“… People who look good, but answer badly… Treat me well, I’ll treat you well / perhaps it will save us / delicacy.”
I recalled the verses of this late-1990s song by the Catalan singer-songwriter Marina Rossell, after accompanying a patient diagnosed with ovarian cancer, already operated on (hysterectomy), and undergoing follow-up chemotherapy, for the past two years.
She seemed well, recovered, feeling as if she had been “reborn,” but then she collapsed and regressed three steps. Being a woman who diligently follows the schedule set by the professionals attending her, she had requested an appointment to repeat a control test.
I’m not a doctor, but I can interpret the studies she handed me with a look of overwhelm and a demeanor of total resignation at the start of the consultation. “I am terrified,” she told me, “and I think there’s nothing more that can be done; what will they take from me now?”
I fell silent.
I took the papers and searched for the data behind such distress. Her laboratory results (the complete blood count and immunology were perfect). Further down appeared the values of two antigens: one called carcinoembryonic antigen, which was normal, and another identified by the number CA125, which refers to ovarian tumor markers (carbohydrate antigen 125). That one, indeed, showed a high value, but it was not a death sentence.
This article isn’t about recounting the session; it’s about sharing a reflection on the power of words.
When the sustaining word is not available
The patient expressed her horror, her freezing, naming it as being “terrified.” There wasn’t a doctor accompanying her to read the results at the hospital: an administrative secretary handed her the envelope. In that utter loneliness she collapsed. She arrived at the consultation utterly devastated… She had already lived through that earthquake of the initial diagnosis 24 months earlier and had undergone a surgery with a high emotional cost.
She had been in good health for more than a year; the reins of life were back in her hands, she felt recovered, energized, with plans, but seeing the analyses left her paralysed again. She could no longer trust. Terrified. She had only read one exorbitant figure and there was no explanation to add humanity to a value that lay outside normal parameters.
Tumor markers do not always indicate cancer. The levels of these antigens can rise due to various causes and—in many cases—benign ones. For example, when there is inflammation, or endometriosis, or liver cysts, these are the results known as false positives.
The patient — she told me upon arrival — had almost cancelled our appointment, but the urge to share that distress brought her to the encounter. She sought refuge in a safe space to thaw. We spoke about the interconsultations still needed, the upcoming studies (ultrasounds and imaging), supplementary analyses, and her medical history.
And we returned to the core of the session: what that gap represents for her, those removed organs (“they took them out,” she says), so central to her sense of femininity. She had already undergone surgery, radiotherapy, chemotherapy… That was history, but now fear returned, the fracture of reliving the impact, the lack of trust.
A Safe Space to Regain Confidence
Being able to talk about the emotions tied to a “crazy” number relative to reference, having someone to connect that bioshock to other moments lived in the solitude that freezes and the fear that paralyzes, hearing that there isn’t a single way to read things (cancer, suffering, death), and acknowledging other manifestations that point to symptoms not explained by the cold analytical form, brought her calm. She left the session much more relieved than she had entered.
For her medical appointment the following week, she would be better prepared to listen to the full repertoire of possibilities and not turn it into a horror movie in advance.
However, that afternoon I found myself reflecting on a topic that has long haunted me: good treatment. Not only in the medical field (where iatrogenesis through words can cause more harm than the illness itself), but in everyday life.
How many times are we indifferent in the face of painful situations? Do we respond with kindness when approached in the street or a shop? Do we show up for someone who seeks support?
Living with Tact
School, hospital, politicians, family, transportation systems—indeed, the media as well, enormous engines of mistreatment or disregard, sometimes more disturbing than a misplaced word. What do we mean by disregard? Gestures so repeated that we have normalized them: a call that isn’t answered, a message that stays dead, a gesture of ignorance that makes us invisible, that invalidates a need, that discounts with a sideways look or a lack of empathy…
And what if good coexistence could be described in that possibility of being-with-tact? With care toward the other, my neighbor, my next closest person. Fostering the subtlety needed to approach a thorny topic, weighing the reaction it might provoke, tempering the pain… Living with tact in these times of speed that rush over us, fail to consider consequences, and lose context because they only see their own goal or benefit seems so difficult.
The proposal is to recover that mammalian quality: contact that repairs and cares, the considerate handling that seeks to prevent the wound that terrifies. The loving word. The commitment to listening.
Courtesy, consideration, good taste, cordiality, harmony, compassion, attention, benevolence, sensitivity to affective nuances: from an appropriate distance to a timely embrace. With these ideas I left the consultation that afternoon. And I turned to my library for a repose from these concerns.
Re-reading some aphorisms from Mínima Moralia, Theodor W. Adorno’s philosophical work from his 1944–1947 exile in the United States, where he diagnoses the tolls of the “damaged life.”
Amidst desolation, dehumanization, and—I would add— a lack of tact, the philosopher defines tenderness as “the awareness of the possibility of relations without a defined purpose.” I see in this a direct critique that applies to our current times, which measure everything by usefulness, practicality, and immediate benefit. If it helps me, it helps… otherwise, it is discarded. And what about the others?
When the importance of manners is neglected, decadence takes hold… I advocate for precise language and the necessary silence. Knowing how to communicate a patient’s result is to practice a tactful dialogue that eases sorrow without unleashing monsters. With gentleness, knowing how to pace, softening difficulties. The mantra is to practice good treatment outwardly as we would like to be treated ourselves. It is a matter of awareness and intention… It isn’t so complex if we desire a less hostile world.
The Spanish song (which I leave you via this link so you don’t miss it) brings us a key: perhaps delicacy will save us.
Source: Diana Paris is a psychoanalyst, psychogenealogist, author of Family Secrets. Her latest book co-authored with Ondi Paris, Your Voice That Blooms. Psychogenealogy and Emotional Management (2026), Del Nuevo Extremo Publishing.
