Stories

When ‘get well soon’ doesn’t cut it

Even when a friend might not recover, you send a ‘get well soon’ card. But there is a kinder, more honest way. Kristin Hohenadel talks to a cancer survivor who now designs the sympathy cards she wishes she’d received during her illness.

Words by Kristin Hohenadel and photography by Steven Pocock

  • Article
Photograph of a white mantlepiece against a white wall. On the mantlepiece is a cactus plant in a silver plant pot, next to which there are three greetings cards. One card reads, 'I know #fuckcancer doesn't help you get through it, I'm here anytime you need help'. The next reads, 'I know there's no normal to go back to but I'm here to help you build a new one (and I'll bring snacks)'. The last reads, 'One more Chemo down! Lets celebrate with whatever doesn't taste disgusting'.
Emily McDowell's empathy cards, Steven Pocock. CC BY.

After receiving a stage 3 Hodgkin’s lymphoma diagnosis at the age of 24, Emily McDowell endured nine months of chemo and radiation before going into remission. The chemo made her sick. She lost her hair. Starbucks baristas called her ‘sir’. But it was her sense of loneliness and isolation that hurt the most, as friends and family inadvertently said the wrong things, or disappeared altogether, seemingly out of fear of not knowing what to say at all.

“I was getting these terrible sympathy cards while I was sick,” McDowell, now 43, said in a phone interview from Los Angeles. The cards she received were replete with platitudes and bad jokes about baldness and boob jobs, or festooned with flowers and sentiments that read like eulogies for the not yet dead. ‘Get well soon’ cards seemed like thoughtless dares to someone who might not recover.

“I was thinking, ‘Why do we talk this way?’” McDowell said. “‘Why are we afraid to be honest around illness? Why is this such a frightening topic and why have cards not caught up with it?’”

Someone should really make better cards, she recalls thinking at the time. The seed of an idea had been planted, but as a recent college graduate with a pre-existing condition in the US, a country that does not provide universal healthcare, she was preoccupied with finding a stable job that offered insurance, and she ended up working as an advertising copywriter and art director for the better part of a decade. 

Then in 2011, McDowell’s college roommate Amy was diagnosed with cancer and died three months later, at the age of 34. “Nobody knew what to say,” McDowell recalled. “Nobody knew what to do. Culturally, we are so ill-equipped to have these conversations. To even show up in the most basic of ways when there is so much fear around illness. And so I saw it again from the perspective of not being the sick person, but being the friend.”

Photograph of a white mantelpiece against a white wall. On the mantlepiece is a greetings card which reads, 'The regents of the school of hard knocks hereby confer upon you having demonstrated extraordinary resilience in the face of adversity, this master's degree in crap nobody should ever have to deal with. Signed. Date.'.
An Emily McDowell's empathy card, Steven Pocock.

How inspiration came from tragedy

Amy’s death was a clarifying moment for McDowell, who left her job and started writing and designing the kinds of sympathy cards that she wished she had received when she was ill.

“I realised that having the experience of a friend being sick, combined with what I had been through, gave me a perspective that allowed me to talk about illness in a different way that could help other people,” McDowell said.

“When I was doing my treatment, if you had said to me that I would do anything with cancer for my career, even in a peripheral way, I would have said, ‘No way. I’m leaving this behind, it’s not part of my identity, I’m done with this.’ I didn’t have any perspective yet. That comes with time and distance.”

In 2015, she released a series of refreshingly direct, often irreverent Empathy Cards with relatable, human-centered designs and a mission to help us talk about illness.

Some cards are spirited rebukes to clichés such as “laughter is the best medicine”, the notion that someone’s illness is “God’s plan”, or that “what doesn’t kill you makes you stronger”. Others offer moral support for those who have endured hearing about one too many internet cures, had their battle with serious illness described as a “journey” or been lobbied on the supposedly miraculous healing powers of kale. McDowell’s late friend Amy’s husband challenged her to write a card for someone who knows they are dying. Her top-selling card is one with black lettering on a white background that simply reads: “There is no good card for this”.

Touching thousands of lives

Since launching the ongoing series, McDowell has been contacted by thousands of people.

“Half of the people who write to us have been ill or lost someone and are saying, ‘Thank you for making something that makes me feel seen and heard, like someone gets it, like I’m not crazy, like the things that I’m experiencing are real things.’” McDowell said. “The other half are like, ‘Thank you for helping me connect with the person who was going through the thing; the cards helped me figure out what to say or made us laugh.’”

Many people have written asking her to make cards for their own specific illness. “A lot of people were like, ‘I have Crohn’s disease and I need you to make a card about Crohn’s disease,’” McDowell said. “I could have become the card brand for every illness, but that wasn’t what I wanted to do. It was hard to balance and say no, and say, ‘I’m sorry, this is important and I recognise that it’s important, but we aren’t the people to make this.’”

Instead, McDowell has sought to make cards that are specific enough to be emotionally powerful but broad enough to apply to the largest number of situations. So rather than making a card for Crohn’s disease, McDowell made a more universal chronic illness card that acknowledges the pain of invisible illness.

McDowell said she has also heard from scores of doctors, nurses, psychologists and other medical professionals who have bought the cards to give to their patients.

“I have friends who have been to med school and are teaching residents now,” McDowell said, “and they get one class in bedside manner. You would think doctors would know how to talk about this stuff, but they don’t unless they’ve learned it on their own.”

McDowell said she is surprised that the Empathy Cards have caught on not only in English-speaking countries such as the US, Ireland, South Africa and the UK (where they now have local distribution) but also in non-native-English-speaking locales, including Israel and the Netherlands.

“When the cards came out, I wasn’t thinking of them as a cross-cultural thing,” McDowell said. “I was really surprised by how pervasive this problem is – that we just don’t know how to talk about illness.”

About the contributors

Photograph of Kristin Hohenadel

Kristin Hohenadel

Author

Kristin Hohenadel is an American writer and editor based in Paris. Her work has appeared widely in publications including the New York Times, Slate and Fast Company.

Photograph of Steven Pocock

Steven Pocock

Photographer

Steven is a photographer at Wellcome. In the studio he captures the fragility of 150 year old manuscripts. At home he is captivated by the fragility of a 150 year old house.