Oh, hi, I have cancer!

And then the thud as the elephant steps into the room. And the stretch of silence expands and you nervously giggle and the other person slowly backs away and looks around for someone else to talk to. Cancer is the ultimate conversation killer.

After a cancer or any other nasty diagnosis, how do you tell people you meet about your medical issues? The people who are with you on the medical roller coaster know everything. But then you meet new people, do you tell or don't you? New co-workers, new jobs, its none of their business. But new friends, new love interests, do you tell or don't you? When do you tell them? HOW do you tell them?

Depending on what kind of medical ailment you have and the maturity of the person you are talking to, you will probably hit a range of responses:

- Oh, can you excuse me a minute? I need to use the rest room/talk to someone across the room/go get a new drink. I'll be right back. (Yeah, sure, see you in the next century.)
- Oh, that's no big deal. My uncle's neighbor's hair dresser's dog walker's cousin had something like that 30 years ago and I hear they are still fine. I heard they had some kind of experimental treatment in Abu Dhabi and it cured them. (Gee thanks. I'll go get my passport to see if they can help me too.)
- Well, that's a bummer. How are you doing these days? Do you want to talk about it? (A human being! Cool.)

What if its just someone over the years who you have gotten to be good friends with. You met them after the medical disaster and they have turned into your best friend.

Or let's make it a little more complicated. You meet someone you REALLY like. You know the one you want to spend the rest of your life with and somewhere between the first date and the 'I do's' you need to figure a way to slip this little factoid in.

Since I have run into these dilemmas myself, in my experience I have learned:

- Tell them at a time when you are sitting around talking in a quiet place where you can talk. Not in a loud bar screaming over the music.

- Be open and honest and tell them why you didn't tell them before. If you were co-workers, maybe its not something you run around the office announcing. Or if its only something you tell the people that are closest to you.

- Be prepared for them to say they can't deal with it or just ignore the medical elephant in the room and ask if you are ready to order dinner. That tells you that they weren't worth the effort.

Its unfortunate that some people either just can't deal with your medical issues or prefer to ignore it and pretend it didn't happen. They aren't your friends if they can't accept you for what you are.