Facing death was difficult," remembers Leslie, "but if I hadn't had my friends beside me, it would have really been impossible."

Leslie is just one of many young people who will become seriously ill this year. Even though accidents are still the leading cause of death among young people, disease will claim a large number of lives as well. For example, cancer alone takes 1,500 young lives each year and is still the leading cause of death from disease for 1- to 15-year-olds.

If you know someone who has been diagnosed with a life-threatening disease, you may be feeling uncomfortable around that person and be uncertain how to offer help through this difficult time. Learning what it's like for someone who has a serious illness can help you to be a positive supportive presence in your friend's life. Sharing the good times is easy, but the true test of friendship comes during the hard times.

Denial and Fear

It is not uncommon for a person who is very afraid of something to deal with it by not dealing with itin other words, simply to deny reality.

Leslie knows firsthand what it's like to be diagnosed with alife-threatening illness. "I was 15 when I first noticed that I was having the same symptoms as my father had before he died .... I was terrified." Leslie decided that she was too afraid to go to the doctor, so she dealt with her fear another way. "I told myself it wasn't happening," says Leslie. "I pretended I was O.K."

This decision to avoid or delay treatment can be a deadly one. The longer treatment is delayed, the more time the disease has to progress. Unfortunately, the fear of the unknown can often easily overcome logic.

Fear is also common in those who are facing possible death. Fear of the illness's symptoms, loss of independence, the reactions family and friends will have, and fear of death are normal under these circumstances.

Bob, who lives in Saginaw, Michigan, was 11 years old when he was first diagnosed. Over the course of several years he was eventually diagnosed with four different types of brain cancer.

"I was very scared that I would die," says Bob. "I was also scared for my mom because I am her only child and she would have a hard time living without me." Bob adds, "It was most difficult facing the loss of my freedom, losing my girlfriend, losing friends and accepting death."

Anger and Guilt

Once its clear what's happening, of course, few people find themselves happy about it. "I remember feeling so very alone," recalls Leslie. "No one could understand or help me. I wondered why there couldn't just be a miracle, you know, like the kind you see in movies, and I prayed and prayed for that-it was so frustrating. I kept asking myself, `Why me?"'

Anger is a normal and healthy reaction to this type of traumatic experience. By cursing the world and sometimes even God, Leslie was able to release some of her fear, pain and anguish. She remembers, "I spent quite a while just being mad. I suppose it was another way to avoid dealing with the illness ...I screamed, cried and pounded with my fists ... and I usually felt more relaxed after I was done. It helped."

Along with anger, people sometimes experience some level of guilt. "I felt like I must have done something terrible to deserve this," says Leslie. "I felt as though I was paying for every bad thing I'd ever done, and that seemed so unfair. After all, I know lots of people who had done worse things than me, and they weren't dying!"

Driving a Bargain With God

After the initial fear and anger, a call for miracles may occur. This is one way of taking control of the situation.

Once Leslie could no longer deny the fact that she might die as her father had, she began desperately to seek a miracle. "I made a deal with God. I said if God would just let me live, I would dedicate my life to good."

This kind of negotiation is not uncommon in people facing a potentially hopeless situation. "I prayed and prayed," continues Leslie. "I felt that it was my only hope. I really believed that if I could make a good enough deal with God, then I could make up for all the bad things I had done in my life, and maybe God would give me a second chance."

Where Are Parents?

We often view our parents as our protectors, the people who will keep us safe and healthy. In the face of serious disease, even parents are helpless to stop the illness.

Rosemary Kroll, a professional counselor, suggests that parents can expect to experience guilt, frustration and anger. "Guilt for not being able to provide safety for their son or daughter, frustration at not having all the answers, and anger with doctors for not giving consistent prognoses and not being able to heal their son or daughter are common," says Ms. Kroll. She adds that anger may be directed at any number of people or things, including themselves and God.

Ms. Kroll empathizes with parents: "Parents may feel deep, excruciating sadness that can express itself in physical pain and depression. They may find it hard to sleep, eat or think about anything else. Parents may feel very much alone in their pain and may find themselves arguing with each other." In addition, Ms. Kroll says there are many more feel ings parents may exp that are "normal reactions to an abnormal situation."

Leslie remembers, "I think that a big part of the reason for my initial denial of my illness was because I wanted to protect my parents. I knew they'd suffer as much, or even more than I would, and I just couldn't stand to see them suffer."

As Leslie's experience shows, the feelings of parents are very important to a teen who is ill. There is often a strong need to protect parents from emotional pain. Being a good friend, therefore, includes helping the ill individual come to terms with the effect his or her illness is having on others, especially on parents.

Be a Friend

If you have a friend who is ill, you may experience a number of feelings. If you feel that you should be able to help your friend, then a sense of helplessness may make you angry.

Sister Anne Ragan, a medical social worker in Saginaw, Michigan, has worked with many dying individuals and their families. She suggests that anger in both the patient and his or her family and friends is a common reaction.

"If you want to get mad at God that's O.K.," says Sister Anne. "Just let yourself experience whatever you are feeling and try to focus on what you treasure about your friendship in the here and now." She adds, , "Talk about how wonderful life is with that person. Just get it all out-allow yourself reverence and respect for your feelings and don't judge yourself."

As a friend of someone who is seriously ill, it's most important that you not allow fear or insecurity to keep you from being supportive. Bob encourages friends just to "be there for the person, don't treat the person as if he or she's not there ... talk to the person about his or her condition. When the person needs someone to talk to, listen."

Bob remembers, "Most of my friends were worried that they would catch the illness that I had so I don't see them anymore. I felt as if I was all alone and deserted. I felt that I had no friends left in the world. I really did not want to live."

Especially in times of difficulty, we need our friends. Being abandoned by them at such a time can only make the situation more painful.

Ms. Kroll suggests, "The gift of your time to your terminally ill friend is probably your very best gift. Many people stop coming around when they hear a friend is dying. They may not know what to say and are afraid they will make their friend sad. When this happens, the terminally ill teen may feel abandoned."

Bob adds, "Your friend will let you know if she or he wants to hear about the parties or games, etc., you are going to, or if she or he just wants to sit and play computer games with you." If being with your friend is making you sad, talk to someone who understands and can support you, like a parent, teacher or school counselor.

Sister Anne encourages friends and family, "Listen with great respect and remember that whatever they [ill friends] are feeling is real for them. Encourage them to keep talking. Love them, hug them and if you don't have an answer, don't worry. Sometimes I find that even I don't know what to say, so before I go in to see a patient I say, `Lord, you have to take charge of my tongue.' Sometimes I'm surprised by what comes out...."

Talking about God and praying can be comforting things to do, but sometimes a patient would rather avoid any religious discussion. Sister Anne remembers, "One patient told me, `Don't talk to me about God; I hate God. God let this happen to me."' In such cases it's important to remember, Sister Anne says, "God knows deep down that what you really hate is what is happening to you-God understands."

Sister Anne adds, "Don't pray unless they [ill persons] have given permission. Everyone has to find God in his or her own way. God loves us all and understands what's in our hearts. If you find it difficult to understand why your friend is acting the way he is, just remember that sometimes God writes straight with crooked lines." Sister Anne continues, "Sometimes I'll tell a patient, `You're too tired to pray. Just ... let God hug you and [you simply] know that God's there." As in Leslie's case, some people feel guilt about their negative feelings toward God as a result of their illness, or they may feel they are being punished for some past sins, but Sister Anne says, "God just wants you to be you-God doesn't want you to feel any pain-no penance is due for your past."

Acceptance

Eventually, after working through all the denial, fear, anger and dealmaking, a person usually comes to some level of acceptance of the situation.

"After the second surgery," says Bob, "the doctor wanted to do radical chemotherapy [a common treatment for cancer] on my head and spine for a year and a half ... but my mom and I took a walk in the park and decided that I wanted to have quality over quantity of life, so we decided against the chemotherapy. The doctors said I had a 15-percent chance to live six months."

Bob was later found to be cancer-free. He's now 21 years old and in excellent health. He says that what helped him most were "God, the prayers of others, my family and my hope."

Leslie is also now healthy, and she plans to honor her "deal" with God by choosing a career in the helping professions. She remembers, "I had one really good friend who stood by me through everything. I don't know what I would have done if she hadn't been there for me." Critically important for Leslie in adjusting to her difficult situation was moving through her frustration with God to an acceptance of the divine will. "Once I got past the frustration with my situation, I really felt a deeper relationship with the Lord and a lot of my fear also went away."

Bob points to his second surgery as an important time in his recovery. He says, "In my second surgery, I sensed myself drifting away from my body, but my faith in God and others' prayers helped me to come back to my body. I lived through it to become a living symbol of God's faithfulness."

You, too, can express God's faithfulness by being a friend especially to those who need one most.

Andrew Mothers (16), Aaron Schmidt (16), Laura Schneider (15), Tiffany Trost (15) and une Smith (15) gathered to critique this edition of Youth Update. AN but June, who came with her friend Tiffany, are members of St. John Vianney Parish In Cicinnati, Ohio. Franciscan Brother Joel Stern, who gathered the group, is parish director of religous education.