The Irish Medical Times - The White Lies that Surround Our Health
I am in New York at the moment, this morning I grabbed a coffee and walked to the statuesque public library on 5th Avenue for a moment’s solitude to write this article. I have interacted with a smattering of people at this early hour yet I have already deployed an arsenal of white lies.
“That’s no problem” when I was given the slightly wrong coffee order by a stressed out barista. “Excuse me” when the large sweaty man with an awkward gait banged into me on the street. “Thank you” to the elderly security guard who did absolutely nothing but stand in my way. And so on.
If I was not prepared to use these communication bridges I might have shouted my way through Midtown (like a normal New Yorker). If we all did this we’d be descending into civil unrest every other Tuesday. I appreciate New York may be a bad example, a place where being blunt is a way of life and society functions just fine - I once heard it described quite neatly “New York is less of a melting pot and more like a nuclear reactor!”
There is a beauty in New York's honesty, although I don’t think it's something we should teach in schools. We are not responsible for every other human being we encounter, but if we can acknowledge that all may not be as it seems, and factor that into our interactions, it might make everyone’s life a little better.
Let’s go easy on eachother.
A Robin Williams quote I am quite fond of captures it very well.
“Everyone you meet is fighting a battle you know nothing about. Be Kind. Always.”
Perhaps we barter in white lies, even with ourselves, to ensure society keeps functioning. In fact, studies have shown that most people tell each other a minimum of ten lies within the first three minutes of meeting. Females have a tendency to tell lies that will make the other person feel good e.g. “You look amazing!”. Males are more prone to tell lies that make themselves look better e.g. “I’m doing great!”
If white lies form the basis of our bonding rituals then it's not surprising that frustrating misconceptions surround our health.
For example - If you look ok, you are ok.
When a person who looks ok tells someone they are seriously ill, it is often met with silence and a slow eyebrow raise. As humans, we seem to find it very hard to reconcile what we see with what we perceive the illness should look like. I think this is a more common experience now that people are detecting things like cancers or heart disease in their early stages, and living longer, more fulfilling lives due to advances in treatment (or indeed alternative treatments).
As a patient it can be frustrating when an onlooker assumes that because you look ok with cancer/heart failure/insert disease of choice, you ARE ok. The patient can feel well for long periods and surprise even themselves with their capabilities, but unless they are slurping an elixir from the holy grail with their breakfast, it is highly likely they will have a list of symptoms and deficits that they are managing (almost too) well.
On the up side, looking well and being treated as such is of course largely a great blessing. Telling someone they look great, especially if they are struggling, is a lovely gesture in my opinion.
It’s not just the onlookers that forget the person is quietly battling an unforgiving aggressor, the patient themselves can buy into the hype they see in the mirror and over extend their abilities leading to flare ups, setbacks and disappointment.
Aside from common-or-garden Joe Public that dismisses your dewy face as dripping with health, doctors are also susceptible to bias. There are even modules now in medical schools to teach strategies on how to mitigate bias during patient interactions. However, they largely focus on race, gender, socioeconomic status and sexual orientation. Perhaps there is a need for another focus, patients with invisible disabilities.
I’ll say it again - Just because we look ok, doesn’t mean we are ok.
Alas, we are all susceptible to the illusion of wellness and capability - including doctors.
Perhaps most sadly, the myth that you are ok because you look ok is particularly pervasive in the realm of mental health. An individual could be on the Olympic squad, smiling out from cereal boxes as the epitome of peak condition, but be collapsing on the inside.
While I’m in New York and imbued with radical candour, here are other patient myths I’d like to bust:
You have no visitors, you must be lonely (we might be delighted to have a minutes peace)
It’s great you’re in a hospital and you get to lie down in bed, I’d love that, a lovely rest (if we are in a hospital bed, we are sick, it is unfortunately not just one big lovely nap)
You have low blood pressure, you are lucky (are we? Up to 30% of falls in the elderly are due to low pressure)
There are many more medical misconceptions and myths I could lay bare, but here’s one that we all fall for - “If you have any questions or need to get in touch, just ring the nurses/ward/secretary”.
For some, contacting your doctor is easy. For many, unless there is someone expecting your call, sitting by the phone with bated breath, it’s almost impossible to ‘get in touch’. At times it can feel like the doctor has disappeared into the witness protection programme or hired the pontifical Swiss Guards to screen their calls. ‘Get in touch’ sounds really casual, like they are your best mate and you’d just pop them a Whatsapp and they’d drop their scalpel into someone’s open chest cavity and come straight over to your house pulling an MRI machine behind them.
It might be more accurate for those elusive physicians if they said “If you have any questions ring seventeen times, send numerous emails, speak to a round robin of nurses who don’t know who you are, get your GP to write to me, contact your local TD, present at the ED, see if your sister’s old college friend remembers a nurse who worked with me once twenty years ago, and then save it all up for your next appointment which will run three hours behind schedule. Whatever you do, don’t sit at home worrying, you know where I am.”
While white lies might grease the wheels of social interaction, they can also obscure the realities of chronic illness. Appearances can be deceiving, we all wear masks, some more convincingly than others. The next time you encounter someone who seems perfectly fine on the surface, try to extend to them some grace and a little less judgment - and also apply that logic generously to yourself.
Comments
Post a Comment