The New York Times published an article titled "When Thumbs Up Is No Comfort" and the health blog asked a simple question - “What do you think? Is upbeat and positive the best way to cope with cancer? Or does unvarnished optimism deny us the opportunity to confront our real fears?”
As we say in medicine, the answer is it depends. Taking a completely different example, years ago and even today, it is considered by society that a woman giving birth should be the happiest day of her life. New moms and dads should be absolutely thrilled about having a baby. It seemed that all new parents needed to smile, say how grateful they were, and repeat the mantra on how overjoyed and happy they were for the blessed event.
Certainly, having children is a precious event and most of us would never give them up. However, the societal pressure that parents should be ecstatic buried for years a more complex discussion of post-partum depression and the challenges and stressors of being parents. If one asked for help or appeared not to cope well with this monumental change then it seemed like there was something wrong with the person. Consequently they became even more alone. It hasn’t been until recently that people are more open about how difficult (and rewarding) it is to be a parent.
So for cancer, public figures, by their nature and profession need to be upbeat. For the rest of us, it is okay to be scared, frightened, and far from stoic. We all have public faces and private faces. We must reveal those private moments with our doctors, our partners, in this challenge. The right treatment for you is what you, the patient, are comfortable with. Find a doctor that listens to you and your needs and supports you and protects you from others, who cannot truly understand your experience, although they mean well.
What patients often don’t realize, but experienced and wise doctors do, is that “fighting” cancer and “not fighting” cancer provides different outcomes and one choice is not necessarily better than the other. Some patients value quality of life over weeks and months of chemotherapy and radiation and their related problems. Others prefer the latter hoping for more time later on.
As someone who had family members diagnosed with cancer, it is extremely stressful, hard, scary, and frightening for all involved. By understanding this, it has made me a far better doctor as I will routinely tell patients that it is okay to be in shock, unsure, and terrified when diagnosed with a serious illness.
What I think people fear the most is if we, doctors, family, and friends, somehow think less of them if they display these emotions. As a doctor, I reassure them that I will always be there for them on good days and bad days. In the end, isn’t that what we all want?