Through blogs and comments, patients and experts explore what it takes to find good health care and make the most of it.

Looking for Meaning in a Meaningless Diagnosis


article image
Follow us on Facebook

“That which doesn’t kill you makes you stronger.  If you tell yourself you feel fine, you will. Don’t cry over anything that can’t cry over you.  When life hands out lemons, squeeze out a smile.”

Translation:  Blah blah blah . . .

Here’s one I like better:  “Sometimes bad things happen to good people.” Period. End of story.As I’ve written here before, there is no Fair Fairy in life.

It is indeed tempting – and common – to spout trite platitudes designed to somehow make people feel better about those bad things with bumper-sticker pop-psych. But can platitudes really lend meaning to a life-altering health crisis?

Consider author Mark Dery‘s take on this question as he struggled to find some semblance of meaning in his profoundly traumatic diagnosis of a rare cancer,and then as he was “poisoned by the cure that felt as if it was killing me.”

Dery, the author of the book I Must Not Think Bad Thoughts, says he doesn’t buy axioms like God doesn’t give us more than we’re able to handle (and clearly this is just not true!) – or that his diagnosis is a meaningful life lesson that’s somehow going to make him into a better person. For example, he writes:

“Every patient has a personal answer. Mine is the existentialist’s koan: the answer is that there is no answer. My first impulse is to say that diseases are object lessons in the capriciousness of the cosmos – the unpredictability of life, its random unfairnesses.

“Our insistence that things must have meanings and morals impels us to turn our sickness into metaphor and narrative; to demand something deeper from it than purposeless pain.”

This existential search for meaning in illness is relentless in medicine, as authorBarbara Ehrenreich has observed, writing in The Guardian about her breast cancer diagnosis: (January 2, 1010)

“The first thing I discovered as I waded out into the relevant websites is that not everyone views the disease with horror and dread. Instead, the appropriate attitude is upbeat and even eagerly acquisitive.

“But, despite all the helpful information, the more fellow victims I discovered and read, the greater my sense of isolation grew. No one among the bloggers and book writers seemed to share my sense of outrage over the disease and the available treatments.

“In the mainstream of breast cancer culture, there is very little anger, no mention of possible environmental causes, and few comments about the fact that, in all but the more advanced, metastasized cases, it is the treatments, not the disease, that cause the immediate illness and pain.

“In fact, the overall tone is almost universally upbeat. The effect of all this positive thinking is to transform breast cancer into a rite of passage – not an injustice or a tragedy to rail against but a normal marker in the life cycle, like menopause or grandmotherhood.”

Ehrenreich quotes a woman who once wrote this to holistic health guru Deepak Chopra after her breast cancer had spread to her bones and lungs:

“Even though I follow the treatments, have come a long way in unburdening myself of toxic feelings, have forgiven everyone, changed my lifestyle to include meditation, prayer, proper diet, exercise, and supplements, the cancer keeps coming back.

“Am I missing a lesson here that it keeps reoccurring? I am positive I am going to beat it, yet it does get harder with each diagnosis to keep a positive attitude.”

And here’s Chopra’s insufferably glib response:

“As far as I can tell, you are doing all the right things to recover. You just have to continue doing them until the cancer is gone for good.

“I know it is discouraging to make great progress only to have it come back again, but sometimes cancer is simply very pernicious and requires the utmost diligence and persistence to eventually overcome it.”

EARTH TO DEEPAK (in the words of the astute Salon writer Mary Beth Williams):

“Telling people with cancer that they need to be strong and have a good attitude is insulting. Believe me, strong, optimistic people die every day.”

And such relentless emphasis on the need for unfailing positivity even in the face of severe illness – and even more debilitating treatments – can wreak havoc on an already anxious sick person with distressing symptoms, for whom a recurrence or decline in condition may feel like a personal failure instead of what it actually is, which is, often, just reality.

As Mark Dery suggests, in response to the eternal quest to find meaning in the meaningless:

“What those who’ve never spent a day in the hospital want to ask those of us who’ve been to the kingdom of the sick and back – or would want to ask, if it ever occurred to the average Baby Boomer that he may not die on his rollerblades or midway through the tasting menu – is:

“What did your trip to the night-side of life teach you? How did it change you? What does it mean to live with the knowledge that you might someday be snatched back into that underworld?

“All of which is to say: What’s the meaning of malady?”

Back in 1997, an Oregon study reported in the Journal of Acute and Critical Care did look at the meaning of illness for women with coronary heart disease. Researchers found that meaning actually evolved over time in a process they called seeking understanding. After the onset of symptoms, the women survivors in the study described three early responses:

1. denial
2. acknowledging
3. being scared

The women also described four additional themes that emerged afterobtaining medical attention:

4. naming the illness
5. seriousness of illness
6. comparing self with others
7. causality

Researchers concluded that a patient’s process of seeking understanding contributes to how health care professionals can assess the decision-making behaviours and lifestyle choices of women living with coronary heart disease.  Note that none of these imply that heart disease provides meaning to one’s life.

Sociologist Dr. Ariela Royer reminds her students at Indiana University that when a serious illness strikes, it becomes the central focus of our lives. Everything else in life by necessity becomes of secondary importance in our forced march of trying to ‘normalize’ life, to continue to live, to carry on, as much as possible the way we used to live before we became sick. In fact, she adds:

“It may be that some chronically ill people try even harder than so-called healthy people, both because of the threat the illness poses to their self-identity, and because of their sense of impending mortality.”

So imagine trying harder than healthy people need to try, and all the while trying as well to come up with the good news message that your diagnosis has just presented to you. 

This is what some call the “gift” of illness. As Barbara Ehrenreich describes this strange phenomenon, a serious illnesis often seen as “not a problem at all, not even an annoyance – it is a gift, deserving of the most heartfelt gratitude.”

I just don’t buy it.

I can, with practice and determination, learn to adjust, to cope, to manage, to function, to put one foot in front of the other in order to adapt to the “new normal” of living with ongoing cardiac issues every day, but please don’t tell me that having a heart attack was somehow a lovely gift-wrapped present that I must have needed to bring meaning into an otherwise meaningless existence.

That’s like asking me to believe that I had little meaning in life before 2008, and I know that this is simply untrue. None of us needs a life-altering diagnosis to convince us of that.

It seems Barbara Erhenreich shares my opinion. For example:

“One survivor writes in her book ‘The Gift Of Cancer: A Call To Awakening’ that cancer is your ticket to your real life.

“Cancer is your passport to the life you were truly meant to live.

“And if that is not enough to make you want to go out and get an injection of live cancer cells, she insists, ‘Cancer will lead you to God’.”

Don’t get me wrong. I am not saying that playing a “poor me” victim role ispreferable to all of that unfailing positivity. The reality is that we all have untapped resources of resiliency that may not be needed until events like a health crisis strike.

Authors Drs. Steven J. Wolin and Sybil Wolin describe something they callhealing resiliency in their book The Resilient Self, in which they claim that creativity and humour can help to “turn nothing into something and something into nothing” when facing adversity in life.

For some of us caught in the midst of adversity, the Wolins explain, even the thought of being resilient during such struggles can seem an impossibility:

“Sometimes it is easier to be a victim. And sympathy can feel sweet; talk of resilience can make some feel that no one is really appreciating exactly how much they have suffered.

“There is a whole industry that would turn you into a victim by having you dwell on the traumas in your life.

“In reality, you have considerable capacity for strength, although you might not be wholly aware of it.”

Finally, if you insist on seeking meaning in bumper-sticker platitudes, let’s heed the ultimate Buddhist reminder which is, simply:

“What is, is.”

Q:  Have you struggled to find meaning in a meaningless diagnosis?

More Blog Posts by Carolyn Thomas

author bio

Carolyn Thomas is a heart attack survivor and a 2008 graduate of the annual WomenHeart Science and Leadership Symposium at Mayo Clinic in Rochester, Minnesota. She was also named by “Our Bodies Ourselves” of Boston in 2009 as one of 20 inductees from seven countries acknowledged as “Women’s Health Heroes” for community activism in promoting women’s health. This post originally appeared on her Heart Sisters blog. She also writes at The Ethical Nag: Marketing Ethics for the Easily Swayed and you can follow her on Twitter @HeartSisters or @TheEthicalNag.

Tags for this article:
Heart Disease   Inside Healthcare   Find Good Health Care   Mental Health  

Comments on this post
Please note: CFAH reserves the right to moderate all comments posted to the Prepared Patient® Blog. Any inappropriate postings will be removed.

Carolyn Thomas says
June 25, 2013 at 1:28 PM

Thanks so much for including my Heart Sisters post here for your readers!