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I, too, have a life-threatening illness. What if find interesting is
how I can spend most of my time not thinking about my prognosis. Is this
denial or wisdom? Calling it denial makes my relative comfort into a
pathological mental mechanism. Perhaps I should not complain about it.
Most of us prefer ignorance about how our sausage was made. I like to
think that I'm learning that the future and the past actually don't exist,
except as they affect the present; that I won’t live 6 months or 20 years,
but only today, and every today.
This need not encourage me to avoid reasonable planning about the
future, and pleasurable and informative recollections of the past, because
such activities are part of the present. When we go through training we
do so because of our future expectations about what we will do with our
training, yet, the training itself, especially in retrospect, is as
important and fulfilling as the future career.
Does my medical knowledge help or hinder? I am a psychiatrist, not a
cardiologist, and have had to learn much cardiology to understand my
illness (myocardial infarction, CABG, ventricular tachycardia) and its
treatment (many pills and an indwelling cardioconverter), but I find
myself uninterested in the technical details and I don’t rummage through
the literature to read about the risk-benefit ratios of various treatments
and of my estimated life-span. Again: denial or wise acceptance of the
inevitable?
I’ve learned during my long years of psychiatric practice to have
less concern about untangling the web of causality of symptoms and blind
spots, and more concern with marshalling intact skills. Do I encourage
ignorance? We, at best, understand very little anyhow. I consider most
important what we do with our limited knowledge.
Denial or Wisdom?
I, too, have a life-threatening illness. What if find interesting is
how I can spend most of my time not thinking about my prognosis. Is this
denial or wisdom? Calling it denial makes my relative comfort into a
pathological mental mechanism. Perhaps I should not complain about it.
Most of us prefer ignorance about how our sausage was made. I like to
think that I'm learning that the future and the past actually don't exist,
except as they affect the present; that I won’t live 6 months or 20 years,
but only today, and every today.
This need not encourage me to avoid reasonable planning about the
future, and pleasurable and informative recollections of the past, because
such activities are part of the present. When we go through training we
do so because of our future expectations about what we will do with our
training, yet, the training itself, especially in retrospect, is as
important and fulfilling as the future career.
Does my medical knowledge help or hinder? I am a psychiatrist, not a
cardiologist, and have had to learn much cardiology to understand my
illness (myocardial infarction, CABG, ventricular tachycardia) and its
treatment (many pills and an indwelling cardioconverter), but I find
myself uninterested in the technical details and I don’t rummage through
the literature to read about the risk-benefit ratios of various treatments
and of my estimated life-span. Again: denial or wise acceptance of the
inevitable?
I’ve learned during my long years of psychiatric practice to have
less concern about untangling the web of causality of symptoms and blind
spots, and more concern with marshalling intact skills. Do I encourage
ignorance? We, at best, understand very little anyhow. I consider most
important what we do with our limited knowledge.
Competing interests: No competing interests