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Death is tough subject, but it has to be discussed

Q. I was recently diagnosed with an aggressive cancer and have been dutifully if miserably going through treatment. The prognosis? Who knows.

The whole "every day is a gift" thing has somewhat cruelly -- and somewhat wonderfully -- become a daily, waking thought.

How do I get the people in my life to confess out loud that this could, and in all likelihood will, kill me? Everyone around me is insistent on being optimistic and denying the truth that this disease kills people every day, and I could be one of them. I try to talk to them about what will happen to my things, and what their plans are when and if I die of this, just as if I were hit by a bus, but they stick their heads in the sand and refuse to have the conversation with me.

Carolyn, I could die from this. I will die someday. These are both factual statements. So why will no one discuss it with me?

V.

A. I am sorry. I am sorry about the cancer and the miserable treatments, and, in the spirit of your question, I am even more sorry that your well-meaning but cowardly intimates have left you no choice but to suffer alone.

Your question is, why? And my answer is, I don't know. I can guess, though: You live in a society that can't get enough of fictional death, but prefers the real thing to be pat, antiseptic and (this is key) offstage.

The difference may be as simple as the ability to click "off" when the emotions start feeling too real. The only thing we have to fear, apparently, is awkwardness itself.

You probably can't call people cowards as easily as I can -- you want openness about your impending demise, after all, not enthusiasm. However, I do think you want to use almost that level of bluntness to get your point across.

As your "somewhat wonderfully" observation suggests, you have clarity, urgency and courage on your side here. Gather these up, then recruit two more allies: specificity and selectivity. Narrow down exactly what you need, zero in on the person who represents your best shot at a straight answer, then, ask.

For example: "I will need someone to distribute my things. Will you please help me?"

And when you get the oh-it-won't-come-to-that answer: "Yes, it will, and you will die someday too, and I feel better talking about it than avoiding it. Will you please help me?"

And when heads start hitting the sand: "Can you explain why you won't help me?"

Clearly this is pressing someone well beyond the point where, under normal conditions, I advise backing off; you can't "get" anyone to confess, or even pretend, anything.

But these aren't normal conditions, and your needs warrant extreme measures to flush loved ones out of hiding -- as a favor to them, I could argue. Target the overlap between people you trust, and people who have said to you "If there's anything I can do. ... " Collect on these offers, and tell people you're doing it.

Ideally, it wouldn't come to this, I know. Ideally, people wouldn't try to escape life's inescapable fact. But, ideally, you wouldn't be sick.

I am so sorry you are. As you've been with cancer, be with people: unflinchingly matter-of-fact.

© 2008, The Washington Post Co.

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