Dear Prudence

A Separate Peace

I’m losing my battle with cancer and want to stop treatment, but my family thinks I’m giving up too soon.

Emily Yoffe.

Emily Yoffe

Photograph by Teresa Castracane.

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Dear Prudie,
After a pretty brutal year with more than 120 days in the hospital fighting a bone cancer (among other things), my condition has gotten worse. My doctor agrees with letting me stop all treatments, except things to help with pain and discomfort. I’m left with a few weeks to perhaps two years to live. I’m in my 40s, and my child is grown and doing well. While I’d like to see future grandchildren and do much more, I’m at peace. I am making the most of my time, and sharing the joy I have each day. Without the medical treatments, I experience much less nausea and pain, and I have a good quality of life for at least a short time. My family and friends, however, are not taking it so well. I hear general admonishments that I shouldn’t give up, to suggestions I seek a third and fourth opinion, to assertions I should have a bone marrow transplant (a rough procedure I would only have a 20 percent chance of surviving). What can I say to people who love me, to reassure them that it really is OK? I don’t want to spend the time I have left defending my choice to not be a hospitalized human pin cushion.

—Enjoying the Time I Have

Dear Enjoying,
I’m sorry about your prognosis, and I hope there are many good days ahead. Your letter touches on the most intimate of our relationships (the pain loved ones feel at having to accept the unacceptable approach of the death of someone still young) and larger social issues (the pressure to give patients every possible treatment, even if treatment is of no use). Please read this article from the Washington Post by Amy Berman, a registered nurse who also is facing stage IV cancer and has made the choice you have. She expresses many of the things you want to get across to the people who care about you and who can’t bear that there’s no miracle left. Berman writes that palliative care, which focuses on maintaining the patient’s quality of life, whether that means continuing treatment or ending it, may in some cases do more to prolong life than aggressive regimens. She also describes how as a medical professional she knows how excruciating and useless it is to subject someone with an incurable disease to every last ditch effort. I suggest you print out this article and ask your friends and family to read it so they can better support your wise choice. You might also include this story by physician Ken Murray about how doctors facing terminal illnesses often don’t put themselves through the same futile treatments they give their patients. Then, for those who persist in saying you must fight on, you can respond, “We all have a finite amount of time, but mine is more finite than most. I can’t spend it defending a choice that is medically and personally best for me. So please, let’s enjoy today and talk about something else.”


Dear Prudence: Suburban Dad Likes His Weed

Dear Prudence,
I am a man in my 50s, and I work in an office with a twentysomething woman with whom I have regular contact. I’m her boss’s boss. She is an excellent worker, professional in every way, except that she regularly displays décolletage and meaningful cleavage. She is attractive, with an hourglass figure, and is nicely endowed. She seems aware of her revealing dress by the way she tries to gather more cover when I come by, generally without success. I work hard to maintain eye contact and keep my eyes from wandering downward. But I see what I see, she knows it, and appears not to like it. If I say something to her directly, not only do I raise the issue a notch but it would likely do little to increase her comfort with me or the company, where she is valued. I can bring it up with her female boss, or I can hope she figures it out sooner or later. This raises the question of allocating fault and responsibility between the man who enjoys the view and the woman who displays it.

—Confused Boss

Dear Confused,
You’re right that this young woman is aware that you regularly exchange meaningful glances with her meaningful cleavage. Even if she covers her chest with Post-it notes when you come by, she’s clearly not deterring you from enjoying the view. We only have your word that she is dressing too revealingly for the office; you revealingly convey that you’re an old letch, which is a problem for you. You say you “work hard” to keep eye contact, but however hard you are—I mean, however hard that is—you need to keep your eyes off the prize. But if this employee is truly diminishing her effectiveness as an asset to the company by displaying too much of her personal assets, then it’s fair that someone speaks to her about this. Go to human resources—let’s hope there’s a woman there—and leaving out a description of your own stirrings, explain that Miranda is terrific, but she needs a word on office attire. If Miranda then exposes less flesh, it will probably be a great relief to her that when she talks to you, she is no longer filled with dread that one day she may have to scoop your eyeballs out of her décolletage.


Dear Prudence,
After a bout with drug abuse, I’ve recently begun seeing a therapist. He has homed in on my relationship with my father, and though I know part of my therapy is dealing with things I sometimes may not be comfortable with, I feel he’s crossed a line. I do seek my father’s approval, but there is nothing inappropriate about our relationship. So when my therapist suggested that my father and I have an incestuous relationship, I was offended. He wants to focus only on issues related to my father, even when I try to steer the conversation elsewhere. When I say that my relationship with my father is not behind the problems in my life, he tells me I’m in denial. I have a session coming up with him, and I don’t want to go. I feel he’s wrong and not listening to me, but part of me that wonders if I actually am in denial. When it comes to psychologists, am I supposed to go with what I believe or concede that the therapist is right?


Dear Shrinking,
When I recommend that a letter writer see a therapist, I sometimes feel I should add, “Preferably one who isn’t crazy.” Yours is crazy and also behind the times. Fabricating memories of childhood sexual abuse is so 1990s. You’re right that therapy can be challenging. You want someone who will make you look at your assumptions and help guide you out of ruts in your thinking and behavior. But this process should not make you squirm as a result of being manipulated by a loon. You have no obligation to this jerk. Cancel your appointments and say you won’t be coming back. You have a specific goal: to stay off drugs. If you went into a rehab clinic, start your search for a new therapist by asking there for recommendations for those specializing in addiction issues. Look at the resources on the Substance Abuse and Mental Health Services Administration website, and here are some additional guidelines for conducting your search. Then call a few of the people on your list and ask if they will talk with you on the phone, or have a short meeting, to discuss your potentially becoming a patient. Explain your issues and say you’d like to know what approach the therapist takes, how many sessions are likely needed, and the kinds of “homework,” if any, that might be assigned. You should feel that you are making a connection and are in a safe place. As for your now-former therapist, consider reporting him to the local licensing board. Trying to falsely convince a vulnerable person that she was abused is itself a form of abuse.


Dear Prudence,
My girlfriend and I have been together for almost three years, love each other dearly, and are marrying soon. She is Christian, and I was raised in a conservative Jewish home. I was never very religious but always enjoyed the Jewish holidays and traditions with my family, with whom I am very close. Early into our relationship I started going to church with my fiancée and found meaning in the words of Christ. Recently, I was baptized. The pastor and I are friends, and he will marry us. My dilemma is that while I think he’ll agree to have elements of both religions in the ceremony, I don’t want to “come out” to my family. They would never understand and it would alienate me from them. If I ask to have a non-Christian ceremony, I risk hurting my fiancée and her family and looking like a hypocrite. Any suggestions?

—Oy Vey

Dear Oy,
I assume you don’t plan to secretly baptize your children on Yom Kippur because you know your family will be tied up elsewhere. Your current approach doesn’t honor either the religion in which you were raised or the one you now embrace. It’s going to be very painful for your family to learn that you have converted. But your family knows other Jews who have abandoned the religion either through conviction or convenience, and, given your Christian fiancée, it’s hardly going to be beyond their imagining that you have joined this exodus. You should have a talk with your pastor about how he can acknowledge your origins during the wedding ceremony. He can find a lot of material in what he calls the Old Testament. And for guidance about being honest, John 8:32 has an observation in your new book, the New Testament: “Then you will know the truth, and the truth will set you free.”


Discuss this column with Emily Yoffe on her Facebook page.

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