Denial or bad news: which is preferable?

Are you a “good news first” or a “bad news first” type of person? Or maybe you prefer no news at all? That's where I found myself following my second bone marrow biopsy in as many months: avoiding contacting my doctor in case the results were not what I wanted to hear. It was a very different kind of response for me. I was all over my first biopsy – the initial one from two years ago, when I was first diagnosed with chronic cancer. I was equally on top of the pathology results from my biopsy in September, which confirmed what the PET CT scan had shown: that this was not a benign growth (the best though least likely scenario) but a return of my lymphoma. I went under the needle one more time to check my bone marrow. Good news: no cancer there. But there was still something off that didn't make sense to my doctor; she ordered a second biopsy. Those were the results I was waiting for now. I should have heard after about 10 days. But I didn't and, remarkably, I seemed to be happier that way. Avoiding news like this goes against how philosophers and scientists have long understood the way human beings process information. The idea that individuals seek – or at least pay attention to – sources of information is “deeply embedded in Western culture, at least as far back as Aristotle's statement that 'all men, by nature, desire to know,'” writes library and information science professor Donald O. Case in a 2005 paper published in the Journal of the Medical Library Association. Yet, as psychologist Abraham Maslow (famous for his “hierarchy of needs”) noted in 1963, “We can seek knowledge in order to reduce anxiety and we can also avoid knowing in order to reduce anxiety.” Herbert Hyman and Paul Sheatsley have described the latter as “selective exposure.” That's where human beings so desire cognitive consistency that they will avoid reading or hearing about information that conflicts with their internal states. That, of course, aptly describes our modern media environment. In my case, though, it's more that I desperately want to believe I'm still healthy, that I won't need more treatment at some point in the future, that this will all somehow just “go away.” Avoiding any news that might contradict that perception serves me in its own perverse way. “Avoidance is a simple way of coping by not having to cope,” therapist and journalist Lori Gottlieb points out in her best-selling book Maybe You Should Talk to Someone. People also opt out of information-gathering when they feel powerless, adds Israeli-born sociologist Elihu Katz. It doesn't make a lot of sense to delve deep into things over which one has no control. IT GETS even trickier when it comes to cancers like mine that wax and wane but always return, and where there's no clear line between “remission” and “relapse.” Indeed, some doctors have stopped using those terms. The cancer is always there; it's just that, for certain periods, the chemotherapy pulverizes it so that the scans can't find any tumors and your status becomes NED (short for “No Evidence of Disease”). In this respect, I never really relapsed. I've just gone “non-NED” for a while and I'll probably do it again another few times over the course of my life. So, could living in denial actually be an effective strategy for contending with chronic cancer? Not really. Science seems to support the opposite: embracing bad news rather than resisting it. Researchers from the University of Toronto and UC Berkeley have dubbed this “habitual acceptance,” and they write that it “helps keep individuals from reacting to – and thus exacerbating – their negative mental experiences.” Dr. Moshe Shay Ben-Haim at Tel Aviv University has proposed a technique involving repeated exposure to a negative event in order to assist people grappling with bad news. “We show that, counterintuitively, you can avoid getting into a bad mood in the first place by dwelling on a negative event,” Ben-Haim writes. “If you look at the newspaper before you go to work and see a headline about a bombing or tragedy of some kind, it's better to read the article all the way through and repeatedly expose yourself to the negative information. You will be freer to go on with your day in a better mood.” Will finding out my bone marrow biopsy results allow me to be happier in the long run? Or will it plunge me into even more uncertainty over which I remain powerless? Uncertainty “doesn't mean the loss of hope – it means there's possibility,” writes Gottlieb in her book. “I don't know what will happen next – how potentially exciting. I'm going to have to figure out how to make the most of the life I have, illness or not.” After a full month had passed with no news from my doctor, I finally mustered up the courage to welcome uncertainty and embrace any bad news. I fired off a WhatsApp. My doctor replied quickly. The second bone marrow sample looked better than the first, she wrote, “with more functioning blood cells than were seen initially” although the percentage was still low. Then again, I have cancer, I reminded myself, so what did I expect? I didn't comment on how I hadn't been in touch, nor did I ask my doctor why she hadn't updated me as soon as she received the results. Maybe she's a no news sort of person, too. Although I'm not so sure I am anymore. The writer's book, Totaled: The Billion-Dollar Crash of the Startup that Took on Big Auto, Big Oil and the World, is available on Amazon and other online booksellers. brianblum.com

Denial or bad news: which is preferable?

After receiving medical test results, is it perhaps better to try to live in denial?

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Denial or bad news: which is preferable?

After receiving medical test results, is it perhaps better to try to live in denial?

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