Recently I read an article in the NY times by H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for health, entitled If You Feel O.K., Maybe You Are O.K. The basic premise was that the once popular movement for early medical diagnosis may be waning in its acceptance, and for good reason.
The explosion of overdiagnosis that leads to overtreatment no longer surprises us, and the answer to the question of how proactive we need to be in our own healthcare is neither sure nor simple. But it’s not hard to find people we know of any age who wouldn’t be alive today without the early medical detection and intervention they got. Nor is it impossible to find ones who would have been better off without it. Professor Welch’s article concludes with a call to put the horse before the cart. He wants us to take care of ourselves first before we ask someone else to do it for us. That makes intuitive sense I’ll admit, yet how do we deal with those who do take care and still get into trouble? “Doctors might be able to help. But so might an author of a good cookbook, a personal trainer, a cleric or a good friend” he finishes by telling us.
Suddenly I see that the point of admitting we need help when we do is just as important as is fending for ourselves. That’s not so easy. “What’s wrong?”, someone asks, and we can’t always answer. Slowly over time, we get used to things as they are and make them into our own normal. But is that really the best we can be? If nothing “seems” wrong, does that mean nothing “is” wrong? I think not. We know certainly that people become inured to chronic pain at some level and even convince themselves it’s not there in order to endure it. Pain, whether physical or emotional, is the built-in early warning system telling us we need to deal with something and make a change. Telling ourselves we can deny it and live with it or that it’s to be expected is asking for trouble; trouble we were clearly not meant to have before the pain began.
So I think it’s important to trouble trouble, because we don’t always know it’s troubling us until we talk about it. We can convince ourselves we’re fine in so many ways when we’re not, just to avoid discomfort. Within reason, I find testing and early detection of medical trouble just as reassuring as airing one’s emotional discomforts before they become debilitating. It’s no surprise that I also like dress rehearsals in the theater, tons of practice before a musical recital, early preparation before a dinner party and taking a car in for its inspections well before the dates suggested. I admit I’m a whimp about trouble, so I don’t want it to trouble me at all if I can avoid it. And I assume the only way to do that is to threaten it first. Trouble is a bully that tends to back down if you stand up to it. If you’re feeling okay, maybe you are okay and maybe you’re not. Maybe you can’t accurately judge how you feel if you’ve been telling yourself stories for years. If dealing with denial before it bites you is troubling trouble, then I’m all for it.
And yes, I agree that you can’t contract out your care of yourself to someone else. As the professor suggested in his article, that is indeed your job. But sometimes we need help with that care in the form of someone who asks, ‘What’s the trouble?’ and is willing to listen to the answer. Whether the challenge is physical or emotional, talking about it could trouble trouble enough to prevent it from troubling you in a much worse way someday.
by Sidney S. Stark