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.