OUR BLOG: A MEDICAL HUMANIST'S NOTES

The Way We Were

January 22, 2018 at 4:24 pm · filed under communication, healthcare professionals, Patients

One of the things I’ve heard many patients speak about is how their diagnosis resulted in what felt like an identity crisis—it seemed to change “who they were” nearly instantly, and in a very fundamental way. Adrienne B., a nurse who became a patient put words to her experience when she said, “Every day you wake up and your whole sense of self has changed whether you want it to or not…you have to think of yourself as different.”

The Reverend Steven Spidell, a chaplain at M.D. Anderson Cancer Center (Houston, TX) and facilitator of the class “Healing Stories” notes:  In the process of becoming patients, people often lose their stories… With chaos and disruption, they begin to tell the doctor’s version of their story, the medical version, not their own. They get tunnel vision and forget who they were before. But people are fundamentally narrative based. They need to find meaning, make sense out of their disease.

Rev. Spidell says people are “narrative based.” I understand that to mean we make sense of who we are by telling stories about ourselves. That is until a doctor tells us “You have cancer,” and suddenly that story seems to overshadow all the ones we had before.

But I’ve learned that this new story can have positive effects, of course—Rich R, a patient in the video from the Difficult Conversations Workbook tells us, “No question you are gonna be in shock, depressed and so forth. And once the dust settles you have to say, ‘Okay now what do I want to do with the rest of my life?’ ”

This is a question that can prompt us to change our priorities: to take better care of ourselves, to take a trip we’ve been putting off, to quit a job we’ve always hated… On the other hand, it can also weigh heavily on us. We spent a lifetime creating an identity, figuring out what was meaningful to us, and just like that it got traded in for “Person With Cancer…”and nobody asked our permission!

Readers, I’d like to invite you to share your thoughts and experiences. Do you feel like your diagnosis replaced your old story of yourself? Or have you hung onto or adapted that story? Does your new story change the way you think of or make sense of who you are?

2 Comments »

  1. Yes, excellent insights, and I am reminded of Dr. Michael Stein’s book of a few years back, “The Lonely Patient,” which is very much about how people sense their identity post-diagnosis. I believe I met Michael at the Iowa conference around the time I met Celia and Bernie!

    Hurried doctors and protocols fail to take account of these tectonic shifts in our perceptions.

    Comment by Rachel Hadas — January 23, 2018 @ 6:23 pm

  2. Thank you for sharing The Way We Were. It is a very poignant, perceptive and accurate statement about the PATIENT (my husband) with cancer.
    I believe it might also be applicable to the partner/spouse/care giver.

    Comment by Vanda Warner — January 31, 2018 @ 3:08 pm

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