The holiday season can conjure up images of festive gatherings of family and loved ones, laughing and eating around a table full of delicious food, nostalgic stories, and holiday music. Joy is served up, as thick and rich as the banana cream pie, while everyone catches up on happy news.  Cut to reality: We know that life is not like the one depicted in the movie “Pleasantville,” where there are never any natural disasters, hardships, or illness. Real life, especially during family gatherings and the holidays, forces us to confront immense challenges, including one that affects one in three women and one in two men: cancer.

 

We live and work as if our plans and dreams for the future are set in stone. When cancer arrives, we often go silent with fear, as if acknowledging this unwanted visitor will ruin the ideal world of our imagination. The silence grows as other well-meaning loved ones remain quiet too. Now, cancer is the “Pink Elephant” in the room. Now, when the family and friends gather, the cousin diagnosed with breast cancer is welcomed with small talk about anything BUT her condition (“You look great”, “love the lipstick!).

 

She’s gently ushered into a comfortable chair in the corner, where she can quietly take in the “joy of the season” around her. She wears a turban over her balding head, with make-up to give the illusion of eyelashes and eyebrows. Bright red lipstick offsets her pale, thin skin. She is weakened and nauseous but knows to play the role of the good guest at the perfect holiday dinner.

 

In this role, her cancer must remain invisible. The laughter, music, and games swirl around her, but no one approaches the Pink Elephant in the room. As wrapping paper piles around opened gifts, the Pink Elephant sits in the middle of the debris, full of pain, struggle, fears and hopes: the story of her cancer.  She wants to be a part of the party, but not “ruin it.” She wants to know her experiences are also part of the family story and that she is loved, respected, and included.

 

Her voice still matters, even if it’s weaker, harder to hear. She wants to share her new-found realizations about living through panic-filled night terrors, only to discover a deep, pure spiritual peace she’s never felt. She also wants to share her loneliness and moments of despair. She wants to be held as she cries.  Our instincts tell us not to touch the elephant and to pretend it’s not there. They tell us to suppress the sadness we felt when we first saw the cousin’s gaunt frame at the door. We live as if avoiding her pain will keep our sadness and our own mortality at bay, but this only perpetuates the cycle of silence and invisibility for those with cancer.

 

What if we acknowledge the Pink Elephant and learn about her with our eyes, our ears, our hands and our hearts? We could even hold her in our arms, despite her size. What if we removed the filters from the family portrait to show even the darkest colors of the emotional rainbow? What if we confront the uncertainty, pain, fear, and possibility of death? We could still have the picture-perfect holiday and know that it will be authentic and whole. Moreover, we may even learn that not all gifts come in beautifully wrapped packages but are discovered through embracing the uncomfortable, as in the poem The Guest House by Rumi:

 

This being human is a guest house.

Every morning a new arrival.

A joy, a depression, a meanness,

some momentary awareness comes

as an unexpected visitor.

Welcome and entertain them all!

Even if they’re a crowd of sorrows,

who violently sweep your house

empty of its furniture,

still, treat each guest honorably.

He may be clearing you out

for some new delight.

 

In thinking about a loved one with cancer this holiday season, here are a few things you could say to breach the silence, even before they show up for the party:

 

Offer Acknowledgement: I’m so glad you will be joining us, and I wanted to reach out to see if there’s anything I can do to ensure you feel comfortable and cared for at today’s festivities. Your presence is our present.

 

Offer Emotional Support: I am reaching out to let you know that while I may not understand exactly what you’re going through, I am here for you.  If you’d like an ear, shoulder or hug, please call on me.

  

Offer Specific and Tangible Help: I’ve been thinking about you and want to know if there’s anything practical I can help you with, including grocery shopping, laundry, a homecooked meal, a ride. I could imagine all that’s on your plate and it would be my sincere pleasure to take something off it.

 

As we approach the holidays, imagine if we welcome all the guests that come our way with open arms. Imagine how freeing, honest, safe, and human it could be. This holiday, may we make room for the Pink Elephants that may come to visit. For more information, click here.

 

For information about cancer support at Montefiore Einstein Comprehensive Cancer Center, click here, call (718) 430-2380, or email cancersupport@einsteinmed.edu.

 

Alyson Moadel-Robblee, Ph.D., is founding director of BOLD Cancer Wellness Program and deputy director of community outreach & engagement at Montefiore Einstein Comprehensive Cancer Center.