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How Should I Tell My Daughter She Needs Brain Surgery?

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How do I tell my daughter she needs surgery? originally appeared on Quora - the knowledge sharing network where compelling questions are answered by people with unique insights.

"My 7-year-old daughter will need a brain tumor surgically removed. I don't know how to explain this to her. How do I tell her she needs surgery?"

Let me start with a true story.

One day I came home from high school to find both my parents weeping on the couch. I knew they had been waiting for news about my brother, so I feared the worst. I asked them, and through the crying I pieced together that he had a brain tumor the size of a grapefruit and would need to go to get prepped for surgery as soon as he got home from school. The doctors couldn't say for sure, but his chances of survival were something like 40 percent.

I told them they needed to stop crying and be strong, and they asked me how I could be so heartless. My brother was about seven at the time. All I could think was that if my kid brother saw them like this, then he would think he was already dead. Having him go into surgery with the expectation of dying was unacceptable to me. Seeing that they weren't going to pull themselves together, I waited outside for my brother.

I stopped him before he went inside and explained that the doctor had called and that he had a brain tumor and would need surgery. I explained that his blurry vision and headache would be gone after the surgery. He cried a little, and said he didn't want to die. I held him and reminded him that the doctors told our Popo that he was going to die 30 years before and he was still going strong. "We're strong and we survive, so don't worry." It all took about five minutes, and then I sent him inside to our parents. They all cried together, but he ended up trying to comfort them.

I believe that a lot of life is about how you frame it. By that I mean that we can shape our experiences by tweaking our viewpoints. It's the old question of whether the glass is half full or half empty. But it goes beyond being optimistic or pessimistic. If you use the frame of reference that the glass is half empty, then how much more precious is the water now that half is gone? And in seeing the value of the water left, are you being pessimistic? Framing and viewpoint can be much more powerful than just showing optimism or pessimism.

By being calm, presenting the facts, and relating a story from our family lore, I created a frame of reference for his situation. By being calm, I showed that there was no reason to panic. By presenting the facts without sugar-coating them, I showed that I was trustworthy, and as such he could trust that there wasn't a reason to panic. By relating a personal story we both could relate to that was similar to his situation, I showed why we didn't need to panic, that I understood in some small way what he was going through, and why there was a good reason to hope. I did my best to give him a frame of reference filled with calm, hope, and understanding.

If the first thing he had gotten was my parents crying and hugging him, and telling him it would be okay but without telling him the actual details, he would have a different frame. The crying would mean something was terribly wrong. Hearing, "Everything is going to be okay," from our crying parents would imply the opposite, that everything would not be okay. Not telling him the actual details would have led to doubt and fear. So he would have been given hopelessness, fear, and a reticence to trust what adults told him.

Should I have gone behind my parents backs to talk to him first like I did? I don't know, but I wanted him to have the best chance of survival possible. Everything I had ever read about cancer suggested that the patient's attitude is as important as the treatments. If a patient is willing to fight for his life, his chances are better. Allowing him to be hopeless was not an option, so I made sure he had hope before anything else.

He survived, and he is doing quite well. Now he's a systems admin for a large corporation.

You know your daughter better than some stranger, so I won't be specific, but here's what I would do:

  • Be strong. Nonverbal communication is as important as verbal. Show that you are hopeful.
  • Be honest. Give her as much information as she wants and don't sugarcoat it. Also, be honest about your feelings. Trust is important. If she can trust you to tell the truth, she can trust that there is reason to be hopeful, just as you are.
  • Be there. Do whatever you can to not only encourage hope, but show that you will be there to do whatever is necessary. Telling your child is only the first step. Just because there is hope doesn't mean she won't be scared and need you to hold her.
  • Don't lose hope. If you do, she may too. Without hope, the battle is much closer to being lost.

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