In your view, is it ever a good idea not to tell children about cancer?
As a physician and as a parent, I realize that there are many different ways to deal with a life situation; there is no one right way to raise children. But studies have shown that even when nothing is said, children know that something is going on. If they're excluded from the crisis, they're left to their own devices to understand what's going on and find ways to cope with the changes. Included in the crisis, the parents have an opportunity to educate their children in hopeful and helpful ways and guide them toward adaptive coping skills. So for me, it was never an issue of trying to keep anything from my children.
I also wanted to use my unwanted illness to help my family grow strong. Every parent wants to teach their children skills and values. I chose to use the challenges of my illness as a platform for teaching my children what I would want to teach them if I'd never been sick a day in my life.
How do you know how much to share with a child?
The first issue is: How much does the child need to know in order to deal with his or her world? If you have a child who doesn't want to talk about it at all, you may need to force them to listen to the basic facts, such as, "Mom's sick, she's going to be in the hospital, she needs a bone marrow transplant and she's going to lose her hair." In other words, you need to tell them the basic facts that will help them understand what's going on and prepare for what's going to happen. The second issue involves what they want to know. And that's where the child moderates how much information is shared.