Anger is a common response to the diagnosis of life-threatening illness. It is nobody's fault that children are stricken with cancer. Since parents cannot direct their anger at the cancer, they target doctors, nurses, spouses, siblings, and sometimes even the ill child. Because anger directed at other people can be very destructive, it is necessary to devise ways to express the anger.

We were sent to the emergency room after my son's diagnosis with leukemia. After the inevitable delays, an IV was started and chest x-rays taken. I struggled to remain calm to help my son, but inside I was screaming NO NO NO. A resident patted me on the shoulder and said, "We'll check him out to make sure that everything is okay." I started to sob. She looked surprised and asked what was the matter. I said "He's not okay, and he won't be okay for a long time. He has cancer" I realized later that she was trying to comfort me, but I was very angry. Surprisingly, by the end of my son's hospitalization, we trusted and felt very close to that resident.

Expressing anger is normal and can be cathartic. Attempting to suppress this powerful emotion is usually not helpful. Some suggestions from parents for managing anger follow.

Anger at healthcare team:

• Try to improve communication with doctors.

• Discuss feelings with one of the nurses or nurse practitioners.

• Discuss feelings with social workers.

• Talk with parents of other ill children, either locally or by joining an on-line support group.

Anger at family:

• Exercise a little every day.

• Do yoga or relaxation exercises.

• Keep a journal or tape-record feelings.

• Cry in the shower or pound a pillow.

• Read other peoples stories about leukemia.

• Talk with parents of other ill children.

• Join or start a support group.

• Improve communication within family.

• Try individual or family counseling.

• Live one day (or sometimes one hour) at a time. Anger at God:

• Share your feelings with spouse or close friends.

• Discuss feelings with clergy or church members.

• Know that anger at God is normal.

• Give yourself time to heal.

It is important to remember that angry feelings are normal and expected. Discovering healthy ways to cope with anger is a vital tool for all parents.

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