On a recent commercial flight I was headed to the head when the captain announced that ATC had reported smooth air ahead, always good to hear when about to attend to the call of nature. Imagine my surprise when, poised in position, I was bounced all over the diminutive facility. But then I cracked up as the pilot announced “Well, that air traffic controller was obviously being mean to us - I think it was my ex-wife.” I had to get a grip on some handholds as I was laughing so hard. And that got me thinking about getting a grip.
The term dates back to 1895 and implies obtaining mastery of a task or control of one’s emotions. Please understand, by using this term I am not implying that if unwell one should be the strong silent type; not at all. I am merely suggesting that you take the literal left seat and state the healthcare equivalent of “my airplane,” because it is your health!
My life has been enriched by friendships with amazing people from all walks of life, one of those friends is Montel Williams, known to millions as a celebrity talk-show host. However, if you asked him what he is most proud of, it would be his service in the Navy and Marines for 22 years. And although he had suffered a range of diverse symptoms for many years, it was not until 1999 that he was diagnosed with multiple sclerosis, a degenerative neurological disease more commonly associated with northern European women, rather than African American males.
Getting a grip is tough when a disease robs one of visual acuity and, the ability to balance and walk easily and imposes almost constant and unremitting pain. But Montel developed, and communicated, a trope that was not a surprise for those who know him: “I have MS but MS doesn’t have me.” Montel got a grip on his disease, put it in a box and was therefore able to deal with it.
Most people are aware of the classical ways people react to grief:
1. Denial: “This can’t be happening to me.”
2. Anger: “Why me?”
3. Bargaining: “If the diagnosis is wrong, I will dedicate my life to charitable works.”
4. Depression: which can be crippling or transitory
5. Acceptance: and this can induce either immobility or, quite the opposite.
People don’t necessarily go through these in order, if at all, and the timescales are highly variable, but a bad diagnosis can certainly induce grief. We do know that people come into contact with serious illness and the need for interventions and behave, broadly speaking, in one of three ways:
Data shows that those who are paralyzed by a diagnosis or treatment will tend to comply poorly and will often fail to complete a course of treatment or to even turn up. They will tend to do poorly. Those in the second group will react badly to any setback, may be argumentative and will also do poorly. Those patients in the third group, while they do not welcome the needed procedure, they are accepting and focused on recovery and will tend to have better outcomes.
Maybe it would be helpful to apply an aviation paradigm:
1. "This stall and spin is scary!"
2. "What stall and spin?"
3. "Okay, aviate, navigate, communicate...."
As a doctor, I have seen numerous people react to adverse diagnoses in many ways. Some are devastated and paralyzed by the news, others are dismissive, and others yet, angry and focused. As the categories above suggest, if a doctor does not take the time to provide information, guidance and resources, get a grip and do that yourself. You would not embark on a flight without availing yourself of any source of useful information – if a guy in the FBO said “the weather looks fine,” a sensible pilot will check out online resources and call a briefer. Do the same for your health. There are countless resources available today online including websites of esteemed institutions, patient advocacy groups and organizations like the National Institutes for Health, Centers for Disease Control or relevant medical professional societies. Use them and compile questions that your doctor should be prepared to answer – and if he or she does not? Get a new doctor.
Finally, in closing, can someone please explain to me why Americans call the toilet a “restroom” or “bathroom”? The last thing I want to do in there is have a snooze or bathe! Fly well, but if sick, learn well and get a grip.