From Child to Adult
The passage from adolescence to adult life is often a stormy one. The maturing teen must gradually separate from the protection of parents and home and become self-reliant and independent. This process is difficult for many teens and occurs at various ages. For survivors of childhood cancer, this task can be complicated by uniquely strong ties forged with parents or complex family dynamics that grew out of the turmoil of cancer treatment. Parents show great variability in how they feel as their teen begins to think about leaving home.
When my daughter chose to go to undergraduate school near home, some of her friends ridiculed her because she was not going to an Ivy League school. It was supposedly uncool to not make a quick break from parents. I will always remember her asking me, "Mom, why do some of the kids think it is a terrible thing to be close to your parents? Why do they think you are less of a person because you choose what is best for you?"
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My son left for college this week and I feel great. I was really worried about it before he left. But he's happy and he comes home weekends. He should be making friends, I guess. I talked about this with him--I asked point-blank: "Do you need friends?" and he said no, not really. He has acquaintances in his classes and I know he will be well-liked. But I said, "Well, they probably just party and drink all weekend," and he said, "Well, they drink and party all week!" So actually I'm relieved that he comes home.
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I'm having a hard time letting go of my 18-year-old daughter. I spent so many years and so much energy keeping her alive. I was so fearful of losing her. She's a miracle. But now she needs her own life and can't continue to be tied to cancer. She wants to leave it behind and she needs to move on. Part of me also wants that for her, while another part is screaming, "I can't lose you." Thinking of her leaving is the only thing that makes me sob, and I'm always surprised at how long the sobbing lasts.
Teens and young adults also show a mixed response to leaving the security of home for the first time.
In some ways, I was so mature so fast, and in other ways I was too dependent. For instance, I didn't even have my driver's license until I was 20. I really didn't drive much until I was 25. I know the social workers thought everything went seamlessly and, on the outer surface, that was so. There were many hesitancies. I stayed close to home for college. I didn't want to leave the clinic or my parents. In some ways, I feel like I'm still making the transition to adulthood, even though I'm 25 and married. I work with a lot of people around my age, and I'm envious. They don't have to worry about insurance or late effects from cancer, or friends who die. So in some ways I feel like I have a normal life, and in other ways I feel quite different.
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I had leukemia 30 years ago when I was in high school. My mother was a rock. She said, "We are going to attack this and you are going to live. Where there's a will, there's a way." My grandmother was very positive too. They pounded that into me. And I'm still here. My mother was way cool about independence. She had remarkable foresight. Here I was, a teenager, sick and dependent. She taught me to drive and let me drive to doctor appointments by myself. She gradually let me go so by the time I was leaving for college, she was treating me like an adult. And I felt ready to go and mature beyond my years.
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My transition was normal because I went away to college--four hours from home. I don't think that my folks thought I would leave. I didn't show a lot of academic ambition, so it surprised them. But one day, I just decided I wanted to go and I applied to five schools. I did end up at the same college as my brother, and we even lived in the same dorm one year. In college, I made a big, fresh, new start. College was a wonderful experience for me. I had been socially awkward in grade school and high school, but in college, I made lots of friends and tried many new things. I was on cloud nine.
One aspect of transitioning to adult life is assuming control of medical decision-making. Teens change from pediatric to adult healthcare when they leave home to enter college or take a job. Many young adults do not seek out comprehensive healthcare, and for healthy individuals, this is often not a problem. But for survivors of childhood cancer who are at risk for possible late effects, a gap in healthcare services can be serious.
I've always been very conscientious about my follow-up care. When I took a job far from home after college, I wanted to find a specialist to provide skilled follow-up care. I heard about a doctor from my hematologist and some friends who have had good experiences with him. I wrote a letter explaining my Hodgkin's history and saying that if he was accepting new patients, I'd like to set up an appointment.
Well, at my first appointment, I was delighted. He knocked, instead of walking right in, introduced himself (without the Dr. in front of his name), and sat down to take the history while I was still in my regular clothes. We went over exactly what things we needed to be concerned about at this point and what I needed to do in terms of screening, infection prevention, etc., in a very reassuring, non-scary way. The way he individualized everything just felt so comforting.
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I'm not on my parent's insurance anymore since I'm out of college. So I don't go to the clinic. I don't even have a regular doctor. I'm supposed to get tests like an echo every year, but I just don't. I guess if I get sick, I'll find a doctor.
By taking responsibility for your adult life, you can integrate the physical, emotional, intellectual, spiritual, and social parts of your life. In decades past, you might have been referred to as a "cancer victim." Now you can view yourself as someone who was victorious over cancer.
I'm an adult survivor of childhood cancer. I think you reach a point in your life where you need to integrate the experience so you are not just a cancer survivor, but a person who had cancer and learned something from it. I know people who still harbor a lot of anger or use the cancer history as a crutch. I still feel some pain for the part of my childhood that I lost, but I try not to let it get out of hand. I've realized that all humans face different crises and struggles in their lives, so my cancer experience doesn't make me special. It should help make us more understanding of other people's struggles. I'm old enough to realize that it wasn't just about me. Everyone in my family was in the experience and changed by it. I like to turn it around in my mind and view it as something that gave me strength.
