My mother lay on the hospital bed, early in May of 1983. The device that held her leg in traction hung off the end of the bed. It was a beautiful spring day, the snow had recently melted off the Alberta prairie. We were chatting during my daily visit to her in the hospital. Her cancer was in her bones, and there was no way to stop it. She was dying slowly. She knew it, she could feel the pain in her back. I had not yet processed her upcoming death in my 16 year old mind. It was too terrible a reality to assimilate, to grieve.
Suddenly, she asked me “were you able to go skiing with your friends?” She knew I loved skiing in the nearby Rockies, swooshing under the chairs at Sunshine Village, or absorbing the stunning scenery at Lake Louise. I was a little startled by her question, but it has never left my soul. Consider where she was. Cancer had laid her flat in a hospital bed, she could only look at a grey wall, or out the window at the changing seasons. Yet she saw so much farther than the room of her solitude and pain. She saw into my heart, the joy I had when I talked about landing a jump in the powder snow. She saw the photos that Doug took, or heard how Bruce forgot his goggles, and was sunburned across his eyeballs.[i] She knew I came alive when I talked about skiing, and she wanted to foster, to enhance my life. She was dying, and yet she wanted to nurture my life. “Did you go skiing with your friends?” It was one of the most powerful ways she ever said “I love you.” Every single time that I go skiing, I think of her gift of love to me.
I was not the only recipient of her love. Her funeral procession a month later had a line of cars over a mile long, as we drove from the church in one town, to her grave in another. She was encouraging and giving to so many people. In her 20’s she was a midwife in Ghana, and decades later, she worked as a nurse in Zambia. And her generosity carried on for decades. When I smushed a kiss onto my toddler’s cheeks, it came directly from her. When I chatted with my teens, it echoed our conversations many years earlier. She lives on in how her children treat their children. Her life was tragically cut short but it was well lived.
Because she gave of herself. Sure she was stubborn at times, (she was Dutch after all), but she tried hard to build up the lives of people around her. She set aside 10% of everything she made selling lamb from our farm, to donate back to Africa. She sought to encourage, or pray for people, or hug, or help out. As I said, it was a life well lived.
For life is not simply about life-span. I meet some people who live completely oriented to themselves, indifferent, or even cruel to others. When they die, there will be a handful at their funeral, not a packed church. Some are so wretched that their children are relieved when their parent dies, free of the bullying and insults at last. All the person gives is contempt, not care. They toss out sneers, rather than support. Their body lived, but their soul was so twisted and turned in on itself that they acted only for their interest, never for the growth or needs of others.
The paradox is that the people who do the opposite, who act for the benefit of others, live better lives. In every way. Their friends, family, and children speak fondly of them, and reproduce the grace that was shown them.
Their mental health is better as well. People who help their friends out, volunteer, spend time with lonely people, or do other prosocial behavior report an improved sense of subjective well being. This finding is very robust, emerging from a study of 78 countries.[ii] This gets around one of the criticisms of a lot of psychological research, that it is focused on rich countries with largely white populations.
Other researchers found an even bigger sample from the Gallup organization, looking at 136 different countries. If people gave to charity, then the more that people donated, the greater their sense of well-being in life. It did not matter if the country was rich or poor. Once the researchers crunched the numbers, they found that donating to charity increases a persons’ sense of well being, as much as a doubling of household income.[iii] Let that sink in for a minute. We think that getting a 10% raise will make us happier. It does, a little bit. But to get the same increase in well being as donating to charity, you would need a raise of 100% How likely is it that you will get such a monster paycheck? On the flip side, how possible is it that you can donate to charity? Such as cancer research? I know I can easily donate.
Other researchers looked at the issue from other angles. Instead of relying on a single questionnaire, they looked at people’s behavior repeatedly. People who were interviewed across three different years said that the more that they volunteered, the less depressed they felt. People who did not volunteer at all had some of the highest levels of depression. In contrast, those who volunteered for all three waves of the study had the fewest symptoms of depression.[iv] The effect was strongest when people volunteered at a religious organization.
The ideal in science is to compare one group that volunteers with another that does not. Whether it is a matched control group[v] or a randomized control group[vi] the results are the same. The more that people volunteer, the less depressed they are later on.[vii] [viii]
I can anticipate a question popping up in your mind. You may be thinking, ‘well, those results came from ordinary people. But I am a cancer survivor.’ Good point. Researchers looked at people who had received a stem cell transplant and had significant survivorship problems as a result of their cancer. They had it tough. When these survivors wrote special essays to help someone else facing a stem cell transplant, they had less depression than survivors who wrote on neutral topics.[ix]
Whatever lens you use to look at it, helping people out improves your sense of well-being, and reduces your depression. And that is really helpful to know for cancer survivors, because the less depressed you are, the lower your risk is of cancer recurrence or mortality, as mentioned in a previous post. Whatever your path is in life, your act of caring for others extends your life in many ways. It can even warm your son as he rides a chair-lift over the snow of a ski hill.
Thanks or reading,
Dr. Eric Kuelker
[i] He healed up eventually.
[ii] Haller E, Lubenko J, Presti G, Squatrito V, Constantinou M, Nicolaou C, Papacostas S, Aydın G, Chong YY, Chien WT, Cheng HY, Ruiz FJ, García-Martín MB, Obando-Posada DP, Segura-Vargas MA, Vasiliou VS, McHugh L, Höfer S, Baban A, Dias Neto D, da Silva AN, Monestès J-L, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Kleszcz B, Lappalainen R, Ivanovic´ I, Gosar D, Dionne F, Merwin RM, Karekla M, Kassianos AP and Gloster AT (2022). To help or not to help? Prosocial behavior, its association with well-being, and predictors of prosocial behavior during the coronavirus disease pandemic. Front. Psychol. 12:775032. doi: 10.3389/fpsyg.2021.775032
[iii] Aknin LB, Barrington-Leigh CP, Dunn EW, et al. (2013). Prosocial spending and well-being: cross-cultural evidence for a psychological universal. J Pers Soc Psychol. 104(4):635-652. doi:10.1037/a0031578
[iv] Musick MA, & Wilson J (2003). Volunteering and depression: The role of psychological and social resources in different age groups. Social Science & Medicine, 56, 259–269.
[v] Hong S. I., Morrow-Howell N. (2010). Health outcomes of Experience Corps®: A high-commitment volunteer program. Social Science & Medicine, 71(2), 414–420. doi: https://doi.org/10.1016/j.socscimed.2010.04.009
[vi] Jiang D, Warner LM, Chong AML, Li T, Wolff JK and Chou KL. (2021). Benefits of volunteering on psychological well-being in older adulthood: Evidence from a randomized controlled trial. Aging & Mental Health 25, 641–649
[vii] Byrne M, Tan RKJ, Wu D, Marley G, Hlatshwako TG, Tao Y, Bissram J, Nachman S, Tang W, Ramaswamy R, Tucker JD. (2023). Prosocial interventions and health outcomes: A systematic review and meta-analysis. JAMA Netw Open. Dec 1;6(12):e2346789. Doi: 10.1001/jamanetworkopen.2023.46789. PMID: 38064214
[viii] Anderson N. D., Damianakis T., Kröger E., Wagner L. M., Dawson D. R., Binns M. A.…Cook S. L. (2014). The benefits associated with volunteering among seniors: A critical review and recommendations for future research. Psychological Bulletin, 140, 1505–1533. doi: 10.1037/a0037610
[ix] Williamson TJ, Stanton AL, Austin JE, Valdimarsdottir HB, Wu LM, Krull JL, Rini CM. (2017). Helping yourself by offering help: Mediators of expressive helping in survivors of hematopoietic stem cell transplant. Ann Behav Med. Oct;51(5):683-693. doi: 10.1007/s12160-017-9892-2. PMID: 28462480
Dr. Eric Kuelker
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