A recent New York Times op-ed stated that personality traits and attitude have no bearing on illness or one's ability to recover. In that the writer, Richard Sloan, is a professor of behavioral medicine at Columbia University Medical Center and a published author on the subject, his superficial and unfocused argument was a surprise.
The article begins with a reference to Representative Gifford's husband describing her as a "fighter," and then immediately introduces the idea that this personality trait will not factor into her recovery. The belief is that the "incessant pressure to be positive imposes an enormous burden on patients whose course of treatment doesn't go as planned." He calls this burden of guilt over a supposed failure to have the right attitude towards one's illness "unconscionable." In my opinion, taking the "fighter" advantage away from a patient, whether perceived or otherwise, is equally unconscionable. However, to hold that opinion, one must believe that even perceiving an advantage because you are a fighter is an advantage.
Fifteen years ago, when I was diagnosed with high risk cancer and faced eight months of intense treatment to include surgery, outpatient chemo, radiation, and a bone marrow transplant, the terror involved was indescribable. In that situation, a patient needs considerably more than a guy in a white coat giving you the worst news (hopefully) that you will ever receive in your life. It is a time for serious inner searching to determine if you are brave and strong enough to face every aspect of the illness and its dramatic and profound effect on every aspect of your life. And to determine if you are convinced that significant change in your life can promote and nurture the healing process.
A close friend called and stated that, with no conscious understanding of why, she knew absolutely that I needed to read Dr. Bernie Siegel's New York Times number one bestseller, "Love, Medicine and Miracles." In retrospect, I consider that suggestion a miracle in itself. Bernie, as he likes to be called, saved me although he has told me dozens of times that I saved myself. His book is full of examples of what he calls "exceptional patients" who used their illness experience to give themselves permission to find their true, authentic selves and in so doing, creatively induced a type of self-healing. Intuitively I knew that my illness was a true and, in some ways, literal symbol of my past and Bernie's book was like a map to understanding that regaining my health was about overcoming, accepting and emerging from the darkness of my past. Even the very location of my huge tumor held profound significance in my story which, for the first time, I embraced. That doesn't mean, as his detractors sometimes suggest, that I felt the disease was my fault. On the contrary, it was an opportunity for self-discovery.
The NYT op-ed article continues, stating that cancer doesn't care "if we're good or bad, virtuous or vicious, compassionate or inconsiderate." Bernie's belief is that impacting one's own health and recovery is an active process, participating in the joy and privilege of living, not relying on pre-existing personality traits or the predicted outcome as described by the guy in the white coat. This active process can be triggered by a dire diagnosis and all types of people have the opportunity to participate when they find themselves in that situation. And often this very process can alter the outcome of disease.
The op-ed states that "we want good things to happen to good people and this desire blinds us to evidence to the contrary." Is it suggesting that we don't want good things to happen to bad people? That we don't want bad people to recover from disease? Certainly it cannot be implying that any of us who believe in the mind/body connection are simple minded enough to purport that "fighters" don't die and more passive patients don't survive. His example of the strong spirited Elizabeth Edwards who died anyway demeans a lifetime of strong spirited work that gave comfort and hope to thousands of people. She herself repeatedly denied death as a failure and chose instead to concentrate on living. It is unlikely that anyone familiar with her story would consider her death a failure but instead a shining example of a life beautifully spent on faith, love and forgiveness.
As for the science that the author believes is the only factor in disease outcome, consider Bernie's reference to multiple-personality patients who exhibit disease as one personality, such as diabetes, that is not present in other personalities. Or his example of a cigarette burn that is visible when one personality is in control that disappears when the new personality takes over. He also cites a study in England where a group of men were administered saline and told it was chemotherapy. Thirty percent lost their hair.
When I wrote a book about my own experience with the connection between emotional trauma and disease, a Mayo physician/researcher working in mind/body studies, Dr. Larry Bergstrom, was quoted as saying that my story is in keeping with his clinical experience and study. Seventy-five percent of his patients with fibromyalgia have a history of sexual abuse and he believes, as do so many others, that unresolved emotional "dis-ease" takes a toll on the immune system, leaving it vulnerable to illness.
Even Hippocrates hinted at this powerful connection when he said that he would rather know what sort of person has a disease than what sort of disease a person has. He also said that natural forces within us are the true healers of disease.
In summary, Bernie writes, "we've come to believe that the resolution of conflicts, the realization of the authentic self, spiritual awareness, and love release incredible energy that promotes the biochemistry of healing." It is enormously sad to me that others believe that science is the only way to measure the implications and outcome of disease feel it necessary to suggest that those who acknowledge the power of self-directed healing are somehow denigrating patients whose disease ends in death.
To call anyone's death a failure is reprehensible and insulting to all who suffer the fear and indignity of a life threatening disease. To find peace and joy in life, and even through illness, is healing but there is no cure for death. Death in the presence of that peace and joy is something we can accept and even embrace. In fact, dying in the presence of peace and joy is one of my greatest aspirations, no matter what the cause.