For many, the question "How are you?" is a simple social nicety. But for individuals facing serious illness, it can become a deeply complex and painful conversational minefield. This is the reality explored by Mark Cottle, a man living with metastatic prostate cancer, who has shared his personal struggle with this everyday ritual.
The Dilemma of the Daily Greeting
Mark Cottle, from Maesygwartha in Monmouthshire, explains how his diagnosis transformed a routine exchange. In Britain, the expected reply to "How are you?" is often a breezy "Oh, not bad…" or similar. However, when facing a life-altering condition like metastatic prostate cancer, where the prognosis is serious, that polite fiction becomes a source of internal conflict.
Cottle finds himself torn between what he calls "the dishonesty of the ritual reply and the full truth." Delivering the unvarnished reality of his situation feels inappropriate as a response to a casual, well-meaning greeting, yet the standard upbeat answer feels fundamentally untrue.
Developing a 'New Normal' Response
To navigate this daily challenge, Cottle has developed a more nuanced way of communicating. He has crafted a response that offers a measure of honesty while being socially manageable. His go-to phrase is now "All right today." He uses this specifically on days when he is managing reasonably well within the overarching context of his illness.
This careful phrasing acknowledges the present moment without making false promises about the future. Cottle consciously tries to gauge his responses relative to his "new normal," the altered baseline of his life with cancer. On genuinely difficult days, he admits it remains a struggle to find the right words.
The Importance of 'Today'
A crucial element of Cottle's approach is the deliberate inclusion of the word "today." Even on occasions when he experiences joyous events or upbeat feelings, allowing him to offer a more buoyant "Pretty good today," he always appends that temporal qualifier.
This is, he states, "a matter of honesty about the future." It is a small but significant linguistic tool that allows him to be truthful about the present moment while implicitly acknowledging the uncertainty and challenges that lie ahead with metastatic disease. His experience echoes that of Carolin Würfel, whose article on a similar theme prompted his letter to the Guardian.
Cottle's insight sheds light on the broader psychological and social challenges faced by those with chronic or terminal illnesses. It highlights how everyday language can become fraught with meaning and how individuals must often develop sophisticated personal strategies to maintain both their integrity and their social connections. His story is a powerful reminder of the complex human reality behind a simple question.
