Betty's Bombshell: On Parenting, Illness And Disclosure

Warning: This piece contains spoilers from "The Milk and Honey Route" episode of "Mad Men."

On last Sunday’s episode of "Mad Men," Betty Draper Francis receives shocking news: she has terminal lung cancer. It is an unexpected twist in the series’ penultimate installment, and we watch Betty and husband Henry grapple with the information in different ways. Henry’s first instinct is to try to fix it, to find treatments and seek out connections that may be able to help them. Betty’s focus is on her children: How can she shield this information from them, and more poignantly, how should she tell them when it is time?

Despite marked differences in diagnoses and circumstances, Betty’s struggle with disclosure resonates with me. Before we became parents, my chronic illnesses figured prominently in the conversations my husband and I had, particularly concerning the physical realities of a high-risk pregnancy for someone with respiratory and autoimmune conditions. Our primary responsibility was making sure we gave our child every opportunity for a healthy start, and managing my illnesses, particularly primary ciliary dyskinesia (PCD), a rare genetic lung disease, was a key part of that.

Despite marked differences in diagnoses and circumstances, Betty’s struggle with disclosure resonates with me.

As we inched closer to my due date, our discussions branched out to include longer-term logistics, like making sure we had an appropriate support system in place for the times when I had illness flares, since this was an important facet of a stable, healthy childhood too.

The conversation we couldn’t predict then, and the one that matters the most now that our daughter is a little older, is this: how and when do you disclose chronic illness to children?

By its very definition, chronic illness is treatable but not curable, so my symptoms and interventions weren’t going to disappear once I became a mother. I didn’t want her to worry about me, but I also didn’t want to gloss over something that was an obvious presence in her daily life. We decided to take our cues from her, agreeing that whatever questions she asked we would answer honestly and simply.

For the most part, chronic illness has simply been just one part of our daily family dynamic. As an example, she has grown up with physical therapists coming to do chest physiotherapy (vigorous clapping of the lobes of my lungs) five days a week, and my physical therapists have become important people in her life. She’s picked up a pretty good technique, and sometimes she will sit behind me and give me her version of chest PT. She knows other people do not get chest PT, but it is all she has ever known, so it isn’t strange to her.

“Your cough is not something doctors can fix, is it?” our now-4-year-old asked me recently. We were stopped at a red light, and I had just finished coughing. It wasn’t a particularly long or painful spell; I likely would not have even noticed at all had she not commented on it.

Her question alone told me she knew the answer. She is into sorting and grouping these days: which friends like similar things, who has siblings and who doesn’t, which animals are nocturnal and which aren’t. She’s seen people she loves get sick, have surgeries, and improve, so already in her mind, natural categories exist between what can be cured and what cannot.

My daughter knows that even if she hears me cough or wheeze, I can still arrange play dates, take her to the park, and work at a job I enjoy -- I am not defined by symptoms or differences.

“Nope, it’s not. It’s just a part of who I am and it will always be there,” I said, and I realized that was exactly the conversation we needed to have. There was nothing scary, shameful, or stressful about it, and as we worked through her various follow up questions — will it get worse, how did I get it, etc. — I was grateful for the entrée her question had given me.

In "Mad Men," Betty is frank about her lack of interest in treatments and her desire for quality time, not quantity. She hands her teenage daughter a letter with matter-of-fact instructions for her hair and makeup at her funeral, and as a patient with terminal illness, she wants her legacy to be in having her children see the grace and strength in knowing how and when to let go.

Thankfully, I do not need to have the type of bombshell conversation she did, but it occurs to me that disclosing illness presents an opportunity that extends far beyond my particular health issues, a different legacy. My daughter knows that even if she hears me cough or wheeze, I can still arrange play dates, take her to the park, and work at a job I enjoy — I am not defined by symptoms or differences. Young children respond well to concrete examples of things, and this has given us a solid framework to talk with her about compassion, empathy, and how the things that make us different are, in the end, just one part of a larger whole.