Six months ago my friend was diagnosed with a serious brain tumor and now it looks like he will not survive. His family has rallied around him seeing to his every need so I'm not sure how I can help, how involved I should be, or what to say when we're together. I want to act normal but with all the tubes and his worsening condition I feel like we're avoiding the obvious.

Preparing For The Death of A Friend
Unfortunately, the cure for cancer has not yet been found. Despite the best efforts of modern medical science, the fight against cancer still can end in death. As a friend, you are obviously in a different position than a family member. In some ways, this can be a difficult position. Your role may be unclear. How much does the patient and his family want you around? Are you helping or in the way? Not only might you be unsure about others' attitudes towards you, you may be quite confused about your own feelings. There is certainly a natural human tendency to want to get away from difficult situations, to avoid, ignore, or deny. You may then find another difficult emotion, guilt, arriving uninvited.

Survivor Guilt
Why, you may find your self secretly thinking, is your friend the one who has been stricken with this illness instead of you? It is certainly natural and unexpected that you might feel glad that you are not the one with the illness, and this too can lead to feelings of guilt. The important point to be made about feelings is that a wide variety of feelings are natural and normal. Sadness, anger, anxiety, guilt, relief, and many others can occur at various times, in various combinations. As always, talking about these feelings, individually with a counselor or clergy person, or in a support group, can be helpful. Difficult feelings after a loved one who has died or before death (anticipating grief) are inevitable and unavoidable. Allowing yourself to feel your feelings and express them is part of the healing process.

Don't Avoid Your Friend
Despite the challenges of staying involved with an ill friend, it is crucial to stay involved. The time you able to spend can be deeply meaningful, to yourself, your friend, and his family. One of the most frequent complaints of seriously ill people is that friends tend to avoid them and treat them differently than before. Treating your friend as normally as possible, reminiscing about shared experiences, and sharing details of your own life can be extremely supportive and help your friend continue to feel connected to the world. Let your friend know the ways you will remember him.

Spending time with a seriously ill person will certainly bring deep feelings about your own mortality. This can be difficult, particularly for your people who are not accustomed to such thoughts. What you will find, over time, is that accepting the reality of death is, in fact, a blessing and an affirmation of life.

What we are all trying to do is live our lives the best we can, one day (and one moment) at a time, knowing that life is finite. The sadness of having a friend die cannot be taken away, but the privilege of being with your friend and their family during this process will live on.

Be well.