What’s Chemo, Mommy?

Saying "no" to such a question is fairly easy. What's harder is explaining why a parent has developed a disease in the first place, especially when doctors themselves don't fully understand the disease process. "I tried to explain about genes to my son, and how they're these little switches that turn on and off and they can work wrong," says Hayes-Cha. "Then I realized he thought I was talking about jeans, and I was, like, 'Oh, forget it, we don't really know'." Sometimes parents may have no choice but to keep things vague. There is, however, one principle that most counselors agree on: don't call it a boo-boo. If you do, the kids may assume their own boo-boos are just as serious. And if their parents are scared of a word—cancer—they'll be scared of it, too.

Is it my fault? Younger kids "think of themselves as the center of the universe," says Nancy Borstelmann, who directs Dana-Farber's Family Connections program. "They can think, Hey, I was mad at my mom and then something bad happened—maybe I made it happen," she says. "Even older kids may still think in some way that they had something to do with the illness." If that sounds strange, consider that even adults can fall prey to similar guilt. It's part of the grieving process. "Yesterday I spoke with someone who was 55 years old and his father was dying, and he was saying he felt like it was his fault," says Elizabeth Colkin, a social worker at Montefiore Medical Center in New York. With kids, the trick is assuring them that this is not their fault—and reassuring them, again and again, as they get older.

Are you going to die? This, of course, is the hardest question to answer, and not just because it's the most emotionally racking. Often, parents simply don't know. Medical science cannot always provide a sure diagnosis one way or the other. That uncertainty is hard on kids, maybe even harder than it is on adults. Children aren't likely to believe hollow assurances that everything will definitely be fine. "That's the one message you never want to pass on," says Borstelmann. "They're going to see right through it."

When kids ask this question, they may not really be asking about their parents at all, says Hayes-Cha: "What they really want to know is who is going to take care of them." Her own daughter had trouble even mustering up the nerve to ask, she says: "She sat on the couch and said, 'Mommy, I'm scared to ask you this, I can't say it, I can't say it,' until she finally said, 'Who's going to be my mommy?' " Hayes-Cha was upset, but she wasn't surprised. She had expected the question, and she realized what her daughter needed to know. She listed all the women who would be in her daughter's life to take care of her. "We went through all her aunts and her grandmother and Angelina, the nanny, and she said, 'Oh, so Angelina could be my mommy?' And I just said, 'Yes, she could'."

That was last year. Hayes-Cha continues to face challenges. She has been through many surgeries, and cancer runs strong in her family; she must be ever vigilant. But she has a different answer to her daughter's question now: she's in remission. "I've told her that I think she'll be all grown up when I die," she says. "She might even be a mommy herself." For those like Wilson who still face a difficult prognosis, the question is tougher. But even then, there is a way to answer it. "We've just been honest and told them that nobody knows when they're going to die," Wilson says. Her point is frank and true. No matter what the future holds for Mary Lynne, her kids are going to be OK.

© 2007