Sunday, February 24, 2008

The Arrogance of Health

I always thought I'd live into my 70s and die from a neurological disease. The only serious illnesses in my recent family history have been ALS (Lou Gehrig's disease) and Parkinson's. The only cancer I thought I was at risk for would be skin cancer, due to my Scandinavian heritage. Any other cancer has just not figured into my life plans. I've known only a few people who had cancer, and like the average person I tended to withdraw when the subject came up -- too scary, too uncomfortable. I didn't know how to react or what to say.

A friend spent about six months in treatment for colon cancer when we were both in our 30s. He pulled through a very difficult series of operations and chemo, but I mostly ignored the situation. I visited him once in the hospital after part of his colon was removed. We never discussed his treatment in depth, let alone his feelings about the experience. I never really asked how I could help

My wife has a good friend from college who was gradually crippled from a rare form of ALS. She lost the muscle tone and then nerves in her appendages over a nearly ten-year period. An artist, she was reduced in the end to creating images on a computer by placing her inert hand on the mouse and shuffling her upper body around to move it so she could draw. She is the first person I'd known in my life who talked about her impending death, how it affected her, and what she wanted from others. Again, it was a very uncomfortable situation that I did not know how to react to in a meaningful way.

To borrow a phrase, I have been guilty of the arrogance of health* for most of my life. I was unable to empathize with others who had serious illnesses, except in superficial ways. I put out of my mind any thoughts about what it would be like to be in their position, and unconsciously prayed my gratitude that it wasn't me in the hospital bed. The healthy do not, as a rule, project their thinking into the situation of the critically ill. It may be a basic rule of survival -- don't think about illness, focus on health and happiness. But it is also a kind of arrogance because we assume that we'll stay healthy if we want to.

The few health problems I've had have generally been easy to understand. I could blame myself for being overweight if I ate too much and exercised too little. I could blame my Scandinavian ancestry for depression and blame my family for mono -- most of my siblings have had it. I could blame the mono and resulting fatigue for ongoing depression as well. There was always, it seemed, an explanation. But there's no reason I should have prostate cancer -- no family history, I eat well, exercise moderately, and have generally been healthy.

My diagnosis was a personal affront. I was healthy! I hadn't done anything to deserve this. I wanted to look for reasons, but there really are no reasons for most cancers unless you want to believe that God is out to get you. Or if you want to get really crazy, start believing that you deserved it because of personal weakness or some character fault. Or for extra credit, try buying into the alkaline diet theory. Once my friends and family heard about my diagnosis, all these theories and more came out of the woodwork. I was obviously holding on to too much anger, or ate too much animal protein, or had a vitamin D or selenium deficiency, or subconsciously I wanted this to happen. If you follow any of those theories for very long, you start to lose it. The truth is, cancer just happens. You can’t give it to yourself, and you can’t will it to go away. But people like those theories because it helps them believe that it’s possible to have control over something as out-of-control as cancer.

When you're healthy, you have respect for cancer patients. You admire them for their courage. You encourage them. You tell them they're doing great and you know they'll pull through it. You tell them to fight it. And you silently pray your thanks that it's not you. But only very, very rarely do you enter their world and try to understand what their experience is like. That's the arrogance of health.

*I first read this phrase in Marvin A. McMickle's book Battling Prostate Cancer: Getting from "Why Me" to "What Next" (Judson Press, 2004). The phrase has been used by others, judging from a quick Google search. I recommend this book, written by a pastor who offers some fine spiritual insights and some basic information about PCa.

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