Taking On A Loved One’s Emotional Burden

crispydoc Uncategorized 5 Comments

Yesterday I watched a particularly moving film, The Farewell. [I hate spoilers, so nothing that follows is not already evident in the trailers.] The film follows the Americanized branch of a Chinese family through the eyes of a millennial granddaughter as she returns home for a final visit to the family matriarch who has been diagnosed with terminal cancer. Heavily influenced by the mainland Chinese relatives, the family has collectively decided not to reveal the diagnosis to the matriarch and insists on the millennial's reluctant cooperation.

The film goes beyond this single premise, and includes a nuanced exploration of the ambivalence inherent in sending your child out of your home country for superior educational opportunities while praying they remain unchanged enough from the experience abroad to want to return home, something many immigrant families will easily relate to. It's not hard to imagine the prospect of "losing" a child to the successful nation to which one entrusts their educational aspirations.

Returning to the main premise, the film beautifully explores the tensions inherent in American culture, where individual rights are paramount, and Chinese culture, where family and community rights often exert greater influence. The millennial Americanized daughter struggles deeply with the family deception, perceiving the lie as a paternalistic form of protection from the truth that would never pass muster in the U.S.

The moment that inspired this post came as I discussed the film with the person who watched it with me. She viewed it entirely as an exploration of cultural difference up until one of the traditional family members explained that the deception was not meant to hide the truth from the matriarch. To the contrary, the greatest respect and affection they could demonstrate was to take on the emotional burden of her diagnosis in order to spare her the suffering it might cause her. Seen in this light, their choice was a sacrifice motivated by love.

It brought to mind an experience I had as an exchange student in Argentina the summer before my 2nd year of medical school.  A professor arranged for me to join the primary care medical residents at the Sanatorio Otamendi in Buenos Aires, where I sat in on daily rounds for a month and shadowed residents and professors throughout the day.

The Otamendi is a well-regarded private hospital located a stone's throw from the large public Hospital San Telmo, and residents rotate through both facilities. The public hospital is a bit shabby and outdated, while the Otamendi had marble floors and chandeliers fit for a palace.

An introduction from the daughter of an Uruguayan pediatrician I'd volunteered with in San Francisco during my first year led to my quick acceptance by a crowd of peers my age. After a couple of weeks in town, one of my new friends asked if I might visit his aunt, a patient in the Otamendi, and convey his regards for a "speedy recovery."

I would eventually get accustomed to this odd request, friends and family asking me to visit hospitalized loved ones I did not know as an emissary of either their love or their influence (I can summon you a doctor on demand!). What was more unusual about my friend's request was the condition he attached: His aunt had terminal pancreatic cancer, and I must not, under any circumstances, inform her of her diagnosis - the news would devastate her.

Despite considerable discomfort at my complicity in his deception, I reluctantly agreed to stop by the aunt's room.

The following day, I found my way to the oncology wing of the hospital, where furnishings that would not look out of place at a Ritz Carleton (or so I imagine, having never been to one) surrounded a hospital bed. A diminutive but elegant woman received me warmly, kisses on both cheeks, as I relayed her nephew's love and concern.

It was an unexpectedly sweet visit with a charming older woman, and it was evident she was grateful for the company. In retrospect, she could not have been much older than the age I am now.

When the time came to leave, after cheek kisses and expressions of gratitude, her tone became suddenly serious. Of course I could not know this, since she had not shared the news with her nephew, but she was dying of pancreatic cancer. I must not, under any circumstances, inform her nephew of her diagnosis - the news would devastate him.

I promised I would not inform her nephew.

She resumed the smile of the gracious hostess she must have been outside those hospital walls.

I fulfilled my obligation to both parties.

Comments 5

  1. And therein lies the complexities of being human. That is why FIRE may work best for those without children and other familial responsibilities.

    When younger, even I could plan on a spreadsheet and come extremely close to my calculations. But with the advent of a bigger life than myself, I am certain spending shocks will come from those I care about.

    Isn’t that the beauty of life. You don’t get all the good without some of the bad.

    Thankfully that is also what makes life worth living.

    Damn it CD. You are a gifted writer.

    1. Post

      You are my proverbial wise lady atop the mountain, Dr. MB. The black swan financial events that upset our carefully planned SWR are likely to come from those we love. The reciprocal side to this is that our black swan happiness events – those moments that fill us up far out of proportion to any experience we could have planned for on our spreadsheets or even conceived of – come from these same sources.

      Or to recall imperfectly a line from the film adaptation of 6 Degrees Of Separation: “Chaos. Control. Chaos. Control. The Kandinsky’s painted on both sides!”

      Grateful for your kindness,


  2. So who was being protected by the deceit?

    I once had a friend, a senior cardiac surgeon ho was toward the end of his career. His wife was his nurse in his practice. He had abdominal surgery and needed hyperal. The hyperal was contaminated with some amino acids from Japan back in the late 80’s which caused pulmonary fibrosis via an autoimmune like mechanism. My friend wanted to know his real prognosis. I was a couple years out of training and had the underground telegraph to the young turks at places like Harvard. My one friend was very keyed in as a MD/PhD who had his own lab at Harvard, worked on the biochemistry of compliment, and was a pulmanologist. He checked the real skinny for me and basically uni-formally fatal. The guy’s immune system was turning his lung tissue into shoe leather. So I told my friend straight up. His wife freaked. The old YOU NEVER DESTROY HOPE rap emerged. This guy had some estranged kids in his life, and an approaching expiration date. He wanted to know the score so he could plan.

    Sounds like the lady in your story knew the score and made her plan.

    1. Post

      Sometimes the worst kept secrets are the ones we all think we must desperately keep. It was a weird fly on the wall experience, but versions of it continue to pop up as time passes.

  3. Ditto on the “gifted writer” comment.

    I always enjoy reading your posts. I’d encourage you to write a book at some point, CD. I don’t care what it’s about; I’m sure it’ll be gold.

    I have to see this movie too. The Farewell has a modest 99% fresh on Rottentomatoes!

    — TDD

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