SOFIA: Hey, Syd. You got a minute?
SYDNEY: Yeah, sure, mom. What's up?
SOFIA: I know you're busy getting ready for your move, but well, before you go.
SYDNEY: Mom? Is everything okay?
SOFIA: I'm sorry if I seem nervous. This is a really hard conversation to have.
SYDNEY: I don't, I don't even know what conversation we're having here. Like, should I be nervous too? What's going on?
COACH: “This is a really hard conversation to have” sends the message that Sydney should brace herself for bad news. Instead, you could stay positive by focusing on how this talk will help SYDNEY: like “I learned some things that could help you make decisions about your health.”
SOFIA: Okay, so, you know we've had people in our family who've had breast cancer. Your Aunt Nicole. My cousin, Jenny.
SYDNEY: And Grandpa.
SOFIA: That's right. Your Grandpa too. Remember, when he got diagnosed, we talked about how it's rare for a man to get breast cancer, and we wondered if, maybe, it runs in our family.
SYDNEY: Um, mom? Where are you going with this?
SOFIA: There are tests now that let us know what we're up against.
SYDNEY: (concerned) What we're up against? What's that mean?
SOFIA: That's what I'm trying to tell you. Your Grandpa's doctor gave him one of these, these genetic tests and found out that one of his genes is different. He was born with a mutation that probably caused his cancer. And I found out that I have that mutation too.
SYDNEY: Um, Mom.
COACH: Sydney reacted to the phrase “what we're up against.” That made the cancer risk sound scarier than it needs to. It can be more positive to stick to the facts, like “There are tests to find out if risk can be passed on.”
SYDNEY: Are you telling me you have cancer?
SOFIA: I don't have cancer. And Grandpa's still doing fine after his treatment. What we both have is a gene mutation that makes it more likely to get breast cancer and some other cancers, including, for me, ovarian cancer.
SOFIA: And since your genetics are half from me and half from your dad, you have a 50% chance of having this gene mutation, too. Does what I'm saying make sense?
SYDNEY: So, it's not that anyone has cancer now, but, (scared) I don't want to think about getting cancer. I just, don't.
SYDNEY'S THOUGHT: This isn't happening. This can't be happening. Not now.
SOFIA: No one's saying you're going to get cancer. (sighs) And I know neither of us wants to be having this talk right now, but it's important.
SYDNEY: I mean, I guess. Whatever. (sighs) What did we ever do to deserve something this bad?
SOFIA: It's nothing we did. It's just the way it happened.
SYDNEY: It just doesn't seem fair.
COACH: Saying you were “dumping” this news on Sydney didn't sound very positive. Sydney felt scared and discouraged. Instead, you could explain how this knowledge can help the family, like “This can help you make decisions that will help you stay healthy.”
SYDNEY: And, I mean, what?
SYDNEY: What about you, mom?
SOFIA: What d'you mean?
SYDNEY: This is a big deal for you too. What's, like what's going on with you?
SOFIA: Well, I'm going to have to make some big life decisions.
SYDNEY: (wary) Like, like what?
SOFIA: Well, the first thing I'll probably think about is preventative surgery.
SYDNEY: Oh. Oh, wow.
SOFIA: If you end up having the mutation, you won't have to make these decisions immediately, but you will want to start thinking about this stuff, even if it's scary.
COACH: Talking about “big life decisions” focuses on just the negative, scary aspects of knowing more about cancer risk. Instead, you could stay positive like “If anything happens, I'll be more prepared.”
SOFIA: You still okay to keep talking about this?
SYDNEY: (clearly distressed) I have a ton on my mind already and just (frustrated sigh) If we have to, let's do it. Say what you gotta say.
SOFIA: I know this is scary, but you need to stay strong.
SYDNEY: (quiet) But I'm not feeling very strong.
COACH: “I know this is scary” assumes that Sydney feels scared. She might not! And “you need to stay strong” sends the message that she should feel scared. Instead, you could ask how she's doing and then express empathy for her reaction.
SOFIA: This was tough news for me too, but I wasn't going to let fear control me.
COACH: You started off strong with “This was tough news for me, too.” That showed empathy for Sydney's reaction. But saying “but I didn't let fear control me” told Sydney you thought she wasn't reacting the right way.
SOFIA: That's, that's good, mom.
SOFIA: I want you to be strong, Syd. That's how we've always dealt with things in this family: head on.
SYDNEY: Well, that explains the headaches anyway.
SOFIA: I'm being serious.
SYDNEY: Me too. That may be how you've always dealt with things, but I'm, (sighs) I get that you're worried about me, but you don't get to tell me how to deal with it. (sighs, calms slightly) Y'know?
SOFIA: Yeah, yeah. I get it.
SYDNEY: This mutation you're talking about, it's the one they talk about on TV, right? People who have it get pretty extreme surgeries.
SOFIA: There are some surgical options that can lower my chances of getting cancer, yes. There are a number of surgeries people can consider, and they can choose to get one, some, or none.