The following New York Times article delves into this a little bit more (the politics of illness). I think some people might consider work itself to be therapeutic.
Source: New York Times
Deval L. Patrick during his campaign for governor of Massachusetts last year with his wife, Diane.
March 25, 2007
Like the Edwardses, Some Use Work When They Must Fight Serious Illness
By JOHN LELAND and PAM BELLUCK
When John and Elizabeth Edwards learned on Wednesday that Mrs. Edwards’s breast cancer had returned, the presidential campaign, which often seems removed from daily life, suddenly mirrored reality for thousands of American families facing deadly illnesses. Mr. Edwards’s choice — whether to scale back a demanding career to be with his wife — is one faced throughout the nation.
Some people choose the path taken by Sandra Day O’Connor, who retired from the Supreme Court after her husband developed Alzheimer’s disease. Others, like Lee Iacocca, whose first wife died in 1984 from diabetes, maintain a demanding career during their spouse’s illness, but then become activists in the search for a cure.
Many spouses, like Mr. Edwards, decide to keep up their work life, for reasons that include practical necessity and their psychological well-being, or that of an ill partner. Faced with this difficult choice, some alter or curtail their careers, but many others say that work can be a ballast and a needed escape. And many doctors and therapists who deal with cancer patients and their families endorse this thinking.
“It was very important to me that he carry on his work,” said Joanne Gillis-Donovan of Philadelphia, recalling her reaction when she and her husband, Joseph Donovan, learned she had Stage 3 breast cancer, which doctors told her had a 20 percent rate of survival. “I needed us to carry on as normally as possible.”
Dr. Gillis-Donovan is the chief executive of Melmark, a nonprofit organization serving families with developmental disabilities. Mr. Donovan is an assistant vice president for communications at LaSalle University. Although Mr. Donovan accompanied her to doctor appointments, she said that if he had spent more time at home it would have felt like defeat: “It would mean I wasn’t able to survive by myself, that I needed him to survive. You hang on to still functioning normally, because it means you’ll function normally down the line.”
Twenty years later, with no recurrence of the cancer, she is following the news about John and Elizabeth Edwards. “I can see that it’s critical to her survival that he run,” Dr. Gillis-Donovan said. “That’s what they’re alive for. That will keep her alive.”
For many women with breast cancer, the last thing they need is a husband hovering over them, said Dr. Marisa Weiss, a breast cancer oncologist and the president and founder of the nonprofit breastcancer.org.
“The modern-day woman does not want pity,” she said. “They hate that. Most of the time the husbands don’t cut back. The woman remains in control, she’s in charge of the household, and if anyone tries to take that away, she would feel usurped, that he feels she’s incapable, and this makes her feel less independent.”
A 2006 survey of households affected by cancer, conducted by USA Today, the Henry J. Kaiser Family Foundation and the Harvard School of Public Health, asked if cancer had caused the patient or someone else in the household to lose or change a job, work fewer hours, or have a lower income. The vast majority of people, nearly 80 percent, said no. The survey had a margin of error of plus or minus 3.6 percentage points.
For many families, the decision whether to cut short a career is an issue of practicality. They do not want to disrupt the lives of their children. They need the income. And, most of all, they need the health insurance.
Hugh Panero, the chief executive of XM Satellite Radio in Washington, was preparing for his company’s public debut in 2001 when he and his wife, Mary Beth Durkin, learned she had leukemia.
“There really wasn’t an option. I needed to commit myself to my wife’s care and also to the birth of the company,” Mr. Panero said. “The reality is you have a job, and you have to do your job. You have medical insurance, and you can’t give that up.”
Other couples briefly stop working but then try to return to their career goals. Jack O’Connell, who runs California’s school system, was in the middle of a re-election campaign last April when his wife, Doree, was hospitalized with a cancerous brain tumor. She required immediate surgery, followed by chemotherapy and radiation therapy.
“There was no discussion,” said Mr. O’Connell, who describes himself as a workaholic. “I dropped everything for three weeks to be with her full time.” He had his staff find substitutes to appear for him at all his scheduled events, sometimes as many as three speeches in a day.
“It was just understood that I’d be there, and she’d be there for me,” he said.
But after three weeks, he said, both felt he should return to his work and campaign. Mrs. O’Connell used the public exposure to raise awareness of health issues.
Mr. O’Connell won re-election in June, and he said he was now considering a run for governor. Mrs. O’Connell’s cancer has not returned; if it does, he said, he does not know how it will affect his plans. “Taking care of her is first. But would that preclude me from running? We’ll have to see.”
There are no easy answers. “For both people the situation is fraught with anxiety and guilt,” said Dr. Irene Goldenberg, a family psychologist and author of several textbooks on family therapy. “Guilt for the sick person might be, ‘I kept you from the thing you would have been best at, because of my inadequacy.’ And that would be a terrible thing to live with. And for the other person it might be, ‘I wasn’t there when the chips were down.’ ”
Illness can generate public exposure for people who do not expect their private life to be in the spotlight.
“It felt almost like being on the front page,” said Dr. Lowell E. Schnipper, chief of hematology and oncology at Beth Israel Deaconness Medical Center in Boston, describing his experience when his wife, Hester Hill Schnipper, 58, battled breast cancer twice. Since Ms. Schnipper is the hospital’s chief oncological social worker, her illness was apparent to patients and physicians.
The pair did not curtail working, partly because they saw their colleagues as family. But the collision between Dr. Schnipper’s private and professional lives sometimes had an “Alice in Wonderland” quality.
“The patients are worrying about me,” he said. “I’m supposed to worry about them. There is an element of magical thinking that is associated with doctoring, even in this age of technology. If I can’t protect my wife from having breast cancer twice, somebody’s got to ask, ‘Well, what can he do for me?’ Their awareness of my troubles has to make their situation feel all the more real and in some sense more vulnerable.”
Even when patients think they would like their spouses to spend more time on their care, they often change their minds. “They find they feel more frightened, more disabled, when it happens,” said Dr. Susan Block, chief of psychosocial oncology and palliative care at the Dana-Farber Cancer Institute in Boston.
Studies find that breast cancer puts a particular kind of psychological squeeze on couples: the spousal relationship is critically important to quality of life, yet coping with the disease causes about as much distress for the husband as for the wife. Feelings of doubt and defeat delay decisions about what kind of life the couple will lead.
“And things can then change again in a few weeks or months, and what felt right at first now seems like the wrong decision,” Dr. Block said.
William Drummond, a professor of journalism at the University of California, Berkeley, went through several evolutions regarding his wife’s breast cancer. When his wife, Faith Fancher, a television news reporter in San Francisco, became ill, Mr. Drummond was also working as a freelance reporter. At first, he said, “the things I thought were really important — the next story I was going to do, the next trip — it didn’t mean a thing. I virtually stopped.”
The career interruption “never bothered me,” he said, until his wife died, five years later, and “I looked up and I was 60 years old and said, ‘Damn, what happened? All of these things I set aside, it’s kind of passed me by.’ ”
The new governor of Massachusetts, Deval L. Patrick, was nine weeks into his job when he announced on March 10 that his wife, Diane, 55, was being treated for exhaustion and depression. He scaled back his schedule on evenings and weekends but told reporters: “You are going to see me consistently perform my duties. I have a job to do.”
Women are still more likely than men to scale back careers for a sick spouse or parent, even when the loss of income is a hardship.
Andrea Jenkins, 31, an educator at Trinity Episcopal School in Austin, Tex., was in graduate school when her husband, Michael, 33, learned he had non-Hodgkin’s lymphoma.
“People think it’s going to impact Mike, and they don’t think about the spouse as much,” Ms. Jenkins said. “It actually impacted my job before it impacted his.”
Ms. Jenkins gave up her job as a full-time teacher to work part time in an instructional support position. Mr. Jenkins, the school’s interim principal, gave up his bid to become principal when he realized he needed a stem-cell transplant.
“The hardest part is being 30 years old and having to talk to your husband about dying,” Ms. Jenkins said. “And having it be a very real and possible scenario. I’m one of the biggest optimists, and I try to find the positives in everything.”
As she spoke, she was waiting for her husband to return from the hospital.
“He’s going to really struggle with rebuilding his entire career and who he is and where he’s going,” she said. “And mostly, we’re tired. We have a 2 1/2-year-old, and we’re tired.”
Reporting was contributed by Benedict Carey, Malcolm Gay, Brenda Goodman and Jeremy W. Peters.
Copyright 2007 The New York Times Company
