Cancer and the Facebook friend

— Illustration by Kate Feiffer

Bemused readers ask novelist Nicole Galland for her take on navigating the precarious social landscape that comes with living on the Vineyard. Nicole,  who grew up in West Tisbury, is known locally as the co-founder of Shakespeare For The Masses at the Vineyard Playhouse. Her combined knowledge of both this island and the world’s greatest melodramas compels her to help prevent unnecessary tragedy wherever possible. Trying to untangle a messy Island ethics or etiquette question? Send it to

Dear Nicole,

I am Facebook friends with a woman I don’t know in person. Yet through her Facebook posts, I know she is battling cancer. The other day I was in the video store and saw her in there. Should I have introduced myself as a Facebook friend and wished her well?

Confidentially Yours,


Dear Tisbury:

This question is complex, as it involves not only cancer etiquette but also the ever-evolving field of Facebook etiquette. As neither a cancer survivor nor a “digital native” (a term for those who’ve grown up with social media), I don’t feel I’m the best person to respond to it. So I have corralled a cancer-surviving digital native into answering in my stead.

I am pleased to introduce Hannah Vanderlaske, a talented and fierce young writer I mentored for a couple of years when she was at the Charter School. A survivor of two forms of pediatric cancer, Hannah expresses an opinion that might not be universal, but should certainly be taken seriously. For the record, a number of other cancer survivors responded to our informal poll by saying (in effect) that being wished well is generally always a good feeling, preferable to being avoided. So bear that in mind. But bear this in mind as well:

From Hannah Vanderlaske:

Facebook is a weird medium, so I’m gonna start off by just talking as if you heard it through the rumor mill. If you didn’t get a memo from the person or a loved one, I would say that you shouldn’t go up to them in public unless they are having an incident. Like not being able to breathe. That’s an acceptable reason to go up to them, though I would hope that at that point you would be focusing on saving them instead of expressing an apology for the (expletive deleted) hand life has dealt them.

And like… especially if this is someone who you’re simply Facebook friends with and don’t actually know in person. They already know they have cancer. They are aware that everyone knows that they have cancer, especially living on a place like Martha’s Vineyard where you can’t really get away with just saying that shaving your head is a fashion statement or something. The thing about having cancer is that you can’t get away from it. Even when you’re “cured,” every ache and pain frightens you, if only for a minute. So just imagine how much it would suck to not only not be able to forget that you have cancer, but then have the fact that you have cancer be reinforced by someone who you don’t even know. For instance, if I was still sick, if someone I only knew through Facebook came up to me and told me they were thinking of me/they hoped I got well soon, the feeling that I would walk away with is that they’re doing this to assuage their own conscience. That they are showing that they’re grateful that this personal hurricane isn’t happening to them, that they’re trying to show any sort of higher power that they are understanding and empathetic and please don’t ever let it happen to them. And that seriously would just make me feel worse. And you don’t want to be that person who makes the cancer patient feel worse, do you?

In that vein, also don’t go up to a cancer patient you never talk to and just attempt to have a casual conversation. That’s transparent as (expletive deleted), and again will only serve to make them feel like (expletive deleted). (The staring can get a bit old too.)

So here’s the thing with Facebook – it is a very weird social media outlet where people are able to catch up on other people’s lives without actually talking to them. Or in some cases, find out about people’s lives without actually talking to them, but that’s what we would call Facebook stalking and is only acceptable when you’re looking up ex-friends/significant others or some Hottie McHotterson you met during your shift at the coffee shop. (I’m not talking about me, noooo, no way.) But that all is beside the point. In order to get to my point, I want to talk about this theory called “Dunbar’s Number.” The theory states that the human brain can only maintain 150 meaningful relationships. The number describes the amount of people you know and can keep up some means of social contact with — and the 150 people are always changing, due to fall-outs with friends or break-ups or simply growing apart from someone.

So keeping in mind Dunbar’s Number, think about what your thought process is when you’re posting something on Facebook. I can’t speak for everyone, as much as I might try, but when I’m posting a status I’m not thinking about the 407 people that make up my friends list. I’m thinking of the maybe thirty or so people I interact with regularly on Facebook. I’m not thinking about that person I met at a party once when we both were possibly incredibly intoxicated and we bonded over a shared affection for some sort of internet meme and therefore decided that we needed to be FB pals. So say, if I posted a status saying “wow, really bad day, feeling so upset and sad,” I’m not expecting someone I don’t know outside of the internet to come up to me and give me a hug and say, “What’s wrong? I saw you were really upset from your status update.” That just comes off as kind of creepy.

This is all probably too long and complicated when it could be simple, so here’s my summary and official stance on this question: While knowing that you have people rooting for you, even though you don’t know them, can be comforting, there is also a huge chance you could say something wrong, if the only way you know about things is through Facebook. And while it definitely feels awful to know that someone is purposely avoiding you because of your sickness, I doubt that this person would notice if you didn’t say anything to them in public, as you’ve never done so before. So stick to Facebook. Send them a message saying what you wanted to say in the video store, and let them know that if they need you for anything, you’re here for them. That way they can reply when it feels right for them, and they don’t feel like they’re being put on the spot. There’s also the chance that you won’t get a response, and that’s fine too. Being a cancer patient is hard work. But at least you’ll know that you’ve expressed your condolences in a tactful manner (hopefully!!!!) and have offered help should they ever need it.

So that’s Hannah take (Did I mention she is fierce?). Disagree with her? We welcome your response as well. Before you comment, though: Whether you agree with her or not, the intensity of her answer demonstrates a larger point: people in extreme circumstances (like battling cancer) can have pretty strong reactions to things others might not expect. By approaching someone in extreme circumstances — specifically to engage with them on the topic of extremity — you assume the responsibility of possibly (not necessarily, but possibly) receiving an intense reaction. Know that, and act with compassion.

That’s MY take.