THE BURDENS OF DENIAL & NEGATIVE ASSUMPTIONS

Here is another essay by guest writer Khadija.
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Hard-Earned Insight #1: “I don’t know” really means that I don’t know what’s going to happen. It’s not good to assume that not knowing is simply the entry point to getting bad news. Only God has perfect knowledge of what’s going to happen. Projecting 100% certainty of the worst outcome is infringing on God’s space. We cause ourselves unnecessary misery by presuming to know more than we do.

Hard-Earned Insight #2: Even if one does know 99% of what’s going to happen, that unknown 1% can make all the difference in the world.

Hard-Earned Insight #3: It’s not just poverty or lack of access that keeps people from medical care. Sometimes people don’t go to the doctor until it’s undeniably necessary because they feel certain, and are afraid, of what they might find out.

Last Wednesday, I was scheduled for a follow-up mammogram and ultrasound. I’ve had follow-up, diagnostic mammograms a couple of times before over the years. Alhamdulilah [Praise God], I’ve been okay so far. Alhamdulilah, the doctors said I’m okay now. I’ve been terrified each time I’ve had to go for a follow-up appointment. Here’s why: Two dead grandmothers. Two dead grandfathers. Two dead aunts. One dead cousin. All dead from cancer. They are the reason why I was assertive with my HMO and insisted on having yearly mammograms when I was 28 (which is many years younger than the recommended age).

My father survived a bout with prostrate cancer. Despite being a suave and grumpy old man who disobeyed the doctors’ post-surgery instructions. He refused to slow down his activities after surgery because he was in denial about being ill and needing rest. He’s still alive and kicking more than ten years later. My uncle [by marriage] survived a bout with prostrate cancer. Despite being a grumpy old man who procrastinated in scheduling his surgery. He was in denial that he had cancer. He’s still alive and kicking more than ten years later.

Then there’s the ongoing situation with one of my born-again colleagues from work. She discovered a lump in her breast. Instead of following the recommendations to have the lump surgically removed, she opted for prayer and herbs. I’ve seen this behavior before with other people. Somehow, they feel that it’s being disloyal to God to avail themselves of modern medical care in these sorts of crises. I’ve never understood it.

Why can’t people pray, use the herbs, AND modern care? It also sometimes seems that people want a spectacular, supernatural miracle from God. Instead of the “mundane,” everyday miracles produced by His Grace in allowing scientific discoveries. The colleague’s cancer has spread to her bones.

With my HMO, there’s typically a weeklong wait from being told to come in for a follow-up mammogram and the scheduled appointment. A week of dread and sheer terror. Even though intellectually I know better, I’ve always perceived not knowing as just the entry point to receiving bad news in this kind of situation. I watched most of my deceased relatives suffer. During this week of waiting, I traditionally engaged in escapist behaviors to crowd out my very vivid memories of their suffering. In the past, I’ve arranged a whirlwind of social and workaholic activities to make sure that I didn’t have a single free moment to think.

Not this time. What happens when these external mental crutches aren’t available? I had better learn some other coping skills. I decided to do my normal activities, and use this situation to engage in tazkiya [purification]. This was an unpleasant opportunity to practice disciplining my thoughts. Alternatively, as the Bible refers to it, “Casting down imaginations, and every high thing that exalteth itself against the knowledge of God, and bringing into captivity every thought to the obedience of Christ.” 2 Corinthians 10:5. I also decided that this time I wasn’t going to mention the follow-up appointment to anyone until after it was finished. Don’t get me wrong, I’m not a stoic person. I’m all for bringing loved ones to appointments for support, and have done so in the past. Just not this time. This one time, I had to work on my thoughts myself.

That’s how it came to be that I was sitting in the outer waiting room in the Mammography department at 9:00 that Wednesday. When I was 30, I had to come back for a follow-up appointment, and had a crying, sobbing, meltdown in that same waiting room. As I said, I’m not particularly brave. I scan the room. Many elderly women with blank expressions. A couple of younger women in their 20s. One of the younger women looks misty-eyed. I smile at her. I don’t know what else to do. Finally, I start staring at a page of the book I brought with me. I’m quickly called in to do the mammogram.

Once I return to the inner waiting room after the mammogram, a muttering, sputtering woman of indeterminate age arrives and plops herself down in the chair next to me. Wonderful. She’s doing a lot of “street lunatic” behaviors. Muttering under her breath. Groaning softly. She quietly gets up to stand in a corner of the room away from everyone else. She’s not quite disruptive enough to warrant calling security. She also didn’t follow instructions and had apparently taken off all of her clothes. I know this because she’s wearing only one gown that she leaves wide open in the back so everyone can see her cheeks. How not lovely. An elderly woman sweetly reminds her to put on the second gown to cover up. I scan the inner waiting room. All the other women are elderly, except for me and the nut. One of the elderly women has an oxygen tank. Great. That means that it’s on me to intervene if the nut does something menacing to one of the elders. I take off my glasses just in case. Just great. Even crazy people need medical care.

I spend the next 4 hours waiting to do the ultrasound. I pray, watch the nut out of the corner of my eyes, intermittently watch television, and stare at the book I brought. While sitting there I learn that a Black couple, Jesse and Angie, are back on All My Children after over 20 years. I haven’t watched a soap opera since college. Thankfully, the nut is one the first women called to leave for her procedures after about 2 hours. I had decided that I couldn’t leave the elders alone with the nut. If I were called for my ultrasound before the nut, I would have to bring her to the attention of security.

Throughout the week, it’s been a constant battle to silence my internal chatter of fearful thoughts. It’s hard to disrupt what I call the spin cycle of negative thinking. To varying degrees, we’ve all experienced this at one time or another:

Step 1: We’re presented with uncertainty about something important.
Step 2: We react to this uncertainty by imagining and expecting a negative outcome. Step 3: We then brood about this expected negative outcome repeatedly.
Step 4: Constant brooding about the expected negative outcome leads to increasing levels of fear and ultimately, panic.
Step 5: Constant fear makes it very difficult to rest, sleep, or think clearly. Exhaustion makes our thinking even more impaired, and leads to another round of expecting a negative outcome and panic.

I’ve found that the earlier I can disrupt this spin cycle, the better I feel. Refusing to project a negative outcome feels better than distracting myself from brooding about the projected negative outcome. It’s been difficult, but the idea has started to sink in that “I don’t know” really means I don’t know. Uncertainty means that the outcome could be positive as well as negative.

If there’s something that you haven’t attended to, call today to make an appointment to see your doctor. Don’t delay. I know that it’s upsetting, but it has to be done. Lay down the burdens of denial and negative assumptions. Everyone should pay at least as much attention to their health as they do to maintaining their cars.

Again, I’m not all that brave. After getting the good news, I could barely keep myself from literally doing a wind sprint out of the hospital. I wanted to get as far away from that place as fast as possible. As it was, I walked very briskly out of there; and I was jogging toward my car by the time I got to the parking lot.