It's OK to talk about the scary stuff

When I go to speak to people at the bedside, or when I see people in consultation in the office I often ask, "how do you feel?" Most of the time I get the usual litany of physical complaints, but sometimes I ask that question and I get answers that go beyond the physical.

"I'm tired" is one of those answers that I often hear... what is interesting and disturbing about this is that it is obvious that they are talking about more than physical fatigue. "I'm tired" has become code for "I am done and I want to talk and no one wants to hear it".

Conversations about how it feels to be very sick... and even thoughts about dying can be disturbing to hear, especially if it is a loved one and you really don't want to hear it.

I suggest that if you care for someone who is chronically ill or dying, listen to what they have to say. Let them complain, let then cry, let them tell you they can't go on. These are not evil thoughts, these are not suicidal thoughts, these are the thoughts that are silent... unspoken inside the mind of your loved one. These thoughts... unspoken... will fester inside and cause real damage, real separation and real sadness.