Miranda Worthen, now 17 and a senior at Newton North High School, was nine when her mother told her she had breast cancer.
Miranda had listened for years to her mother’s stories about her own mother, who died before Miranda was born. Now, as her mother put her to bed that night eight years ago, Miranda went straight to the heart of the matter.
“What is it like,” she asked, “not to have a mother?”
Contemplating a world without a parent is difficult, whether you’re 17 or 70. But for a teen-ager, it can be truly destabilizing to think that the person you count on as both your friend and your intimate enemy might not be there to set the very limits you detest.
Yet despite the huge challenge of growing up knowing that a parent might be facing death, teen-agers like Miranda have discovered that there are ways not merely to avoid falling apart, but to grow up sane and healthy, even happy.
Like younger children, of course, teen-agers worry – often secretly – about who will care for them if a parent dies. But beyond that fear, the issues are different for teen-agers than for younger kids, even in the same family.
Young children, for instance, may not understand what death means. But adolescents, their sometimes-reckless behavior notwithstanding, grasp that death is permanent, and that if a parent dies it will change their lives forever. They also usually know there’s no truth to “magical thinking” – the idea young kids often have that their own anger could kill a parent.
Teen-agers face other problems that younger kids do not.
Because they think they’re immortal, for instance, “it really shakes them up” when a parent gets a serious diagnosis, says Dr. Alvin Poussaint, a Harvard Medical School psychiatrist.
Teen-agers are also busy “moving toward independence,” says Dr. David Spiegel, a psychiatrist at Stanford Medical Center in California, “so there’s a tremendous pull on them when a parent gets sick. They feel infantilized, like, ‘God, I’m 6 again, I can’t go out, I can’t be with my friends.’ “
A parent’s potentially fatal illness is an “intrusion on their own personal development,” he adds. “Sometimes they can articulate that, but often they feel too guilty and ashamed.”
“All of a sudden, it becomes very scary,” agrees Gerald Koocher, a psychologist at Boston’s Children’s Hospital. “You can’t storm out of the house and say, ‘I wish you were dead.’ “
But there are things you can do, say both the pros and parents and teen-agers who’ve been there. For instance:
1. Recognize that even if your parent does not die, things may never be the same.
Susan Anthony, now 19 and a paralegal in North Reading, was 13 when her father had surgery to remove his cancerous vocal cords.
Richard Anthony, now 60, says a cancer diagnosis has “a hell of an impact on the family, even the dog.” Today, he swallows air to produce a raspy “esophageal speech.”
For Susan, the whole experience was “pretty traumatic, and the hardest part was accepting his new voice. He had a wonderful, soft, melodic voice. . .”
Even the good changes were hard. Her dad “had had a quick temper,” she says. Now he’s “calmer. . .but I had a hard time accepting the change. He didn’t seem to be the same person.”
2. Try to find ways to help out that also help you.
Even when she was only 10, Miranda recalls, she gave her mother long foot massages and hugged her “constantly.”
Sometimes, her mother, Kathy Weingarten, now 49 and a psychologist at Children’s Hospital and the Family Institute in Cambridge, worried that Miranda was doing too much. But Miranda says, “It helped me get through it then, to know I could help her.”
Still, parents should set limits on how much help they expect, says Siegel. “It can’t be that every time you go out, you’re abandoning your mom. Tell the child to clean up the kitchen or whatever, then let them go out.” And acknowledge the child’s help. “That means a great deal to kids.”
3. If you’re old enough, consider participating in your parent’s treatment, if everyone agrees that’s appropriate.
Kathryn Bailis, 21, the daughter of Susan Bailis, 50, president of The ADS Group, an elder service organization, was 17 when her mother was diagnosed with breast cancer. “It was the worst day of my life,” she recalls. “We sat on the kitchen floor for a long time. I collapsed in her arms.. . . I wailed.”
Since her mother’s cancer came back, Kathryn says, “I go to chemo with her a lot,” which gives her pride in her mother’s courage. “She sits in her nice silk suit while everyone else looks like a victim,” says Kathryn. “She makes phone calls and does work. . . It’s amazing.”
4. After you have offered whatever help you can, don’t try to be superkid. You still have a right to be a teen-ager.
Some adults burden kids by saying they’ll be the “man of the house” or the new mother if the parent dies. What kids should hear, says Koocher, is that “We’re all going to have to pull together as a family.”
5. Find ways to spend extra time with your parents.
Because of her mother’s illness, Kathryn Bailis, a senior at Colgate University, decided to spend the summer at home. “Now, every moment is special,” she says.
6. Stop fighting with your parents about little stuff.
“I fought with my mom for years,” Kathryn says. “I was angry because she worked so much. . .Now I feel there’s no point in getting angry because in the end, who knows how long I have with her, so I’d rather not waste the time fighting over what’s not important.”
7. Try to turn the crisis into a chance to grow.
When Kathy Weingarten’s cancer recurred and she had a partial mastectomy, Miranda worried that her friends would be “creeped out.” So the two talked about it in their mother-daughter reading group, then Weingarten asked if the group wanted to see her chest. They did.
“So she took off her shirt and showed us. She was really brave,” says Miranda. “The mothers walked out with their daughters and held their hands. The girls would sort of bury their faces in their mothers’ intact chests and look at my mother.”
But her friends “grew into a different emotion about it,” she says, and she learned “if they couldn’t accept a woman who had had a terrible disease. . .then I wouldn’t want to be friends with them anyway. I ended up not losing any friends at all.”
Weingarten was as awed by Miranda’s growth as her daughter was by hers. Miranda was “deeply politicized,” she says. “She became very supportive of me. She’s an extraordinary kid.”
8. Recognize that it’s natural to fear you could get the same kind of cancer your parent has. Ask for extra medical checkups for reassurance.
Both Miranda Worthen and Kathryn Bailis, for instance, worry a lot about breast cancer. When asked what she wanted for her 17th birthday, Miranda answered, “A mammogram.” She was too young, but her doctor agreed to give her frequent breast exams.
9. Face the fear of death together – by talking.
Discussing death with Miranda, her husband Hilary and their son Ben, 20, has been “a very profound experience,” says Weingarten.
“Of course, it would be the worst thing that could happen,” she says. But she and the others tell each other, “We don’t have to deal with that now. It’s not happening. . . You don’t have to worry alone and I don’t have to worry alone.”
10. Avoid information or people that upset you.
When she was diagnosed with breast cancer this spring, Eve Nichols, 44, director of public affairs at the Whitehead Institute for Biomedical Research in Cambridge, discovered well-meaning adults were telling her kids, Matthew, 19, and Beth, 17, about their own parents’ deaths at a young age.
“I had a very good prognosis, so that was difficult for the kids,” she says. “My advice to people is to listen to the kids and support where they are at the time.”
And simply get out of harm’s way if you feel bombarded by information – or feelings – you don’t want to deal with right then.
Miranda recalls a conversation not long ago when a woman started talking about her mammogram. “I got really frightened. . . . I dug my nails into my hands. Three minutes later, I realized what I was doing and said, ‘Mom, we need to stop this conversation.’ Then we sort of pieced together what had happened to make me so freaked out.”
11. Talk, talk, talk. If your parents can’t listen when you need them to, seek out other adults – clergy, teachers, family friends – as well as your own friends, who can.
Before her daughter could talk to her directly about her fears, says Eve Nichols, Beth confided in a family friend, a source of support that was crucial.
Avoid the friends who, as Kathryn Bailis puts it, “can’t deal at all.” Focus on those who can, the ones you can have fun with when you’re up and cry with when you need to.
If you become depressed or suicidal, you may need a professional to talk to, says Poussaint. One sign you may need this help is if you start drinking heavily or using drugs.
12. When the going gets rough, do as Susan Anthony does: “Remember, your parents are going through as much as you are, so it’s going to be hard to deal with. Just take it one day at a time.”
Someone to talk to
If you’re a teen-ager who has a parent with cancer, you might consider attending a networking group for teens at the Wellness Community in Newton Centre. The telephone number is 617-332-1919.
You can also find adults outside the family to talk to through many schools, churches and hospital emergency rooms.