204 Being a Doctor After Being a Patient
But how does one know the difference between such ‘‘good’’ and
‘‘bad’’ denial? Indeed, many rationalized that their denial was purely ben-
eficial. Tom, whose lover died of AIDS, argued that ‘‘positive’’ denial
was in fact healthy:
Denial can be very dangerous if you do unhealthy things. But it’s
healthy to use ‘‘positive denial’’ and not get stuck in bad places.
‘‘Negative denial’’ is making believe something’s not true, so that
you can do things that aren’t good for you. If I was in denial and
didn’t go to the doctor, that would be silly. But not fretting for
three days before the labs come back, and not losing sleep because
my count’s jumped, is positive. I use ‘‘positive denial’’ to say ‘‘Not
today.’’ That’s healthy.
Here, Tom suggested a continuum between ‘‘positive’’ and ‘‘negative’’
denial, with multiple pants in between.
But self-judgments about the two extremes may be hard to make, and
not always accurate. Denial can, after all, foster procrastination and im-
pede essential activities. Deborah acknowledged, ‘‘Maybe I should plan to
die.’’ But she avoided doing so, since she felt she would then become too
depressed:
Maybe I should keep the fact that I might die as a given in my
immediate future. But I don’t. If I do, I would be very distraught.
I want to write a will, which I haven’t done.
Deborah delayed, not completing projects or a will—wanting to keep her
hope alive.
I have uncompleted projects that I should complete—relationships
that need to be clarified, writing projects I don’t want to do, open
family issues. I’m procrastinating, completely resisting doing any-
thing about them.
Deborah questioned how hard she should keep pushing and fighting, and
wrestling with these demands, or resigning herself to their incompleteness.
Sadly, six months after this interview, she died, with many of these pro-
jects unaccomplished.
Feelings about an illness can conflict. One can outwardly appear to
accept one’s illness in many ways, but still inwardly be terrified. Jessica
added, ‘‘I never dealt with the fact that I had a serious, life-threatening
illness. The face I presented to the world was ‘I’m fine, coming to work.’