How Can You Say Goodbye to Your Kids?

When I was a pediatric oncology nurse, people often asked me,“How can you work with children with cancer? It’s so sad!” And I would invariably tell them, “Yes, it is, sometimes. But children are so resilient. They don’t feel self-pity or resentment or frustration the way adults often do. They live moment to moment, and that makes caring for them so much easier for me.”

And that certainly was true. But what I didn’t say, and perhaps wasn’t in touch with myself at the time, was that the way children handled their illness was just part of the reason I chose to work with kids. The other part was that working with adults with cancer — young people with spouses and families who loved them and relied on them — completely broke my heart. I would look at them and wonder, “How can you live with the knowledge that in the not too distant future, you may have to leave this beautiful family behind? How on earth do you say goodbye to your kids?”

Then, not long ago, I had the honor of speaking with a woman of about 40 who I met on a flight from California to Hawaii. It’s a long flight — about 5 hours — and I usually stay occupied by watching a movie or reading a book. I’m not one to chit-chat with strangers…at least not usually. But the woman in the seat next to me was obviously ill. She wore a scarf on her head and looked very thin and pale. So when she smiled warmly and said “Hi,” I wanted to respond in kind.

What ensued after that initial greeting was a long conversation about what it’s like to be a mother of young children and know you are going to die. The woman (I will call her Sally) had metastatic ovarian cancer, and her doctor had told her she had very little time left. She was going to Hawaii to meet her husband and her boys, ages 10 and 14. It was a long-planned dream vacation that they had decided to move up by a few months when she became ill. Now, she said, she was very glad they had.

We talked for a long time about her cancer journey, and I was amazed at how positive and upbeat she was. She was determined to enjoy the trip to Maui and do the things her children and her husband wanted to do. “I can’t snorkel,” she said at one point, “I’m too weak for that! But I can take the boat trip to Molokini with them and watch them have fun. And I can go with them to see the sights, even if I’m doing it in a wheelchair!”

“That’s all I want now,” she said wistfully. “To see them happy instead of sad. They’ve been so heartbroken and lost since I got sick.”

“How truly awful,” I thought to myself. “How horrible to see your children suffering and know that you, however, unwillingly, are the cause!” And though I didn’t say the words aloud, my feelings must have shown on my face, because Sally smiled wanly at me and said just two words. “I know.”

“How do you do it?” I finally gathered up the courage to ask her. “How do you live with the fact that you have to say goodbye to your kids?” At that point my eyes filled with tears. But Sally remained incredibly composed.

“I have no choice,” she answered. “I have no choice about the fact that I am going to die — and probably very soon. And I hate it with every fiber of my being; I would do anything for more time! But I have accepted it, and made up my mind that, though my body will no longer be with my family, I will leave as much of myself behind as I can.”

“I write my boys letters,” she went on, “every single day. I write them letters about when they were babies and all of the funny things they did. I write them letters about the things I want them to remember, like the first time they rode a bike, or the Christmas when they got the Best Present Ever from Santa. I write to them about how I imagine they will look and act and the kind of people they will be when they grow up. I write to them about how I expect them to treat their girlfriends and the kind of parents I hope they will be. And I tell them I will come back to haunt them if they ever drink and drive. “

“I write down everything I can remember about our lives together,” she added, “because I won’t be here to remind them, and I never want them to forget. 

“Have you given the letters to them?” I asked.

“No,” she said. “That would make them and me way too sad. I have them saved in a drawer in my desk. One pile is labeled “For Danny” the other pile says “For Jess.” My husband knows they’re there, and he knows that he’s supposed to give them to the boys when he thinks they’re ready to read them. But not all at once….he knows that too. Only when it’s the right time.”

I thought about how hard that would be for her husband. Yet, I imagined, it would also be comforting to have those letters, and to read and reread them himself. It would almost be like his wife was still with him, helping him raise their children.

Almost……but not really.

When I said goodbye to Sally at the airport on Maui, I felt very sad. Sad that I would never see her again. Sad that such a brave, strong, beautiful woman was losing everything to a horrible disease. And, of course, sad for her husband and children, who — despite everything Sally was doing to leave them with wonderful memories and help ease their pain — would miss her terribly when she was gone.

But I also felt strangely hopeful. Because Sally had shown me something that those of us who have (thus far) been shielded from such heartbreaking tragedy rarely see — the enormous love and immense courage we can access when we come to terms with the fact that we are going to die.

“I shall not wholly die, and a great part of me will escape the grave.”– Horace

About Kathleen

Each month Kathleen Clohessy, R.N., offers a new perspective on living with a terminal illness. Kathleen comes to SevenPonds with 25 years experience as a registered nurse caring for families and children facing life-threatening illness. She began her career in the Pediatric Intensive Care Unit at Nassau County Medical Center in New York. After relocating to California, she spent 15 years as an R.N. and Assistant Nurse Manager at the Pediatric Oncology & Bone Marrow Transplant Unit at Lucille Salter Packard Children’s Hospital at Stanford. She uses her knowledge and expertise to enlighten our readers about the challenges associated with chronic illness and its effects on family relationships.