An oft-viewed post on this little site is What to Say to Someone with Cancer. That gets a lot of hits as October nears and everything from eggbeaters to sock garters is dipped dyed pink as otherwise good people Sympathize for Awareness. The best reaction to my crap news was similar to Steve’s. Matt phoned just to say, “FUCK. Should we go get drunk?” Stevie outlines the reasons why these expletives are the best.

Of all the reactions I received telling people I had cancer, the most empathetic came from my cousin, Gregg. He called right after he heard the news.

“WHAT THE FUCK?” said Gregg, getting right to the point.

It was absolutely the right thing to say. That’s not to discount the many sympathetic calls I got in those early days. People expressed their love, concern, prayers, and hope for my speedy recovery. And that was nice. It’s just, well, “What the fuck?” was on a closed, repeating loop in my head and it was a relief to hear it aired aloud. Gregg nailed it.

Hence, the difference between empathy and sympathy.

Sympathy says, “I’m sorry to hear it. But you’ll get better.”

Empathy says, “I’m coming over.”

Sympathy says, “Don’t cry. You’ll be fine.”

Empathy says, “Cry. This is something to cry about. I’m getting more Kleenex.”

Sympathy says, “I know you’ll be fine. I had a friend who had this, and he got better.”

Empathy says, “Scootch over. Let’s watch Netflix.”

It’s not that there’s anything wrong with sympathy. Sympathy comes from a good place. And oddly, a cancer diagnosis quickly reveals that there are people who actually struggle with sympathy. These are the ones who say stuff like “At least you don’t have double cancer” or other it-could-be-worse scenarios. They say, “You should stay positive” or “Get over it” when you’re sad. When was the last time you “got over” anything—much less cancer— on demand? “Let it go” is another doozy. Oh, I was going to hang on and stay scared and angry, but since you said “Let it go,” I’m just gonna let it go. Thanks. Who wants to go for sushi?

Empathy doesn’t require solutions. It doesn’t even want them. “What the fuck?” says a whole lot. It says, “I’m mad, too,” “This sucks,” “I hear you,” and it respects a shitty moment with appropriately angry humor. Sympathizers are sorry, and you’ll feel that; but empathizers are already pouring you three fingers of scotch or queuing up Breaking Bad episodes.

People will try to come up with solutions when there aren’t any. This is human and forgivable– it comes from a feeling of helplessness. But there’s a better way to help: don’t make any suggestions at all. A cancer patient (or someone who’s depressed or stressed or addicted or mourning or any number of afflictions) is already losing sleep over possible solutions. What helps is having someone just to be there and share those uncomfortable feelings.

“Why the fuck is this happening to me?”

“I have no idea. Sucks, though. And I hate that it is.”