if he/she has never taken much notice of religion previously.  I certainly was pleased to know that representatives of every major religion were making appeals on my behalf.

2. Grand, dramatic gestures – If you can pull one of these off, kudos to you.  Two examples: First, my cousin, Kristin, convinced the Stanford Tree to send me a supportive picture.  This meant a lot.  People that know me know that the happiest time of my life was at Stanford, and that more than half my wardrobe has “Stanford” printed on it somewhere.  The tree itself is a heroic, Dionysian figure, with exactly the right sort of connotations for someone facing a major raymondillness.  Second, my college roommate, Raymond, returned to our Sophomore dorm to send me a very special message.  Context: Our dorm was named “Lantana” and at some point, the “L” on the main sign fell off.  Raymond and I lobbied quite unsuccessfully to have the dorm’s name changed to “Santana”.  This was during the peak popularity of “So Smooth“.  In recognition of this bit of adolescent enthusiasm, Raymond returned to the scene of the crime to send a special message.  Much appreciated.

The things to NOT do:

1. Don’t send a text message after midnight.

” Greetings from Amsterdam Airport! – Received at 1:31 AM”

I get it that you’re an international traveler and you maybe just checked Facebook, email, etc., but please, please realize that sleep in hospitals is damn near impossible (discussed here), and that patients who recently had brain surgery need sleep more than anyone.  Send a sensible email that can be opened and read at leisure.  Also, international travelers can be expected to realize that the Earth has many different time zones, and that Amsterdam is actually quite a bit later than St. Louis.

2. Don’t offer inappropriate gifts.

“Trust you are doing well, sire, under the circumstances.  I’ll bring you a Cuban cigar when next we meet!”

I understand that Cuban cigars are expensive, difficult to obtain, and highly valued in some circles, but please use a little judgement: I just had CANCER cut out of my brain, and you’re going to make it all better with TOBACCO.  Thanks, but no thanks.

Likewise, I’ve had a ton of well-meaning friends offer to buy me drinks when all this is over.  I greatly appreciate the sentiment, and I’d really love a well-earned drink, but please realize that alcohol and seizures are a really bad combination.  Alcohol and anti-seizure medications don’t play nicely together either.  For better or worse, my drinking days are over.  Which is just fine with me.  Inviting me to have a drink is kind of like inviting someone who just had knee replacement surgery to go skiing next week.

3. Don’t bring your favorite sports team into it.

For reasons entirely unclear to me, I’ve received about a dozen messages with some variation of “Let’s Go Royals” thrown in.  To be clear: On a good day, I don’t care whether the Royals’ record is 100-62 or 62-100.  On a bad day, I’d trade every win the Royals have ever had and will ever have to see my children’s faces one more time.  The only virtue of cancer that I’ve found is that it clarifies what’s really important.  Baseball, despite being a fine thing under ordinary circumstances, does not make the list.  Plan your supportive letters accordingly.

4. Avoid even oblique references to death and / or permanent disability.

Remember that depression, despair, and negativity are enemies to your loved one, and remember that they’re trying hard to discipline their mind to be brave.  It’s easy for you to be brave; you don’t have to look cancer in the eye.  Avoid bringing up topics with bad associations:

“Wow, that’s stunning. It’s great to hear that it’s manageable, but anything to do with the brain is scary. Good luck, man.”

Agreed, anything to do with the brain is scary.  I suspect it was scarier for me than for you, when I spent a week in rehab re-learning how to walk.

“Our thoughts, prayers and love are with you Always!”

What’s the deal with capitalizing the “Always!”??  Seems a smidgen morbid.  Perhaps I’m over-sensitive, but it’s worth remembering that your reader will likely be over-sensitive as well.


I don’t want to be overly negative, because I really have been overwhelmed with thejourney love and support and prayers I’ve received through this whole ordeal.  Nevertheless, chances are good that all of us will unfortunately have to try to comfort someone with cancer at some point in the future, and it’s worthwhile to think about the most effective way to convey your thoughts.  I should point out that I’m not the first person to cover this ground; please check out the “empathy cards” created by cancer survivor Emily McDowell (an example is nearby).

Closing thought:

Journey, the band, and “Journey” the euphemism both suck.