Tuesday, October 2, 2012

Why do we do that?

Why do we do that?
Often the question presupposes a clear answer: we do that because...But not a long, drawn-out answer with sub-parts and conditionals.  However, though messy and not succinct, the real answer may well be just that twisted, complicated and extensive.

I read with interest Dr. Mehmet Oz's description in Time of his worry related to his own doctor finding a suspicious polyp in his intestine:

When it is about you, your mind races. Am I at fault? Could I have done something differently? What do I tell my children and wife? What if I actually get cancer? Have I done everything I set out to do in life? I am a physician who gives advice for a living. I have spent much of my professional life extolling the value of healthy eating and regular exercise, and I practice both. So how in the world did this happen to me?

The growth coming into focus indeed looked precancerous, but that was impossible! I have lived a pious life! I was feeling fear, yes, but also — irrationally — anger. LaPook coolly carved out the polyp and forwarded the specimen to pathology for rapid diagnosis.

The lentils in my intestines at my initial colonoscopy had partly obstructed LaPook's view, so he insisted on repeating the colonoscopy to look for potentially missed polyps. He gave me a three-month window, which is about standard in a case like this. Remarkably, I stalled. He called to remind me. I scheduled and then canceled. He sent periodic e-mails. I procrastinated. Once again, I was engaging in behaviors that had left me dumbfounded when my patients exhibited them. How could they be so casual with their health when there was real reason to worry about it?

Why in the world did he put off rescheduling the needed 2nd exam?

What we can grasp much more clearly — and what we dread much more immediately — is the world-jolting way a bad medical diagnosis will affect us today.

He wanted to avoid a BAD DIAGNOSIS!  It would complicate his life!  It would "frighten his family" (but not him, of course).  He realizes he wouldn't accept such an excuse from his own patients but in truth, it is the sort of thing people, including him, actually feel.

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