One of the most common things people with cancer tell me is that the experience of hospitalization and treatment is profoundly isolating. I suspect that this sense of aloneness may even undermine the will to live. When we feel the support of others, many of us can face the unknown with greater strength. I often use ritual to help people at times like this.

For more than twenty years I have offered a very simple yet powerful ritual to people before their radiation, chemotherapy or surgery. I suggest they meet together with some of their closest friends and family the day before their procedure. It does not matter how large or small the group is, but it is important that it be made up of those who are connected to the them through a bond of the heart.

Before this meeting I suggest they find an ordinary stone, a piece of the earth, big enough to fit in the palm of their hand and bring it to the meeting with them. The ritual begins by having people sit in a circle. In any order they wish to speak, each person tells the story of a time when they too faced a crisis. People may talk about the death of important persons, the loss of jobs or of relationships or even about their own illnesses. The person who is speaking holds the stone the patient has brought. When they finish telling their story of survival, they take a moment to reflect on the personal quality that they feel helped them come through that difficult time. People will say such things as, "What brought me through was determination," "what brought me through was faith," "what brought me through was humor." When they have named the quality of their strength they speak directly to the person preparing for surgery or treatment, saying, "I put determination into this stone for you," or "I put faith into this stone for you."

Often what people say is surprising. Sometimes they tell of crises that occurred when they were young or in wartime that others, even family members may not have known before, or they attribute their survival to qualities that are not ordinarily seen as strengths. It is usually a moving and intimate meeting and often all the people who participate say that they feel strengthened and inspired by it. After everyone has spoken the stone is given back to the patient who takes it with them to the hospital, to keep nearby and hold in their hand when things get hard.

I have had several patients go to their chemotherapy, their radiation or even their surgery with their stones strapped with adhesive tape into the palm of one of their hands or to the bottom of their foot.

Over the years, many of the oncologists and surgeons in our community have learned about these stones from their patients and are very careful about them. One surgeon even had the staff go through the hospital laundry in search of a stone that was accidentally thrown away with the sheets in the recovery room. I asked him why he had done this and he laughed and said, "Listen. I have seen people do badly after surgery and even die when there was no reason for it other then the fact they believed they wouldn't make it. I need all the help I can get."