Double Lens 203
Others merely fantasized about defying the odds. Yet these wishes can have other effects, prompting more aggressive self-treatment. Dan, the oncologist with chest metastases, said,‘‘ I think,‘ Let’ s do everything,’ since I fantasize about being free of this: taking another dose of radioiodine, and having the scan come back negative.’’ Dan sought to support this desire to be cured, and make it come true.
I have the thought that I can be cured 100 percent, which may or may not be reasonable. It’ s a belief— lots of people support me in that. That’ s why I am so aggressive: the way you cure this is to be aggressive.
Dan had been very assertive throughout his life, and his cancer had now metastasized to his bone— making it terminal, and further fueling his proactivity.
In sum, inherent tendencies toward optimism and pessimism are prevalent, but subject to change. These doctors either accepted or denied objective data to varying degrees. Similarly, physicians may have intrinsic therapeutic styles of nihilism or aggressiveness toward patients. It is not clear whether these, too, change over a physician’ s lifetime, and if so, how and to what degree. Presumably they do. Moreover, depending on their conditions, these doctors may be therapeutic nihilists with patients, but more aggressive with their own care. These physicians may treat themselves and others very differently.
‘‘ Good Denial?’’
These ill physicians came to reassess the roles in their lives of overconfidence, denial, and belief in‘‘ defying the odds’’— whether these attitudes helped or hindered, and how. Though originally employed by psychoanalysts to refer to an unconscious psychological defense mechanism, the term‘‘ denial’’ has clearly permeated popular psychology and culture.
On the one hand, these doctors argued that certain minimization was beneficial. Jessica recognized her use of this defense, but tried to see it as advantageous:‘‘ A lot of my thought processes are a form of denial— but good denial.’’ Similarly, Walter felt that such minimization aided him in continuing on in his life.‘‘ I can have normalcy reassert itself: I’ m not really a cancer patient. It’ s very positive, because I get on with my life.’’