While various groups of people hold differing beliefs, I believe that all health insurance companies should cover the cost of psychological and psychiatric care of the family members of cancer patients. Cancer has been an all too prevalent topic in my life, and I have seen first hand the effects that it can have on the sons, daughters, wives, husbands, sisters, and brothers of the patient. It hurts my heart to see how people have so drastically changed their life goals and beliefs due to their experiences with cancer; I believe that if they had had some sort of professional counseling that was covered by insurance, their beliefs would not have been so negatively influenced by cancer. Doctors, nurses, family members, and patients are only some of the people influenced by cancer, and while they are all affected in similar ways, they are also affected in very different ways. The personal ways in which they have been affected by cancer often explain what they believe regarding the emotional care of family members.
The dictionary definition of a son is quite simple: a male child or person in relation to his parents. However a son is so much more than that. Most men hold the belief that a son should assist and protect the family in the absence of his father. This belief quickly becomes overwhelming with the great possibility that a son will have to soon fulfill the shoes of his father in the face of cancer.
As a young boy, a close friend was faced with any child’s worst nightmare: his dad’s diagnosis of prostate cancer. Although at the tender age of six, the naivety that came with Henry’s age protected him from knowing how devastating cancer truly is. It was not until four years later when his mom was diagnosed with breast cancer that Henry was able to more fully realize what it meant to have cancer. As if having both his mother and father diagnosed with one of the deadliest diseases before he was a teenager was not enough, three years later, his mother was diagnosed for the second time with breast cancer. By the third diagnosis, Henry was fully aware of how precious life and family are. He agreed with this mentality of sons protecting their families upon saying, “I also grew to feel like I was the one that had to protect my family from anything bad.”
Throughout this progression of illness in his family, Henry had to find ways to occupy his mind and cope with his fear. He once told me, “With my mom, I remember the only thing I could do was try to distract myself. Sports were a major influence. As well as weightlifting. I thought I had to try to be strong because I knew I had to support my mother.” This mentality of the son providing strength and support to the family inhabited Henry’s everyday life. To this day, Henry spends many hours each day at the gym and playing multiple sports, which serve not only as ways of expelling his emotions, but also exemplifies the ways in which he believes he has to step in as another strong, supporting male figure.
One of the most difficult things that Henry, along with any other youth, had to deal with was uncertainty. “I never knew if my parents were ever being straight up with me because they wanted to protect my sister and I from the truth. I never knew if she was never going to wake up after her naps from chemo or if she would make it through the surgeries. It was not until later in high school that I found out, she was really not supposed to live.” Cancer itself is a very uncertain disease. It breaks my heart to see how deeply Henry’s parents’ battles with cancer affected his life at such a young age; however, the emotional and physical strength that his experiences instilled in him at such a young age is something to be immensely admired and respected.
Like sons, the dictionary definition of a daughter is quite simple: a female child or person in relation to her parents. When a parent is diagnosed with cancer, daughters often feel just as much pressure to support their family as sons do, although in a different form. Daughters feel the emotional stress that diseases, such as cancer, bring much more openly. I do not mean to stereotype; but it is merely fact that females express their feelings of fear, anger, and sadness much more freely than males do. As the females express their feelings and emotions, the rest of the family feels the need to support them. Daughters also play an integral role in providing support for the patient. Often they are able to connect better because they are more in touch with their deeper longer to please their parents.
Pieter was a very close family friend who was like a second father to me. He battled against cancer for six years. Throughout his journey, his three daughters, Jamie, Sharyn, and Ali, were his constant supply of support and happiness. Pieter was by far one of the funniest people I have met and his humor coupled with his daughters’ encouragement were the main things that kept him fighting in the darkest hours. His daughters always brought a smile to his face in a way that no one else seemed to be able to. The joy Pieter felt when his girls came to spend time with him was so deeply rooted in his love for his family. His daughters showed him in a way that is difficult to explain in words, that he had raised them to be strong, compassionate, successful women. Seeing this in his daughters gave Pieter the confidence that they would all be able to take care of each other once he was gone.
It has now been just more than two years after Pieter’s passing and his daughters are all doing so incredibly well, honoring their dad in everything they do. They constantly support each other and their mother, Cheryll, while raising their own young daughters in the same way that Pieter raised them.
Most doctors and nurses get into the medical field because they are inspired by family members. Sharyn Boissevain was no exception. She was not a nurse before her father, Pieter, got sick. She was in school and thought that she wanted to get into women’s health and labor and delivery nursing. After taking a couple classes in school that were about cancer and cancer treatment, she started getting really interested in oncology. At the same time, Sharyn felt nervous about stepping into an area that was so close to home for her. Talking to various professors and counselors about her dilemma reassured her when they told her that many health care professionals get into oncology because of a family member or friend who had been diagnosed.
In nursing school, Sharyn took a job as a nursing assistant on a bone marrow transplant unit. This was one of the first times that she realized oncology was the right career path for her. Sharyn once told me, “I felt so connected with the patients and I just wanted to learn as much as I could about how to care for this group of patients. I think it was partly because, for whatever reason, oncology was just a good fit for me, but I think I was still just wanting to learn what my dad was up against.” After realizing what her father as well as her family was going to face for the next few years, Sharyn was ready to take her first job as a nurse at UCSF.
Day in and day out, Sharyn spent her time with cancer patients, just like her own father, comforting them and caring for them. As time went on, she realized how valuable her job was in her personal life because of her own connections to cancer. However, there were definitely positive and negative aspects of being in the oncology field. In times of question regarding her father’s illness , Sharyn had many answers, yet sometimes knowing the answers made it more difficult: “My knowledge and nursing skills really helped my parents when they had a question or if my dad needed help with his medications or his port, etc. I could help my parents advocate for my dad's treatment in ways that other people dealing with cancer cannot do. But then it was also hard because it was almost like I knew too much. I've seen many success stories on my unit, but also many sad cases as well.” It was a continual struggle for Sharyn to try to balance her professional and personal life, yet she did an amazing job at supporting her patients while simultaneously supporting her family.
Now, two years after Pieter’s passing, Sharyn, as well as myself, still struggles with the fact that cancer took the life of such an amazing, genuine man and father. Sharyn once said: “Sometimes it's hard to put into words about how I feel about my dad and the fact that he was diagnosed with a cancer that ultimately took his life. I still look for him, hoping, thinking that he will still be coming back. That fact that he is gone just feels so final and it's really hard to put my head around it still.” When she says this, she is not only speaking for herself, but for me as well. I know how difficult it has been for her as a nurse, interacting with people just like her father every day. I have so much respect and admiration for Sharyn and all of the strength that she has had throughout the past eight years. I look up to her as a sister, a nurse, and an amazing daughter.
While nurses are essential people in the treatment of cancer patients, caretakers also play very key roles in the treatment and are often overlooked. Attention and thanks are given to caregivers; however, their needs throughout the journey are not always understood or met. These people are often the main decision makers when a patient becomes too ill to decide for him or herself the proper plan of action for treatment. They are expected to provide concrete care-giving, meet financial and social costs, maintain stability in the patient’s life while simultaneously maintaining stability in their own life, and acclimate to the constant changes that arise. All of these responsibilities accumulate over time, placing physical as well as emotional burdens on them that soon interfere with their day-to-day lives. There are many options as to how to deal with these burdens. Some of the most common of these problems are depression and sleeplessness and cannot be resolved by simply time alone. A comprehensive support system, consisting of therapists, psychologists, and psychiatrists and various other ways of physically expressing one’s pent-up feelings, for caregivers and family members is desperately needed if they intend to be able to continue taking care of themselves and the patient.
Caregivers and nurses go through so many emotional states throughout the course of a day caring for a cancer patient; however, they are not the only people riding the sinusoidal curve of cancer. While I can only imagine what it must be like to be an oncologist, facing death everyday, I imagine that it must be a very stressful and emotional job. Facing real people with real lives, friends, and family, and telling them that they are facing a death sentence disguised by the label of “cancer” is not an easy task. Not only do oncologists work with and get to know their patients, but they also get to know the families of patients. The doctors know what the patients go through in terms of chemo and various treatments and have ways to medically support and heal them. However, oncologists do not have the tools or abilities to treat the family members of the patients who are going through just as much, emotionally, as the patient. Often times the sons, daughters, fathers, mothers, husbands, wives, brothers, and sisters go through so much more emotional damage than one may realize. Doctors know the effects that stress and emotional anxiety have on people, especially when they are sick and undergoing more strenuous medical treatment for cancer. Cancer patients often worry about their family member’s emotional state, bringing more stress to themselves. Any supportive, caring doctor would want the best for not only their patients, but for the family members of their patients. The emotional state of the people closest to the patient have a profound effect on how well patients respond to treatments; thus any good doctor would be in favor of having psychological services for family members covered by all insurance companies.
Finally, one must consider the state of the actual cancer patient. Patients go through an immense amount of physical and emotional damage without having to worry about how their family is coping. Cherie, a cancer patient herself, has expressed her own worry about how her friends and family are handling her disease: "I have stage four colorectal cancer with liver mets. This is a strange journey, one I am not entirely sure I can share with my loved ones. I am scared it might rob them of the hope I see in their eyes. The hope which I sometimes don't believe in." These sentiments that she is sharing are shared by almost all cancer patients at some point along their journey. Patients understand the strength it takes to go through chemo and radiation and surgery after surgery; yet they also understand the amount of strength required by others to support them throughout all of it. It is impossible to encompass enough strength to sustain both yourself and your family members when traveling down the heart-wrenching road that cancer leads to. Patients like Cherie do not need the excess stress that is put on them by worrying about how their family is holding up. Sometimes it simply becomes too hard for even the closest family members to bear the burden of support all alone. Patients already know how difficult it is to hold their own emotional composure; some days they simply cannot and they let their emotional front break down. When this happens they have family and therapists to lean on. They get how tough it is. Leroy Sievers, a man who lost his battle with cancer two years ago, emphasized this point: “Not talking about it and keeping it all inside — or at least a lot of it — can make you pretty lonely.” When cancer patients recognize this breakdown happening to their family members, the patients can’t help but want the best for those who are caring for them.
For many people, opening up about their feelings is a very intimidating and scary thought. An even scarier thought is opening up about an illness as devastating as cancer. While it is a healthy practice for family members of cancer patients to talk about their feelings and worries, it can sometimes be interpreted as showing signs of weakness. This vulnerability is very necessary to ease the emotional pain of journeying through cancer, yet it is very difficult to acknowledge and accept the challenge to talk about the emotional struggles. For this reason, some family members might be greatly opposed to the coverage of psychological services for families. If the services were openly available and they did not have to pay for them, there would be no excuse to book an appointment or two with a psychologist to relieve their worries. Because not all insurance companies cover these services, many families will use this as an excuse for not opening up and allowing themselves to receive help along the way. Families should know that talking to a professional about their own emotional and mental state is a sign of strength and responsibility, not weakness.
Last but not least, health insurance companies are yet another entity affected by cancer. In today’s economy and health insurance situation, they are not always the nicest institutions to deal with. They have become too caught up in numerous political and capitalistic issues that ultimately take away from their original purpose of insuring that all humans receive proper services to keep them healthy and well. The world market today has become so capitalistic and filled with greed that insurance companies will do nearly anything to guarantee profit. Often times gaining profit takes precedence over patients’ overall health and well being. While this is very corrupt, it is the harsh reality that is quickly setting in. If all health insurance companies were forced to cover psychological issues of direct family members of cancer patients, most companies would rebut. If only the policy makers behind the big names of health insurance companies could let their guard down, take a look inside themselves, and reflect upon how cancer has affected their own lives, the health insurance world would be a much more supportive place.
With the incredible number of people affected by cancer emotionally, physically, mentally, and psychologically, it seems simple that everyone should be on the same page regarding the psychological support that family members receive. Unfortunately, with so many different types of people, motives, personalities, experiences, and coping mechanisms, there is no universal support system that can be set in motion for those people affected by cancer. Until this universal system is found, the best we can do is reflect back upon our own experiences with this ugly disease to remember how we felt during the darkest most desolate hours. From this introspection, we can provide a strong support base for the family and friends in our lives going through their own emotional struggles with cancer.
