For many, the question "How are you?" is a harmless social ritual. But for those facing a serious health crisis, it can become a deeply painful and complex moment to navigate.
The Dilemma of a Simple Greeting
Mark Cottle, from Maesygwartha in Monmouthshire, knows this conflict all too well. Following a diagnosis of metastatic prostate cancer, the commonplace British query transformed from a casual conversation starter into an emotional minefield. He found himself torn between giving the expected, polite response and confronting people with the overwhelming reality of his situation.
As Cottle explains, the conventional reply in Britain is often a vague "Oh, not bad…" However, when facing a terminal illness, this feels like a dishonesty. Yet, delivering the full, brutal truth in response to a casual greeting feels inappropriate and burdensome to the other person.
Crafting a 'New Normal' Response
To bridge this impossible gap, Cottle has developed a more nuanced answer. On days when his condition is manageable within the context of his illness, he might respond with "All right today." This carefully chosen phrase acknowledges the present moment without making false promises about the future.
He admits some days are "genuinely rotten," and finding words remains a struggle. On better days, where joyous events or upbeat feelings break through, he may offer a "Pretty good today." The crucial element he always includes is the word "today". This small addition acts as a vital anchor of honesty, implicitly acknowledging the precarious and uncertain nature of his future.
A Shared Human Experience
Cottle's reflection was prompted by an article from Carolin Würfel in The Guardian on 16 December, which highlighted that this challenge is not unique to any one culture. It underscores a universal human experience: how we communicate profound personal suffering within the constraints of everyday social etiquette.
His letter reveals the ongoing psychological work required to live with a life-altering diagnosis. It involves constantly recalibrating responses relative to a "new normal" and making micro-decisions about vulnerability and disclosure with almost every interaction.
Cottle's experience sheds light on the hidden emotional labour performed by many living with chronic or terminal conditions. It serves as a poignant reminder of the complex stories that may lie behind a simple answer to a simple question.
