Messages to remember from “It’s Okay to Be a Coward About Cancer” by Josh Friedman

In the summer of 2017, Josh Friedman—a successful screenwriter and brave cancer survivor—shared his personal thoughts about cancer and the battle against it in the Times article: It's Okay to be a Coward about Cancer. We recently stumbled upon it again and wanted to spend some time reflecting on his powerful messages.

So let's reflect together on some of the most notable excerpts from Friedman's article. His words have lessons for all of us, whether you're a patient, survivor, caregiver, or healthcare professional.
ariel view of trees as the sun sets

Friedman: "Toughness and courage are staples of our cultural business. But these are not how we survive cancer."

From our favorite movie superheroes to bold, charismatic co-workers, we often idolize those who exemplify bravery. We tell ourselves that bravery is the factor that separates heroes from everyone else; it makes them able to succeed when the rest of us fail.

Yet, for Friedman and many others diagnosed with life-threatening conditions, bravery seems far from grasp. Most patients don't feel heroic or fearless. Instead, anxiety, fear, and confusion overwhelm their thoughts.

Friedman: "Courageousness is a standard that no sick person should feel like they have to meet."

While encouraging (and expecting) bravery may appear motivational to those who haven't faced cancer, it tends to have the opposite effect on patients. Patients often wonder why they can't put a brave face on like others and live up to these cultural expectations of courageousness. They feel guilty, or like something is wrong with them. But this is never the case.

path through the woods in the fall
Our language can push patients towards unrealistic and unnecessary expectations.

Friedman: "[Cancer survivors] know the dirty secret."

Experiencing a life-threatening diagnosis teaches you many things. One of these things is that sometimes you have to accept the things you can't control and act on those you can.

Cancer is not something patients can control.

However, using battle language in relation to cancer and other chronic health conditions suggests that patients can control their outcome. This language leaves many patients feeling like a failure if they do not "win the battle"—a battle they never could control.

trees in the fall at sunset

One of the most common misconceptions associated with battle language is that "doing everything" is the only appropriate option. It suggests that if patients fight hard enough, they can always beat the cancer. But this isn't true; "winning" isn't a decision. It's an outcome beyond a patient's control. Unfortunately, treatment doesn't always work.

We need to help patients understand that "beating cancer" is not based solely on effort.

Friedman: "It's Okay to Be a Coward… If we survived through courage, I probably wouldn't have."

For many, the battle is not against cancer. It's for understanding of their disease, accepting their prognosis, and deciding if treatment will give them a life of quality (and not just quantity).

The fight against cancer is not on the shoulders of an individual patient. The true fight is in the hands of researchers striving to obtain a cure.

Thank you, Josh Friedman, for your willingness to share such personal feelings about cancer and the "fight" against it. It takes courage to publish personal thoughts, feelings, and experiences into an often-skeptical world—especially challenging our culture's norms.

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