Chapter 4 -- A thoughtful word from Charlotte Lankard

"Life is Real: Writing the Final Chapters" is a blog The Oklahoman provided to help us have a conversation about what happens to an individual and their family and friends when one has been told there is no hope for a long life.

It is not an easy conversation, but who among us would not like to do it well when that time comes for us or for someone we love?

In addition to Jim, I have other friends who are making a similar journey. From all of them I have learned a great deal - and they have given me permission to share what I have learned with you. I will not use their names because what we are discovering is the honesty of what they are experiencing is difficult for family members and close friends to hear.

What happens when an illness such as cancer is pronounced terminal is the patient is immediately set apart, seen as different and separated from those who are healthy. At that point, relationships with ones they love most begin to change and will keep changing.

When there are times of remission, after undergoing chemotherapy and radiation treatments, and the patient begins to get back into a normal routine - no longer in bed, shops for groceries or drinks coffee at the office, friends and family assume that because they don’t “look sick,” they are not sick.

At this point, the patient begins to carry a secret identity: Who knows that only last week they completed treatments? Who knows about the constant pain or about the itchy scar under the shirt? Who gives a second thought to the wig that covers a bald head? Thus they manage the grind of daily living while their illness looms over everything - shadowing, trivializing and obscuring their reality.

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