August 14, 2014 — Blog Post
Advice from Athletes: Overcoming the Power of “Denial” in Healthcare
I was a two-sport athlete—soccer and Shotokan karate—for the vast majority of my life, culminating in my early twenties. I played competitive soccer through high school and college and eventually co-captained the Amherst Women’s Soccer team. Concurrently, I traveled all over the country and the world to compete in karate, and was a national team member starting at the ripe age of 13. In 2009, at 21 years old, I co-captained the USA National Karate Team at the WKC World Karate Championships. At the end of Worlds, I stepped off the podium the Middleweight World Champion and promptly retired from competitive martial arts. A season later, my soccer career was over, as well.
Why? Largely because I had pushed aside a variety of nagging aches and pains for years, and convinced myself that this wasn’t the time to deal with them—that they’d go away on their own or I could just handle the pain and tough it out. The consequence?At 21, instead of minor setbacks, those aches and pains had become serious injuries.
It’s with that history that I read and appreciated Jeff Haden’s recent article describing his pursuit of ever greater cycling challenges, and the insight he gained from a truly near-death health scare. The lessons he described resonated with those I also learned the hard way. And the relevance of those lessons doesn’t apply only to those injuries accumulated through years of athletics; they apply to all varieties of healthcare. Despite having both an academic healthcare background and personal history highlighting the importance of preventive and non-acute care, I still find myself dragging my feet on making those appointments. And for that, sadly, I’m in good company.
Putting aside for a moment questions of access to and affordability of such screenings, procedures and doctor’s appointments, there is quite a bit of evidence—anecdotal and quantitative—that suggests people just don’t seek out non-acute care with the frequency they should. Why is that? The answers are complicated and multifaceted, ranging from the macro-economic to the psychological. There is, however, at least one major factor on which the literature—as well as Jeff and I, as evidenced by our athletic escapades—agree: Denial.
Traditionally, the tendency toward denial and delay of seeking healthcare has—not surprisingly—been more strongly associated with men, but recent research has complicated this widely held belief. Women, it seems, are also prone to delaying care, albeit with different rationale. Gender aside, the result of denial and the delay of seeking care is significant: decreased survival rates in cancer, stroke and heart disease, among other diagnoses. Early detection proves powerful, but is only possible if people participate in those kinds of care aimed at catching early stage pathologies.
At face value, it’s not surprising that people don’t immediately respond to warning signs. Early symptoms of potentially serious illnesses and diseases often aren’t themselves all that serious. Feeling lightheaded or short of breath is uncomfortable and maybe a bit disconcerting momentarily, but often such sensations pass. Knee pain or low back pain may make getting out of bed even less enjoyable, but Advil every day may take care of it. We’re busy, we have a million other things on our plates, and maybe it’ll go away on its own. Even beyond those simple nuisances, a surprising number of people do just “cope” with chronic pain, discomfort or disability, slowly and unconsciously changing their habits and lifestyle to work around those things they can no longer do. In all such instances—chronic and acute alike—it’s amazing the lengths to which our brains will go to rationalize away what’s really happening (for a perfect example, I’ll refer you back to the article and Jeff’s firm belief his heart attack was an allergic reaction to the energy gel he’d consumed).
We can and should call for individuals to be more proactive in their own health—to pay attention to patterns of abnormal sensations, pain or features and to ask for help quickly in acute situations. The importance of this can’t be overemphasized. Sometimes, though, this isn’t enough—our powers of stubborn denial are stronger even than our commitment to take better care of ourselves. We need others around us, our friends and family, to give us a push. Jeff had this—his wife knew immediately that he needed to get to the hospital and wouldn’t take no for an answer. I did as well, in the form of concerned friends who persistently questioned the validity of my years-old “back tweak” with increasing concern. It’s not easy, and certainly not always comfortable to talk about health problems with family or friends. These are deeply personal and often sensitive topics. But as Jeff points out, silence on the matter can have serious consequences and leaves us wishing we’d spoken up.
His recommendation is a great one, and one I’ll follow and restate: start by setting an example. Talk about your own health concerns to the extent you’re comfortable. Prove that there’s no shame in seeking help for those things bothering you. Describe the close calls, the fears and the relief you felt when you found out it was just that. Emphasize that you prioritize that annual exam. Mention the relief you experienced thanks to prescribed physical therapy. Support others when they do share their health-related concerns and experiences with you. Certainly, it will remove any possibility of others employing the age-old “pot calling the kettle black” argument, but there’s a good chance that someone you talk to will take note, consciously or subconsciously, and follow suit. This is especially important for men, who—again, not surprisingly—are less likely to discuss health concerns, and tend to talk about them indirectly, if at all. Breaking down the association between seeking help or advice and losing your man card could literally save lives.
All of us have people we care about that could be a little healthier or a little more proactive about staying healthy. It may be tough and uncomfortable, but starting with your own experiences and proactivity may be the ice breaker needed for more open conversation about their health. Of course, there’s another benefit to the example-setting solution—you may just save your own life in the process.