Heather Thompson Buum, MD, an internist at the University of Minnesota in Minneapolis, was diagnosed with breast cancer in 2016 after finding a lump while doing a self-exam in the shower.
She immediately faced a dilemma — what and how to tell her two young children, Sam, 11, and Lydia, 8.
Uncertain, the internist, who is known professionally as Thompson, sought help from colleagues, who, among other things, advised: "Tell them just enough information, and not too much; let them ask the questions, I'm sure they will surprise you."
Indeed, what follows for Thompson are plenty of surprises, including the revelation that her kids have been paying a lot of attention to their mom's work life.
On a school night, she delivers the news: "I am afraid that your mom has something to tell you…I found a lump in my breast; my doctors did a biopsy and discovered it is cancer."
It's a "very treatable disease," she tells a quiet Sam, and a crying Lydia.
"But is it curable?" asks Sam, a fifth-grader.
Yes, Thompson tells him, it is potentially curable.
"But could it come back?" he counters.
"Yes, but the medicine helps prevent that," she answers.
Sam's responses "truly stopped me in my tracks," Thompson told Medscape Medical News in an email.
Second-grader Lydia then takes a turn shocking her mom, weeks after her surgery.
"As I tuck Lydia in for the night," writes Thompson in an essay published online in the Journal of Clinical Oncology, "sitting on the edge of her bed between a menagerie of stuffed animals and a pile of books, suddenly she asks, 'What if I get breast cancer? And what if it's not stage 1 but stage 4?' After I swallow hard and take a deep breath, I think, wow, children overhear more conversations around this house than I think they do. My 8-year-old is asking about cancer staging, for God's sake."
Thompson calms her daughter by saying that, when she grows up, she will have x-rays to look for any problem.
"You mean an MRI? I don't want to have an MRI!" Lydia says.
Thompson is taken aback at how closely Lydia has been listening. "Whoa. Again, those big ears overheard me describe how loud and confining the machine felt," she writes.
Despite her children's precociousness, the Minnesota internist suspects that her kids actually hear and absorb less than kids who have two physician parents.
"I'm a doc but my husband is an architect; therefore, I think I tend to 'talk shop' quite a bit less around the house than I would if we were both physicians," said Thompson.
"It would be interesting to know if there were any differences in two-physician families vs one," she added.
Thompson aspires to limit the shared details of her work to commonplace descriptions of patients' occupations or good qualities. But sometimes, her home is a place to release tension. "Over 16 years in practice I have shared a couple of stressful, negative outcomes when I just needed to vent about it," she acknowledged.
After a patient with a mass on a CT scan was lost to follow-up, Thompson was deeply upset and she spoke to her children about it. "That stuck with me for months, and I had to talk about it at home because they could see I was obviously affected by it."
Thompson's colleagues who predicted her kids would surprise her were prescient, as the two grammar schoolers continue to pay fresh and inspiring attention to their mom.
As Thompson approaches her 12-month follow-up appointment and 1 year of being cancer free, Lydia coins a term for it: "cancer-versary."
And Sam lets Thompson read a year-old journal entry he wrote after her surgery. "4/26/16. (Log). Tuesday. Today I practiced my play instead of having English class. And…my Mom is cured of cancer! Today was good."
Her diagnosis and treatment have been transformed into a cause for celebration instead of one of "fear or dread," says Thompson.
"Bad news" is something all doctors have to deliver, she points out. Her cancer experience has instilled her belief in the importance of involving family, even young children, in medical matters.
"It also reminded me about how intuitive and resilient children can be. Out of the mouths of babes…you have ordained strength (Psalms 8:2)," writes Thompson.
In the end, Thompson sees her children's knowledge about her work — difficult as it can be at times — to be a good thing.
"Children are very intuitive and perceptive and are always picking up on the things we say and do in our everyday lives," she said. "I hope on some level that would help them process an illness that occurs, either in them, or in another family member, such as when my grandpa recently fell, broke his hip, then came down with a severe pneumonia and passed away in a matter of days."
Thompson's new essay serves as a preview of her forthcoming book, "Mirth is God's Medicine: Coping with a Cancer Diagnosis, As a Physician" (Joshua Tree Publishing, Chicago). The book will be available online at Barnes & Noble and Amazon, and at the Coffman Memorial Union bookstore at the University of Minnesota.
J Clin Oncol. Published online November 15, 2018. Full text
Follow Medscape's Nick Mulcahy on Twitter @MulcahyNick
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Cite this: Doctors' Kids Absorb a Lot - Medscape - Jan 01, 2019.