How Well Is Well When Talking About How We Feel?

"I'm doing fine."

That is the response I usually give when asked how I am doing. People ask me how I feel and I usually tell them that "I feel well." Between an uncontrolled cough and my bloodshot eyes, I must look fairly worked over some mornings. But it may not represent how I feel, at least comparatively speaking. And some days I certainly look fine even when I feel like crap. But expressing these nuances or even trying to assess the relative feeling of wellness I experience is always somewhat complicated. Communication and understanding between patient and caregiver can be challenging.

Adjusting to the physical demands

As a cancer patient, some level of improvisation is necessary most days, if only in adjusting to the ever-changing physical demands brought on by treatment. And since "feeling" is subjective, as we adjust to changes in our bodies, we consistently reconfigure how we assess our own well-being.

For most of us, I imagine, we try to recall a baseline of personal wellness from the "normal" we had pre-diagnosis. Doctors are constantly offering that ubiquitous chart of faces, ranging from the green, smiley one to the red, frowny one, or asking us to judge our wellness or the severity of our symptoms on a scale of one to ten. But can we even go back to that baseline we tried to establish, or can we really ever only compare how we are feeling today with how we felt yesterday or just a few hours before?

Different answer for different people

My partner recently pointed out to me that when I described how I was feeling to friends it was different than the way I described it to her. I replied that she lives with me, so I hardly needed to go into the same detail, but she had a valid point. And perhaps the main reason for this is that at home, I update my well-being on a daily basis, as opposed to discussions with friends that may encompass details from weeks or months all at once.

When we have our usual morning "check-in" at home, I am always comparing how I feel relative to the past twelve to twenty-four hours. Sometimes, for perspective, I'll qualify my statement by being relative to "last week" or "last month" or even "this time last year," but that will usually just be with regard to a particular malady, like a cough, rash, or stomach upset. And quite frequently, one side-effect will so over-shadow another that when it abates the impression is mixed between feeling fabulously better on one hand and suddenly being reminded of how crummy feeling it still is on the other.

Changing baseline for "fine"

So, on that scale of one to ten, how are you feeling? Even if today's "five" would be the same as yesterday's "five," the rating would still be wildly imprecise because odds are that my "five" is never going to be quite the same as yours. But we still want to gauge how we are feeling, and how our loved ones are doing. It just may be important to recognize that in reality, our baselines are always changing. I'm doing (relatively) well. I'm feeling (relatively) fine. It is all about context and perspective. And if we can keep that in mind, the better our communication will be.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.