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Can't Blame Patients For Their Disease

By    |   Tuesday, 24 Jun 2014 03:48 PM

Former San Diego Padres baseball player Tony Gywnn, who died on June 16 at age 54, believed that his salivary gland cancer was caused by years of chewing tobacco, prompting a flood of articles on whether or not baseball should ban this known carcinogen.
 
Chewing tobacco contains toxins that can trigger cancer of the lip, tongue, and mouth — which is a good reason to fight its use. But according to some experts, it did not cause the rare type of cancer that took Gwynn’s life. In his case, the cancer was more likely caused by genetic mutation and just plain bad luck.
 
That’s something that I can understand all too well; my doctor had told me that there was no known cause for the leukemia I got despite having maintained a healthy lifestyle.
 
Absent obvious causes such as smoking and exposure to environmental carcinogens, sometimes there is just no explanation for cancer, opening the door to psychological theories that can leave a patient feeling at fault.
 
For example, in “You Can Heal Your Life,” author Louise Hay writes that
disease has an underlying emotional cause.  In the case of cancer, she suggests that the cause is holding on to feelings of resentment, which eat away at the spirit just as cancer eats away at the body. Her prescription: Forgive, and become free of resentment.
 
A friend gave me that book in an attempt to be helpful. I read that blood disorders stem from "brutally killing inspiration” and the tendency to ask, "What's the use?"
 
Hay advises countering this tendency with an affirmation: “I move beyond past limitations into the freedom of the now. It is safe to be me."
 
Affirmations are well and good, but none of this made sense to me.
 
Mary Lou Hackett, my social worker at the Dana-Farber Cancer Institute, explained to me that patients often worry that they did something cause their cancer. (I often wondered if my cancer was payback for being particularly mean to my younger sister.) Mary Lou always assures patients that cancer is not their fault.
 
In another best-selling book about the mind-body connection — “Love, Medicine and Miracles” — Bernie Siegel, M.D., writes that self-healing can be accomplished by love and positive thinking.
 
Mary Lou pointed out to me why this book is so unpopular at Dana-Farber. While positive thinking certainly has benefits, such books imply the inverse as well: that if you succumb to the disease, you simply didn’t try hard enough.
 
In her 1978 book “Illness as Metaphor,” Susan Sontag, then a cancer patient herself, wrote that cancer is not a punishment, and that the metaphors and myths surrounding cancer only add to the suffering of patients.
 
I think often of a dear friend who died of lung cancer at 46. Yes, she smoked. When a smoker is alive you can hound him or her all you want. But if they die, you need to blame the illness, not the victim.
 
And you can’t blame patients for not trying hard enough. I know that because my friend was the most positive person I knew.

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Ronni-Gordon
Former San Diego Padres baseball player Tony Gywnn, who passed away on June 16 at age 54, believed that his salivary gland cancer was caused by years of chewing tobacco.
cancer, Tony Gwynn, chewing tobacco, Sontag, leukemia
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2014-48-24
Tuesday, 24 Jun 2014 03:48 PM
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