When Not to Say “How Are You?”

| 02-19-AD2013 | [21]

Tammy Ruiz - How Are You

In my job caring for women and families during pregnancy loss and infant death, about 90% of what I do is communication. I enter a room to meet strangers experiencing (most often) the worst day of their lives. People in full blown crisis often hear only a smalI percentage of what is said to them and remember little of it. I must explain their care options (in the bereavement realm, not the obstetric), the normal process of what to expect, learn what their overriding concerns are and many other deep and complex issues all without offending or overwhelming them.

It is actually quite difficult, but after interacting with about 500 families and really applying myself to learning how to communicate well, my families tell me they feel nurtured, respected and cared-for.

One unexpected side effect, however, is that I have also gained a profound disdain for poor communication. Having observed and been subjected to bad communication habits, I have come to believe that our witness and even our capacity for momentary evangelization can be destroyed by falling into mindless, careless, or trite blathering. Those amongst us who may be hurting and in most need of our kindness can be alienated and injured by us if we don’t engage our minds in how we speak to them.

Of the many examples of bad communication I could use, the one I want to deal with in depth, is how phrases that might be passable for a person in normal circumstances become (sometimes grossly) inappropriate when used with the newly or deeply bereaved/hurting. My first example is “How are you?” when used as a greeting.

If I could singlehandedly change a societal norm, this would be it.

When used as a greeting, “How are you?” demands – by societal convention – a “Fine,” or “Fine, and you?” People in very bad circumstances are forced to cough up these words even if their insides are screaming in despair and near brokenness…and nothing can suck your spirit like being forced to say that you are “fine” when you are not. Trying to go against the cultural grain and remain silent or actually answer that question honestly with a, “Suicidal teen in mental hospital, thanks.” or, “Baby on a vent and not expected to survive, and you?” are seen as inappropriately hostile.

Five months ago, with no warning at all, my young and healthy husband died suddenly in our home. He was my beloved of 29 years and I found him cold and lifeless on the floor. (Imagine screams of anguish that rose up the stairs and fell on the ears of my children.) I was a teenager when I met him and in our late 40′s; we had joyfully entered grandparenthood together; we had many plans for our united future. To say that I wasn’t “fine” for quite a while is an understatement.

After the normal rituals of death and burial, I made fledgling attempts to reenter my normal world. A trip to the mall seemed a great idea for my daughter and me, but after 15 consecutive “HOW ARE YOU!?”s from sales people who were obviously told to “greet” each customer…my 15th “fine” was followed by a full meltdown.

I understand the need to greet, but “Hello, welcome to blah blah store, please let us know if we can be of assistance,” would be clear, effective and non-harming. What other phrases could you use? I personally like, “Hello,” and “Welcome,” but you could also use, “Greetings,” or “Good morning/afternoon,” etc. For those you know who are in deep despair, I suggest, “It’s so nice to see you, I think of you ALL the time,” so they perhaps won’t feel alone and forgotten.

So how can our mindless words actually impair our Christian service to others?

I was still reeling from my mall experience when I went to Mass the next day. On my way out, I saw a leader who full well knew my husband had been dead for a short 3 weeks and his greeting was, “HOW ARE YOU!?” with a huge smile on his face as if it had never occurred to him that such a question is loaded (and to this minute I don’t understand the huge smile, I was the only person he was interacting with at the time). His words were empty and (even if not deliberately mean) mindlessly unconsidered. I was in need of pastoral care but his greeting repelled me and I bolted past him. How much better another leader did with a soft voice, extended hand and sincere words of concern for us that did not demand a pain-inducing, trite and untrue answer.

For the rest of today, please listen for this phrase and imagine how many people faced with it might be hurting from some serious cause.

Is this greeting always wrong? No, but I suggest you use it only when you have the time, privacy and inclination to let the person you are greeting know that you care to hear a real answer then let them tell their story; it may be very healing for them and you will likely have a chance to bring a glimmer of Grace into their painful world.

Getting back to the specific population I care for – one of the 900,000 who suffer early pregnancy loss or 50,000 who suffer late pregnancy / early newborn loss in the US each year, they often find that topics that might seem casual to others become for them HUGE sources of pain and angst.

Questions like, “Is this your first?” or “How many children do you have?” seem harmless until the person trying to answer it agonizes over whether to tell you about the one(s) who died. I urge sincere caution when engaging in this sort of chat; please be very aware that the person you are speaking with may have a tragic death they are still dealing with.

The ladies I care for who carry babies with life limiting conditions to term tell me of folks out in public who pry and pry for information yet are not really ready to hear, “This baby isn’t expected to live.” After 8 years doing my job, I don’t ask strangers about their childbearing – general kindness and a sweet smile communicates everything I need to express to them. If you really need to speak, consider, “Blessings to you and your sweet baby.”

I hope in my contributions to Catholic Stand I am able to bring a unique point of view to share with you. I consider the opportunity to serve my dear people as a precious and sacred thing and I live my vocation everyday. I wasn’t sure what my first column would be about until this morning; I wrote & mailed a Valentine card for my mother-in-law to take to my husband’s grave (near his parents, far from me). While still reeling in emotion, I went to a clothing store where I was met with the loudest, strongest “How are you?!” of my life. I made it all the way into the fitting room before I dissolved into tears, terribly disinterested in the dress pants awaiting my approval. May my pain teach a precious lesson that will spare another.

© Tammy Ruiz. All Rights Reserved.

About the Author:

Tammy Ruiz has been a Nurse for 28 years and spent most of her career in Neonatal Intensive Care. For 9 years, she has been a Perinatal Bereavement Coordinator - caring for women and families suffering miscarriage, stillbirth, neonatal death and SIDS. Part of her work involves assisting parents in preparing for births when the baby has received the diagnosis of a life limiting condition (often called "Perinatal Hospice"). In addition to her Nursing education, she studied (but did not become certified in) Clinical Pastoral Education at a Catholic Hospital in the midwest. She has been on EWTN and speaks regularly to Physicians & Nurses on the topic of perinatal loss care. Her work has been translated into Polish, Spanish, Czech, French, Italian & Japanese. Her career was both fragmented and enhanced by having 14 different jobs because of moves for her husband who was an active duty Officer in the USMC. A convert to the Catholic Church, she was widowed after 26 years of marriage. She has 3 quasi-adult children and one super-cute grandchild.
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  • Jonathan

    Ms. Ruiz,

    Well thought through and considered – an excellent reflection. As an adjunct to this line of thinking, may I recommend David Bentley Hart’s “Doors of the Sea”? Not only an excellent work on theodicy, I have found pastoral implications throughout, and think it should be on the reading list for any caregiver, of any sort.

    Sincerely,

    Jonathan Watson

    • http://Perinatalbereavement.com Tammy

      Im intrigued to find this work of Mr Hart you speak of…it sounds really interesting ! thanks

    • Jonathan

      Ms. Ruiz:

      The book is based on the essay found here: http://www.firstthings.com/onthesquare/2010/01/tsunami-and-theodicy. If you like the essay (or at least want to read more), get the book. If you find the essay uninteresting or off-putting, then you’ve saved money for the book .

      Sincerely,

      Jonathan

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  • http://SpiritDaily Rita Biesemans

    Dear Tammy,
    Rita Biesemans says:
    February 19, 2013 at 4:34 pm
    I work as a Labor and Delivery nurse in a Hospital where most of the patients are on drugs, or abused, or lonely. I’m a nurse midwife for almost 43 years now.
    I try to bring God’s Love to them and I tell you the persecution around me is terrible, the devil is furious at me for that, especially when family members or the patients thank me for the warmth and love and hope I gave them. I always tell them how proud I am that they kept the baby and praise them for the goodness they show to their baby.
    So please pray for me too that the devil will NOT be victorious and that I might continue doing what I’m doing. Nursing is viewed as a career nowadays, and 3/4 of the time is spent on computer charting. Little time is left to be at the bedside. This is very frustrating !!!!!! Love and Peace to you and all the ones you encounter !!!

  • http://Perinatalbereavement.com Tammy

    Dear Rita,

    I have been a nurse for 28 years and I know that we have the opportunities to bless our patients every day and I know our presence, kindness and prayers is sometimes the only thing that helps some of them keep going. May God bless you richly for your work with these ladies and give you strength to deal with the attacks that we endure when we give love to those in need. Imagine the people we may get to see in heaven…hundreds and hundreds of women and babies we helped !! Blessings, Tammy

  • http://Spiritdaily.com Milagros Sanchez

    Ms. Ruiz

    I found your article to be so helpful. I do volunteer work with Special Needs children and I give communion to Aids patients. The children are so will care for, I have no problems when dealing with them. They are very happy children. The Aids patients are more sensitive. Many of them are bed bound and so I need to learn to approach them with cautious. I don’t want to hurt them with my words or actions. I mean, they are going through so much, already. I will be more conscious and find other ways to communicate with them. Thank you so much.

    • http://Perinatalbereavement.com Tammy

      “It is so nice to meet you” or “It is so nice to see you again”…neither require a response, so you can simply say it without expecting something back from them (although its a friendly enough opening you may get a response).

      One of the phrases I use when I know someone is bereaved is “Tell me about your _____” (mother, brother grandma).

      Another phrase I keep at-the-ready if a person tells me their child died is “Tell me your child’s name…” most bereaved parents LOVE to say their child’s name but often feel it is unwelcome. That phrase alone can open the floodgates to interaction that is kind and helpful.

  • http://hallelujahismysong.blogspot.com/ Catherine

    Tammy, thank you so much for cutting to the truth and for sharing what so many people have felt in times of grief. I was twelve weeks along when we lost our baby in November. Months later, we are expecting again, and I’m learning that the words “How are you?” can elicit a gamut of emotions depending on how they are used. If they are merely a greeting and I’m having a tough day emotionally, they cut to my core. If it’s a dear friend wanting to know the real answer, the words finally allow me to open up and share my innermost feelings.

    Studying abroad in Spain during my junior year of undergrad taught me how strange it is that Americans use “How are you?” as a greeting. I studied at the local university and one of my native friends asked me why Americans even ask “How are you?” if they don’t really want the answer and keep walking right on past each other. That moment made me try to erase the question as a greeting and only reserve it for the times when I’m in a conversation where the person will want to share the answer.

    I am so very sorry to hear about the death of your husband. You, your family, and your husband are in my prayers. Thank you for sharing your gift of writing with all of us. God bless you!

    • http://Perinatalbereavement.com Tammy

      Catherine,

      Im so sorry for the loss you had last fall…our hearts were broken at the same time. I hope all the best for the pregnancy you are blessed with now but I never think that one replaces another. Having had a broken heart and knowing what trite words do to it can change us forever…I try to let pain change me for the better. Thank you for your prayers. Tammy

  • http://thecloisteredheart.org Nancy

    I’ve experienced the automatic “how are you” from a number of viewpoints, and if there is one phrase I wish could be untaught as an automatic greeting in society, it would be this one. I’ve heard it asked (with no malicious intent, certainly) of the newly bereaved at funerals, of people lying on their deathbeds struggling to talk, and (thankfully most commonly) of “fine” people when everyone knows the asker has no actual interest in an answer. Having been brought up to ask it, I did so until some years ago – when I read an article providing a perspective like your own. An eye opener! I stopped using the phrase altogether, except in those cases when I and the askee were in a position to know I truly meant it, and that I would take time to listen to the real answer. There are kind alternatives, and I thank you for suggesting them. May our eyes be opened!

    • http://Perinatalbereavement.com Tammy

      Nancy,
      Thank you for corroborating my thoughts on this..sometimes when I expound on it I get blank stares from people. Like you I still use it in specific circumstances when I really want to hear an answer and have a good time and place for it.

  • http://www.theguidingstarproject.com Leah

    Thank you for this poignant reminder to speak thoughtfully when interacting with others. The work you are doing with bereaved families is beautiful and I thank you for sharing the resulting wisdom from this work and your personal experience with the rest of us who have not experienced a deep loss in our lives (yet). Blessings on you, leah

    • http://Perinatalbereavement.com Tammy

      You are that “Guiding Star” gal, arent you? I’ve read about your projects. Thank you for your kind words.

    • http://catholicstand.com Stacy Trasancos

      Haha! Yes she sure is that “Guiding Star” gal! :-)

  • Mr. Jim Kramer

    A definition of “Christ” that I like is a list of words that begin with each letter of “Christ” (I forget what that is called), but the words are Caring, Honest, Respectful, Intelligent, Simple, Trustworthy. I find these qualities in your article. I can see Jesus Christ in you and your writings. The one invisible, living Jesus using the one you. I have found these qualities in the late Fred Rogers. I have also found them in late Dr. Forrest C. Shaklee, and many people in the Shaklee company. I found your article convicting. I have a daughter in what I believe to be “deep grief” because she has completed a Master’s Degree in Music Theory, but no job, or teaching positions, now that she has completed her Master’s degree. I was blessed by your writing.

    • http://Perinatalbereavement.com Tammy

      Thank you for your kind words although I think “simple” us the most accurate of the words you mentioned : ) Interesting you mention Fred Rogers. I asked on e friend to read this prior to submitting it and she is a biographer and friend of Fred Rogers, she wrote “The Simple Faith of Mr Rogers”. You are wise as a father to see that loss comes in many forms and your daughter is feeling a loss from her dream remaining empty. What a blessing she has you.

  • http://www.sherryantonettiwrites.blogspot.com Sherry

    Beautiful thoughts about how mindful we must be about the invisible crosses all around us. Saint Paul talks about “Briddling the tongue.” so it does not do damage. Thank you for the reminder and the good counsel.

    I’ll look forward to your next piece and you and your family are in my prayers.

  • Dr. Siegfried Paul Posch

    I was sent information on POLYCARP (POLÝKARPOS) and it was copied and discussed shortly here in Austria. The discussion would seem to make necessary a decision on the “APOSTOLIC SUCCESSION” – s. this article of the “Wikipedia”, in which I read the note “last modified on 22 March 2013 at 05:45″ less than one hour ago, I contributed to “Wikipedia”. Could you give me a list of persons that claim to be bishops in the States of the USA and in political units of the USA that are independent of the States and tell me how to contact them: of those bishops of the USA who are legitimized, in your opinion, by an “APOSTOLIC SUCCESSION”? That should be an easy task. You could first put three names of your list on “GÄSTEBUCH MARKTGEMEINDE PÖLLAU” (“GOOGLE.AT”), that seemed to be possible, still, less than one hour ago. – I was not able to put these lines on http://newtheologicalmovement.blogspot.co.at/2011/10/st-simon-canaanite-not-from-canaan-and.html .