Life, death, and doctors

I've been mulling over a recent project in which we interviewed people who are mainly old, and mainly very, very sick. As a fifty+ American, I have the usual anxieties over inevitable age-related illness and my no-doubt completely inadequate insurance coverage. So I'm hardly an objective observer!

Beyond sickness itself and the financial hell it entails, I'm concerned about the time when I will rely more on doctors than I do today. I've never gotten along very well with doctors, who seem to operate more like faith-healers than scientists much of the time. I know it's not their fault; diagnosis is frequently a guessing-game and if anything, all those expensive new diagnostic tests make the guessing more complicated. Unfortunately, knowing that doesn't help me to feel like a competent consumer of medical care; quite the opposite--I feel helpless and suspect that my wallet is being exploited.

Given my personal issues around health care, it was extraordinary to sit behind the mirror and watch a parade of very sick people talk about their medical care. These are folks with mutiple conditions which, in the words of one of them, are going to "get me", sooner rather than later. Most had already encountered Mr. D in the course of prior heart attacks or strokes.

I observed two very different attitudinal groups. (Bear in mind that this is not a quantitative result, just an observation, as most of these blog posts will be.) One group tended to display a faint little smile, sit back in the chair, talk matter-of-factly about symptoms and outcomes, and speak of their doctors with faith. Why didn't they have all the facts about their condition? "My doctor tries to protect me." Why didn't they even know the name of their condition? "Probably he/she said it, but I don't remember." Are they curious about new treatments? "If my doctor thinks I need it he/she will tell me."

The other (a minority) were the angry ones. They sat up straight and did not smile. They wanted to believe they could be cured, but they didn't trust anyone's help very much. So they focus on all of the things they can control, from healthy behaviors to internet searches. When they saw the information we had for them, they asked the key question: "Why didn't my doctor tell me this!!??" (I have to admit I felt a little sorry for the doctors when these respondents left the room.)

Probably--actually, almost definitely--the angry patient receives and will continue to receive better care than the accepting group. That's because they act like consumers of health care, not parishioners in the Temple of Health. They expect and demand clear, accurate information, and that helps them to make better lifestyle decisions as well as treatment decisions. This is the group I identify with.

But which group would I rather belong to? If it came down to a complete breakdown of my health--the accepting patients. For one thing, they are completely right. Probably their doctor is trying to protect them from information that will only make them anxious. Probably their doctor would tell them about any treatments that could really help them, with help defined a little more loosely. Their diseases are going to "get" them, sooner rather than later, no matter what treatment they receive. So "help" doesn't just mean treatment, it means acceptance; being emotionally and physically comfortable enough to enjoy the time you have left.

All of this leaves me with a question about life, appropriate to my middle-aged lifestage and anxiety-prone character: wouldn't it be better to learn to let go a little? To accept that death is part of the narrative that is Me? That it shouldn't in any way prevent me from enjoying the wonders of the universe I've been born into? Would I want to spend my waning days fighting with doctors? Really? Because there are much better things to do with my limited time.

Anger inspires you to work on problems. Acceptance can let you live well despite problems. There is a season for each of them; I hope that somewhere along the way I gain the wisdom to know when the seasons turn.

What's Important?

As an advertising strategist, I have a strange window on humanity--the two-way mirror of the focus group room. I sit on one side, in the dark. On the other side, people of all types, ages, sexes, sizes talk about ads and products. We ask whether the photo of the middle aged woman in this ad is "relevant". Or if the brochure we are planning to write is hefty enough to be "important". Thanks to trends and fashions, all of this learning is about as eternal and profound as dust in the wind.


Yet after twenty years lurking in the darkened back room, combing through surveys and dissecting research reports, it has finally occurred to me that I was searching for something that actually matters. No matter what I am researching, as a strategist I always want to understand what's important to people. And that's a profound question.


If you watch people's faces as they react and discuss ads (eew! yessss! *yawn*), you soon realize that people bring their full humanity to every decision, no matter how concrete or obvious their reasons are on the surface. Nonetheless, experts in advertising psychology have distilled the rich spectrum of human motivations down to short lists that include things like sex, self-esteem, self-preservation, and greed. Did I mention sex?


Maybe this is basically true, but it's also hopelessly reductionist. (It's easy to boil the soup until there's nothing but brown goop left, too, but you won't learn much about soup that way.) And from my personal point of view, it's sadly dismissive of the actual lives and concerns of all of the individual human beings I've been watching through the mirror all these years. What if you or I were on the other side of the mirror? Would we want our voices to be heard as the grunts and screeches of primitive impulse?


I've watched young people talk about buying their first car and though self-esteem was obviously a big part of that experience, so was everything from childhood memories to their dreams of having children of their own. I've watched older people in the last stages of crippling illness talk about how they manage their conditions and though they certainly still care about self-preservation, they could also teach every one of us about endurance, dignity, and humor.


So this blog isn't about the useful reductions and formulations common in my industry. It's about what I've actually learned about people throughout the years. It isn't scientific, because I am not a scientist. Call it a diary of revelations granted to me by my fellow beings; my personal antidote to the cynicism of the marketplace.