Wednesday, February 26, 2014

I've just read an excellent book called In Sickness As In Health: Helping couples cope with the complexities of illness, by Barbara Kivowitz and Roanne Weisman.  I recommend it highly. It serves an an excellent reference to people who find they have to deal with the acute or chronic illness of one of the partners in a marriage or other close relationship.  Beyond exploring the three phases of such situations--crisis, balancing act, and regaining equilibrium--it offers thoughtful commentary about a lot of related issues. 

There was one that I found particularly perceptive.  You've been informed by your doctor that something bad has occurred, and s/he offers a prognosis for the illness and thereby implies what it is likely to mean for the physical or mental functionality of the patient.  As the partner, you take this to be true:

All their normal coping skills remain on planet Earth even as they have to immediately learn to breathe in this new atmosphere.  In this unhinged state, they naturally seek a powerful guide, and typically grant omniscient status to the doctor.

The doctor becomes the orientation point in this new and frightening universe.  Her words signify more than educated opinion; they become oracular.

It is not unusual, in the aftershock of diagnosis, for patients and their partners to either submit silently to the sentence or pummel the doctor with questions as they desparately seek loopholes through which they can squeeze their fading hopes.  The doctor remains the focal point. Her words at this delicate moment . . . can have fateful impact.

This a superb observation, and the authors quickly explain the fallacy.  The doctor, after all, is making judgments based on personal experience, observation, and general statistics about the illness--but cannot actually predict the course of your particular illness.  What the authors call a "healing doctor," though, will:

call on his own humility and acknowledge that while death or disability are possible, he can't write your next chapters or know the exact trajectory of your illiness.  Healing is being present and promoting hope while presenting the medical perspective, and, at the same time, acknowledging the patient's fears with compassion.

So, how ironic and telling that a book designed to help couples is also an advisory to doctors who serve for and care for those couples!  My advice is that this book should be read by physicians as well as those of us who might need it for our families.


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