/ˈkäɡnədiv ˈdisənəns/
noun
- the state of having inconsistent thoughts, beliefs, or attitudes, especially as relating to behavioral decisions and attitude change.
Something I have been struggling with since I started to suspect that I had cancer is the conflict between my nurse brain and my normal human brain.
As I’ve mentioned before, I’ve been a nurse for a little while now and, among other things, this has resulted in me having a pretty seriously skewed perspective on what qualifies as being “sick”.
I’ve talked about this before (with people in real life, not here obviously); the categories of “sick” and “not-sick” are useful in pre-hospital, emergency triage and intensive care settings to get a very quick idea of how much you have to worry about a patient. Ideally you should make an initial determination about sick or not-sick within the first few seconds of seeing a patient. These are not categories with strict inclusion criteria or even any objective meaning at all. It’s a very quick, very cursory assessment and can absolutely change as you get more information (the “sicker-than-I-thought” category).
For me, “sick” has come to mean a patient that is very likely to die in the next minutes to hours if you’re not watching very closely and frequently intervening to block their exit from this mortal coil.
“Not-sick” is everyone else.
Not-sick doesn’t mean that there is nothing wrong with a patient, it just means that there is nothing wrong with them that is going to kill them in the next 12 hours.
Astute readers may have already started to get an idea of the difficulty that I’ve been having with my brain on this one.
According to my nurse brain I am not even remotely sick. If I, as a nurse, was presented with me, as a patient, I would wonder why my time was being wasted with this. Right now, by any objective measure, I am solidly not-sick. My vital signs are fine, my lab work has only some very minor abnormalities, and I’m not having any particular physical symptoms. In short, what am I getting all twisted up about? I should just shut the fuck up and get back to work.
Simultaneously, my normal human brain is saying “well if having cancer isn’t worth getting twisted up about, what is?” and continues to tell my sympathetic nervous system that there is a major crisis going on and I should be hyper-alert and jittery all the time.
As is often the case (but absolutely not always, which is a different discussion) the truth is somewhere in the middle. Knowing that, though, doesn’t really make either side of my brain any more willing to calm down and play nice.
I think maybe that the problem lies partially in that word; “sick” is thrown around with very little in the way of context or nuance with which to effectively asses the facts on the ground. “I can’t come in to work, I’m sick” can mean anything from “I have a fever of a hundred and three and have dialed 9-1- on my phone just in case” to “I’m nursing a brutal hangover” to “I’m just waaay too comfortable in bed right now to move” to “I’m currently being crushed by the weight of my own depression and unable to move.”
That’s why you medical-ish types have an entire vocabulary dedicated to describing the nature and severity of a patient’s condition. Maybe try to think of yourself in those terms. The patient has been diagnosed with a potentially virulent form of bladder cancer, but it was caught early and would appear to be under control. The patient’s treatment regimen has left him with residual fatigue but the extent of same is still being evaluated. Patient has expressed some anxiety about his condition, but nothing outside of the normal bounds for someone in this situation. Patient’s mood and outlook seem positive overall. His general level of health and physical fitness are above average. Recommend continued periodic observation to monitor both patient’s somatic and psychological/emotional condition. Some ice cream and a couple of furry pets wouldn’t hurt either.
His general level of health and physical fitness are above average
Have you MET me?
Oh sorry, did you lose a couple of limbs while I had my back turned? Face it: cancer aside, you are in pretty good shape, my man. Which I admit is a lot like saying, “Otherwise, how did you enjoy the play, Mrs. Lincoln?” But alas.