The child and death.

Olle Jane Z. Sahler, MD* 1. 2. *Professor, Department of Pediatrics, Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY. Three siblings, Debbie, age 13, Mark, age 7, and Heather, age 3, are brought to you by their father, John Morgan, 1 month after the death of their 35-year-old mother from ovarian cancer. Despite aggressive medical and surgical therapy that required multiple hospitalizations, Mrs. Morgan died 4 months after diagnosis. The children were told initially that their mother was “very sick from an infection.” About 2 weeks before her death, they were told that their mother had cancer and that she would be “going to heaven to be with God.” Immediately after the mother’s diagnosis, the children were sent to live with their paternal aunt in a town about 10 miles from their home. This allowed the father to continue working to maintain his medical insurance and still take care of his wife at home and at the hospital. The children were driven to and from school each day. They saw their mother every weekend during the first 2 months, but because of her altered appearance from chemotherapy and altered sensorium from brain metastases, they saw her after that only once, about 2 weeks before her death. At that time, she recognized them but was unable to converse coherently. Debbie was given the choice of attending her mother’s funeral, but because neither of her siblings was considered old enough to attend, she chose to stay with them at the home of a family friend. After the funeral, the children returned to their aunt’s home for a week while their father grieved, disposed of most of his wife’s belongings to various charities, and made arrangements for the children to be taken care of after school when they returned home. Now, 3 weeks after returning home, Debbie is sullen around the house, refuses to do extra chores, and wants to spend time …