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Dear Eric: I have a friend who I've known since childhood. Our relationship has always been platonic. Through the years we have gone our separate ways but always stayed in touch. I was living in another state when he had and beat cancer.

I've been back in my hometown for a few years now and have spent quite a lot of time with him doing things friends do. He has had some intermittent blindness, and his sight is back to normal after a few hours.

I've asked him what his doctor has said about it, and his response is “they want me to do an MRI and I'm claustrophobic and not doing that.”

Eric, how do I respect that decision when it could be a life-threatening issue? He and I have talked about it but it always ends by changing the subject. I know there's nothing I can do. Your thoughts, please?

– Caring Friend

Dear Friend: Respect has multiple definitions. You can respect his decision by acknowledging it and abiding by it without necessarily agreeing with it or thinking highly of it. Even if it doesn't feel like it, you may already be taking the best approach in this difficult situation.

When a mentally competent adult refuses medical care, sometimes the only option is to listen and validate their feelings. Intermittent blindness is indeed alarming and could indicate serious conditions. His previous cancer experience may have left him traumatized, fearful or simply exhausted by treatments.

Communication is key to understanding what's really happening – whether it's medical anxiety, hopelessness or a deeper mental health issue that might require intervention. If you haven't already, consider asking about options like open MRIs or CT scans instead of traditional MRIs. Through conversation, you can explore alternatives and better understanding his needs in hopes of offering different kinds of support. Does he want or need someone to come to the doctor with him, for instance?

While armchair diagnoses won’t be helpful for either of you, asking thoughtful questions about his current medical care, comfort level with his doctors and the information he's received might reveal new perspectives or options he hasn't considered.

As you work to support him, please remember to care for yourself. This situation is undoubtedly frightening and stressful for you as well. Make time to process your own emotions by reaching out to someone you trust.

Dear Eric: I have a wonderful relationship with my neighbor, "Jody." We have gone to church and Bible study together, we have gone out for dinner, we have exchanged recipes and dinner items and prayed together. That's why my problem is such a sensitive one. Jody has a mentally challenged son "Troy" who lives independently and takes the bus up from a different city each Friday to spend the weekend with his mother. He is a very sweet boy who is a big help to his mom who has myriad health problems. On occasion when Jody is having a bad day, she has asked me to drive to pick Troy up. This has happened on six occasions so far. It is a 30-mile round trip from our neighborhood. While I'm happy to help Jody when I can, driving 30 miles uses up a lot of gas in my SUV. I know that Jody is not hard-up for money, but my income is quite limited (Social Security).

Can you suggest how I might broach this issue to my good friend without causing a rift between us? I can't think of a way to phrase it that wouldn't put her off. I don't want anything to come between us because she is a dear woman, and I wouldn't hurt her for the world.

– Carpooling

Dear Carpooling: At the risk of overanalyzing, I wonder if there's a part of you that thinks it's uncharitable to ask for reimbursement from a friend. I humbly suggest that it's not, and Jody may not think it is, either. You'd still be spending your time and energy doing this out of the goodness of your heart; it's good to let your friend know how she can help you help her.

The words you wrote to me are perfect: "Jody, I am happy to drive Troy and it's really meaningful that you trust me to help in this way. The only thing is that gas is hard for me to manage financially. Would you be willing to cover the cost of a tank (or whatever portion of a tank it is)?" You could even, if you feel comfortable, share your concerns that this request might affect your friendship.

Think of it this way: how would Jody feel if she knew these trips are creating so much stress for you, both financially and emotionally? Surely, she'd want to do what she can to alleviate it.

(Send questions to R. Eric Thomas at eric@askingeric.com or P.O. Box 22474, Philadelphia, PA 19110. Follow him on Instagram and sign up for his weekly newsletter at rericthomas.com.)

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