Dear Debra: Burdensome Secret
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My wife was recently diagnosed with breast cancer and has begun treatment. She has forbidden me from telling our friends or any members of my family about what has happened. Only two of her family members know.
Her insistence on secrecy is growing increasingly difficult for me. When family members ask why we are not accepting invitations, I mumble a white lie. My wife’s need for secrecy is isolating me at a time when we could both use the support and love from our friends and family. How can I convince her that a cancer diagnosis shouldn’t be treated as a state secret?
I spoke to Wendy Goldberg, MSN, APRN, BC, a nurse practitioner at the Josephine Ford Cancer Institute of Henry Ford Health System, for insights into how to best advise you. She explained to me that there are typically three overlapping reasons for this kind of “news blackout” that some cancer patients insist on: threatened sense of security and heightened vulnerability; fear of being seen as no longer competent (usually felt by those whom Goldberg described as “high performers” for whom an image of inviolable success is paramount in their professional world); and those who insist on secrecy under the mistaken belief that others will avoid them for fear of “catching” the cancer or wanting to avoid sick people.
“While each person’s story is unique,” Goldberg explained, “the issues of vulnerability, diminishment and contamination get bundled together, and people create a story as justification for their demand for secrecy.”
Working with her patients, Goldberg helps them uncover what fears have led them to impose a news blackout and then helps couples recognize the aspects of their relationship that make them strong as well as vulnerable. Is your wife afraid to let your family know because they might call every day, which could be an intrusion? How do you and your spouse’s definition of “sharing” differ?
Goldberg also discussed where in the trajectory a couple is and how that impacts when and how much they choose to share with others.
“If the person has just received the news, she needs time to process what has happened. But certainly [by the time treatment has begun] the spouse should not be left stranded without emotional or practical support … Being the caregiver is emotionally and physically draining.”
Above all, Goldberg said, “Don’t give everything away to the cancer. Your roles haven’t changed. You are there to care for one another just as you did before the diagnosis. Ultimately, the partner who is the caregiver must have at least one person or place to take his/her thoughts and feelings. The couple can work together to find a way for both to feel comfortable sharing the news; but, ultimately, the patient’s choice for absolute privacy cannot be imposed upon the partner.”
I just learned that I am pregnant and am overjoyed. My cousin, with whom I am very close, believes in living a natural life, which for her means not vaccinating her children. I am appalled and don’t know how to respond to her excitement about having our children play together one day. Until our child will be fully immunized, I do not want her children anywhere near my baby. How do I say this without seeming rude?
— Pro-Vaccine Mom
Rude schmood. You are in charge when it comes to your child’s safety. You have every right — and the responsibility — to be sure your child’s health is protected from the diseases these vaccinations were developed to prevent.
Next time Cuz starts bubbling about playtime, simply say, “That sounds great! When baby’s vaccinations are all up to date, it will be great to have them play.” Then change the subject. No discussion.
Your pediatrician can provide information about the practicalities of protecting your baby until her shots are up to date as well as help you frame your answers to the anti-vax moms you meet along the way. You’ll also want to talk to your pediatrician for guidance in making sure doulas, baby nurses and any others who will be caring for your child are up to date with their vaccinations. CDC.gov can also supply you with good resources and information.