Illness Etiquette

Answers to your health-related etiquette questions, by manners expert Charles Purdy.

Q: My wife was diagnosed with COPD about a year ago. She’d been a closet smoker for 20 years, but she had always exercised regularly and stayed in great shape. Since her diagnosis, everything’s changed. She’s very depressed, and she rarely does active things. Meanwhile, she’s so embarrassed by this that she refuses to tell people she has COPD. So now I find myself making excuses to our friends and family about why we can’t do certain things, and it’s starting to seem odd. Would it be awful for me to tell people about her condition and tell them to keep it quiet? -- Charlie, Devon, PA 

A: Every spousal relationship—and every spouse—is different, so please understand that I’m generalizing now. But as with many questions of how to treat people who are ill or who have recently been diagnosed with a life-changing health condition, you might first ask yourself, “How would I like to be treated?” Then, to illuminate your particular situation further, you might ask yourself, “How will my wife react when she finds out what I’ve done?” (And note that I’ve said “when”— not “if.”) 

I hope the answer to your question becomes clearer after you’ve answered my two questions. In case it hasn’t, I’ll add this bit of marital wisdom: Keeping elaborate secrets from one’s partner—secrets involving multiple family members and directly concerning a partner’s seeming ability to determine his/her own destiny—is not just a bad idea. It’s an idea so bad that it’s a movie-of-the-week cliché. 

At the same time, it’s a well-meant idea, and your concern for your wife sounds well placed. I think you should encourage her to talk with both you and her medical advisors about the sorts of activity she can safely engage in, about alleviating some of her depression, and about how to discuss her COPD with loved ones. 

Q: I work with a great guy who was diagnosed with COPD about 6 months ago. He’s married and has two children, and he’s wonderful to work with. Ever since he found out he has COPD, he seems depressed, and he swears to me that he quit smoking. But when he comes back from his lunch breaks, I can smell smoke on him. I really want him to quit for his health, but is there a polite way I can tell him “Hey, it’s obvious you’re still smoking, and I really think you need to quit?” -- George, Chicago 

A: Unless you are, in addition to this man’s coworker, his spouse, brother, father, or very close friend, this just isn’t any of your business. If he is smoking, he already knows he should quit, so what is to be gained by your confronting him? Channel your concern into less-intrusive help. For instance, why don’t you offer to go to lunch with him?   

Q: I’ve been living with COPD for 14 months now. Since I found out, I haven’t smoked, and I stay as active as I can because I am determined to live in the healthiest way possible. I’ve been in a relationship with a great woman for six months, and we are getting serious. She never knew I was a smoker, but last week, I told her the whole story. Her reaction really rubbed me the wrong way. She basically said that I deserved to get this, that it was my fault because I smoked, and that she needed time to “take it in.” I realize there’s not a lot of sympathy for this condition, and that she’s now concerned how healthy I’ll be as I age (I’m 51). But a part of me wants to tell her that I was really hurt by what she said. Should I explain why that hurt me, or should I just suck it up? -- James, New Brunswick, NJ 

A: If you want to establish a serious romantic relationship with someone, you’ll have to—at some point—find a way to talk about things that have hurt your feelings. Sure, some minor things need to be shrugged off, and there’s a lot of gray between that category of things and the first— but I don’t see a lot of gray in this woman’s behavior. 

Not that I need to tell you, but the correct response to learning that a person has an illness or a disease is never “It’s your own fault” or “You had it coming” or any variation on those sentiments. This woman doesn’t have to continue a romantic relationship with you if she doesn’t want to—but she has no reason to be hurtful.

As for you—I might think twice about dating someone who doles out judgment when compassion is the appropriate response. 

Q: I breathe with the aid of supplied oxygen, and I need to have my tank with me at all times. When it’s functioning, the tank makes a sound: a clearly audible metallic ticking. As someone who has done her fair share of “shushing” when people made noise in movie theaters and the like, I have given up on going to the movies and so on, thinking the sound of my tank would be obtrusive. But my friend says I’m being silly. I wonder what your thoughts on this are. -- Madeleine, Tucson, AZ 

A: I like it when I can settle a disagreement between friends by saying, “You’re both right.”

A music critic for The New York Times recently addressed this issue, after being seated near a ticking oxygen tank during a symphonic performance. A spirited public discussion ensued—and both sides raised valid points: On one hand, we, as a polite and respectful society, must make accommodations (and have compassion) for people with disabilities of all kinds. On the other hand, we (people with disabilities included) have a responsibility to not infringe too terribly or too unreasonably on the comfort and happiness of people around us.

Clearly, using a ticking oxygen tank doesn’t make one less a member of society, in terms of both your rights and your responsibilities. Nor, to further the example, does having a bad cough, being in charge of a fussy baby, or expecting an urgent call from the office. But perhaps some of these things might prevent us from attending a live orchestra performance, where utter silence is a well-understood responsibility of audience members. (Many people fail in this responsibility, yes—but we don’t base our own behavior on the bad behavior of others!)  

But back to your question, I see movies as being in a rather different category—well, many of them, anyway. I don’t imagine that the sound of an oxygen tank is more than the audience for a loud summer blockbuster or a sparsely attended matinee (where you can find a seat positioned away from other moviegoers) should reasonably be able to bear.

I applaud your sensitivity but don’t want you to deny yourself pleasures unnecessarily. Use your judgment and common sense—and I suggest that you take advantage of cinematic options available to you. If you have doubts, call the theater beforehand and ask about their accommodations for people with disabilities.

Charles Purdy writes frequently about issues related to manners (among other things). He is the author of the book “Urban Etiquette.”