I spent a good chunk of Easter Sunday at a friend’s house, helping out because she’s basically trapped on her couch after a nasty car accident. Amazingly, despite the fact that her car was totaled (among other things, the entire passenger side was basically crushed), she basically walked away; she has some severe bruising and it’s difficult to walk right now because of her lower back pain, but she is likely to make a full recovery, and the people in the other car weren’t injured.
Which is pretty exciting. Living where I do, with a lot of long, windy roads, I’m used to my friends getting in car accidents, and not all of them have these kinds of outcomes. Some of them have bionic bodily additions, post-traumatic stress disorder, and serious injuries that will linger for life. Others are dead.
Like a lot of people who’ve been through a major trauma, she triaged her notification list and I wasn’t at the top of it, but when she emailed me on Sunday to let me know what had happened, I asked her if she needed anything. Because, here’s the thing: I’ve dealt with a lot of situations like this one, and I’m pretty damn good at dealing with them at this point, from managing notifications and being a primary point of contact to being a mule for a few days.
“I really just want some cookies,” she said, so I promised to come over and bake her some cookies. I ended up staying for five hours to make her some food she could eat cold or reheat easily, tidy up her floors, get the dishes taken care of, and do a few other odds and ends. She slept through a good chunk of it. That's okay.
And it made me think about how most people don’t really know what to do when a friend experiences a major medical event, and they flail around wanting to help but don’t really accomplish anything. So here are a few tips -- and I’m sure you’ll have more in comments.
Not everyone wants help.
This is important to keep in mind, especially if you’re an alpha personality, fix-it type person, like I tend to be. The instinct is to rush in and do things and hover around, and some people really don’t react well to that. Ask if people need assistance and if they say they do not, respect that; it’s fine to make it clear that you’re available in the future, but don’t force someone to take help.
As I know well from my own days of being laid up, when you are an independent personality, it’s really, really hard to accept help from people. Even when it’s beloved friends it feels kind of humiliating. And sometimes you’re willing to accept help from one person but not another. In other words, don’t be insulted if a friend of yours is laid up in bed and says she doesn’t want your help but is having Susan over all the time. This isn’t a contest.
Offer specific and concrete help.
A lot of people respond with “Oh, please tell me if there’s anything I can do to help” in the face of major news like a car accident, big surgery, or similar event. The fact is that most people are 1. Too overwhelmed to even begin to think about what they need. 2. Too in shock to really be making decisions. And 3. Dealing with a situation that’s so new and alien, they don’t even know what kind of help they might actually need.
Offer to cook or bring meals over, to take shifts so someone isn’t alone, to run errands to pick up medications or other supplies. To walk someone’s dog (do you have any idea how agonizing it is to walk a dog after major abdominal surgery?) or even to bring someone’s animals over to your place for a few days or weeks (cats walking on your body at night out of a mistaken attempt at being loving can hurt like the dickens if you’ve just been in a car accident).
Offer your assistance with being a point of contact, managing mail, email, and phone calls, clearing the person’s schedule, and making sure that bills get paid and things get done.
Do some laundry, and help out by folding it and putting it away, too. Clean. When you’re trapped in your house, it’s really depressing to look at dirty floors (thanks to all your helpful friends, the floors are covered in filth from high traffic), dusty bookshelves, and the debris of illness.
If someone’s in the hospital, volunteer to look after the garden, clean out the fridge (imagine coming home to...things...left in the fridge for a week or more), collect the mail, and do all those other little things around the house that need to be done to keep it going. Offer to talk to landlords/leasing agents and anyone else who might need to be notified.
Be aware that hospitals won’t guarantee the safety of belongings, but if someone’s going to be in a room for a while, supplies are useful. However, for things like checkbooks and financial paperwork, it can be a good idea to have a designated person who holds on to these items and brings them to the hospital as-needed (for example, for a once-weekly check signing to pay bills and so forth).
Don’t go away.
In the immediate wake of a medical crisis, tons of people often crowd around. Sometimes too many, actually, which can be a little intense and sometimes frustrating (making it a good idea for one person to be a central point of contact to coordinate everyone!). However, support drops off very rapidly, sometimes within a few weeks, leaving the patient largely alone, but often still in need of assistance.
So don’t be one of those people. Commit to sticking around and enlist some other folks to help with support; remember that in the wake of medical crisis often comes emotional trauma. Someone might not need a driver after a month, for example, but she could need someone to come over and play Scrabble once a week, or provide other emotional support.
If someone’s living alone, coming over to cook meals and setting her up with some food to eat later can be helpful, not just because she might not have energy to cook, but because she might really appreciate the support on an emotional level.
People with chronic illnesses or terminal illnesses that are very slow are especially vulnerable to this problem. With diseases like cancer and ALS, which can take months or years to kill while the patient’s mobility and activities are slowly restricted, patients may be totally isolated near the end. That’s a horrible way to go, and a small circle of friends who regularly take turns with visits and helping out can change that.
Being injured seems to come with mounds of paperwork. There’s all the medical stuff, with things piled on top of things and multiple bills showing up every which way. Then there’s all the other stuff; leaves of absence to arrange from work, forbearances on student loans, disability/injury insurance claims, insurance claims in general, and so forth.
It’s a lot to deal with, but you don’t have to be a paperwork expert to help with it. Just organizing it by type and due date can help a lot, as can sifting through it to translate what’s going on into plain language.
For example, with medical documents it’s common to get multiple bills and updates regarding the same service. A patient who was in a car accident might have a radiology bill from the hospital, a statement from the insurance company (who got the same bill) telling the patient how much it paid, and another statement from the hospital (yes, billing departments really are this inefficient) telling the patient the balance due. And then there might be another statement from the other driver’s insurance, just for kicks.
Sorting through these papers (and ultimately calling the billing department at the hospital to find out how much is actually owed) is immensely helpful; in fact, making calls of these sorts in general is a big help because most people who are sick don’t want to spend all their time on the phone because it’s exhausting and confusing. (Remember, your pal may be on some pretty heavy narcotics.)
It definitely helps to generate a list of contact numbers and people to help with this stuff, too. Write down the names and extensions of helpful people you talk to at the insurance company, hospital, government agencies, and other organizations you have to work with. That will make it much easier and faster to process incoming paperwork.
Riding out the aftermath.
A major medical event can lead to temporary disability, long-term disability with no clear indicator as to prognosis, or a permanent acquired disability. My friend, for example, could have snapped her spine and developed paralysis. She could still have a hidden hairline fracture or nerve damage that may cause problems in the future.
This can be really rough, and the adjustment period can be brutal as people start to learn more about the extent of their injuries (something that may not be apparent for months), and the new configurations of their bodies. Many people experience some degree of depression and mourning, and while you are not a counselor (well, maybe you are! In which case you already know all this), you should be prepared for it.
Some people react by getting angry and lashing out, others by isolating themselves. It can be difficult to maintain a friendship through a rocky emotional time, and it’s okay to take a step back sometimes for self-care. This is one reason why it’s a good idea to have a broad network of people who can help, so that a handful of people aren’t forced to be everything for someone who might really be struggling.
If you can stick it out (and no judgment if you cannot -- people can change radically and all the preparation in the world can’t always prepare you for that) and see your friend through to the other side with your practical and emotional support, you’ll be making a big difference in her life. You might find it helpful to talk to people with similar injuries about what helped them to get a list of ideas for helping out, and to join a support group for people like you so you have a place to talk, think through issues, and get practical assistance.
Sometimes, all you need to do is be there as a person to talk to while people react to trauma, think through it, and process it. Don’t be surprised if your friend starts talking about making major life changes, or processes feelings of guilt, depression, and rage. Just be there. And let her talk.