How are you?

“Miten voit?” (“How are you?”) asks the occupational health doctor when take a seat in her office. Her question does not come as a surprise.  On the contrary, I have braced myself for questions like: How are you? How is life? or How are you doing? 

Questions like that, generally used as a routine greeting, can become uncomfortable if you’ve recently dealt with a serious illness or with loss for that matter.

What should you say? I'm fine, thanks. How about you? It would be the end of the conversation. I need to come up with something better. She is my occupational health doctor after all. Deep inside I hope for a follow up question but if that stays out, I will have to lead the conversation.

*

Weeks ago, when I started researching the topic, I realized how complex a simple question like how are you can be. Do people really want to know about my cancer journey or are they just trying to be polite?

Responding to family and friends who’ve walked along this year is easy.  I kept them informed after each chemo treatment. But I’m ready to go out in the world again and I surely will meet with people who have heard about my illness from someone who heard it from someone else. 

The how are you question makes me feel uneasy. How long should my answer be? Which words should I use or what details do I want to reveal? Do I need to tell the same story over again? Cancer has completely changed my life but do people really want to hear about it? 

I asked my friend Alana if she’d experienced awkward moments with the how are you”question after a long sick leave. 

“I made the mistake of assuming that one person wanted details but when they started to look uncomfortable, I stopped, made a joke about it and then changed the subject.  It's a difficult line to see sometimes,” she wrote. 

From Alana’s reply I get that it’s up to the receiver to formulate a response and estimate how much the inquirer can handle. That’s a significant task. Would I be capable of steering a gawky conversation in another direction?  Or should I try to pave the way for a genuine discussion? 

*

With my friend Karin I had an email conversation about the how are you question.” It’s best to stay in the present,” she advised. It sounded great but anticipating my visit to the occupational health doctor, I wonder how I possibly can stay in the present. I’m emotionally sucked up by the events of the past eleven months and at the same time planning my professional future.

On the other hand, a fellow chemo patient also once advised me to practice living in the present. “Live the day,” she said. “If your condition gets worse, try to live from meal to meal or if that’s too difficult to oversee, live from coffee break to lunch,” she advised. Her tip helped me to keep my worries at bay, to stay focused and it made me feel grateful for little pleasures such as a pancake with strawberry jam or the view of a woodpecker in the yard.

“Here and now” is a Gestalt therapy concept where “the emphasis is placed on understanding present feelings and interpersonal reactions as they occur,” says Google.

So, I should focus on what’s happening in a specific moment. According to some Harvard researchers, a deep breath and focus on an artifact in the room might help. The first steps seem easy. I have a good eye for my surroundings. 

*

Forward in time. As soon as I walk in the office of the occupational health doctor, I identify a window behind her and two large sized computer screens on a relatively high desk in front of her. After I have taken a seat on the chair before the desk, I notice that her face goes hidden behind one of the computer screens.  I need to move the chair and bend my body to the right to make eye contact.

The Harvard research also talks about the ACT criteria: before you start a conversation, think of “authenticity, connection and a topic that will give them a taste of who you are,” it recommends.

Taking my time before opening my mouth and reading people’s faces or body language shouldn’t be a problem either. I’m a sensitive person after all. Also, generally, in Finland people weigh their words before speaking. I never feel I need to rush into a conversation.

But the next step, articulating thoughts into words could be a challenge? If I were a fast thinker or an enchanting speaker with a sexy voice, I would have started a podcast instead of a blog.

*

Reframing the question might be a first step to stay in the moment and take control of the situation, claimed another website. 

“How are you? It’s a hard question to answer but is it OK if I tell you how today has been,” I reply. It is an example of one of the options I had written in my notebook before the meeting. This answer will help me to stay in the moment and give me time to check if she cares. Talking about the blood count results, stoma issues or my tiredness would give any doctor enough information to start a proper conversation, I guess.

As an alternative, "It's been tough, but I'm getting through it. Some days are harder than others, but I'm taking it day by day and try to stay positive," I could have replied if I didn’t want to share too much information. 

What’s more, if I would have felt intimidated, I could have said that I’m happy to be alive? Such a reply would certainly be the end of the conversation. Maybe “thanks for asking, yes, I’ve had a tough year,” would be a better reply to test the water for instance with colleagues at work.

Another website suggested using an unexpected word to see if folks are really interested. 

“How are you?” 

“Thanks for asking, I feel discombobulated,” I could say and then wait if a reaction would follow. Dismissing people seems straightforward. 

*

But much to my relief, the doctor nods after I tell her about the blood count results and my tiredness. She immediately opens the door for a proper conversation:

 “A surgery, chemos and Covid, you’ve had a rough autumn,” she acknowledges my health struggles of the past months. 

“How do you feel about returning to work?”