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Audiobook
First published January 1, 2003
The author says that he doesn’t like to “blame” the cancer patient or chronic illness sufferer, but that is exactly what he is doing.i) Carefully refuting “blame” is indeed foundational to the book, and it’s a tragedy this was miscommunicated from the review’s perspective (hopefully I can ease this).
So I learned [in the past] that if I felt lonely that there must be something wrong with me, fueling anxiety, creating a wound that would never heal.
One of the most transformative experiences for me was going to a therapy group […] Well, I was lonely. But newsflash: Being lonely is actually healthy! Everyone is lonely from time to time. That emotion is completely normal. The feeling was correct, but the conclusion was incorrect. [Note: this is critical self-analysis/self-diagnosis; surely we would not label it as self-blame]
Well, the author is going to talk about personality types that repress their feelings, and that used to be me. [Self-diagnosis, not self-blame…]
This author’s premise is that there are three personality types, Type A (people who are angry), Type B, Type C (the people who repress their feelings and get sick). The author says that he doesn’t like to “blame” the cancer patient or chronic illness sufferer [sounds like the author is presenting theory on contributing factors as part of a diagnosis, since it’s not an 100% cause-and-effect], but that is exactly what he is doing [how?]. He asserts that people with breast cancer brought it on themselves. [Note: the partial diagnosis seems to be interpreted as an accusatory, punitive, you-deserve-this “blame”. This is the tone of the “brought it on themselves” phrase, i.e. you-get-what-you-deserve, a moralizing tone which the book does not use and indeed refutes.]
Respectfully, this author is way off base. He was talking about genetically based diseases and then blaming the patients [note: evading psychological/socioenvironmental factors by using the label of “genetically based” is a key issue addressed in the book, see later…]. Additionally, I knew from the very first chapter that the author was a white male. How do I know that? [Prepare for more shared values/concerns] Well, if women go to the doctor, no matter what the complaint, the doctor will think that she is either crazy, pregnant, or both, in about 95% of cases [inferring that the book does this?]. It was a running joke at uni that if a female came in with a stubbed toe, that the medical staff would automatically assume pregnancy.
Women are over diagnosed with either depression or functional neurological disorder [inferring the book?] when in fact they have very serious medical problems. […] Women and people of color are still treated as second-class citizens in healthcare.
“The view of sickness and death as a personal failure is a particularly unfortunate form of blaming the victim,” charged the 1985 editorial in the New England Journal of Medicine. “At a time when patients are already burdened by disease, they should not be further burdened by having to accept responsibility for the outcome.”
[…] blame and failure are not the issue. Such terms only cloud the picture. As we shall see, blaming the sufferer—apart from being morally obtuse—is completely unfounded from a scientific point of view.
The NEJM editorial confused blame and responsibility. While all of us dread being blamed, we all would wish to be more responsible—that is, to have the ability to respond with awareness to the circumstances of our lives rather than just reacting. We want to be the authoritative person in our own lives: in charge, able to make the authentic decisions that affect us [i.e. autonomy]. There is no true responsibility without awareness. One of the weaknesses of the Western medical approach is that we have made the physician the only authority, with the patient too often a mere recipient of the treatment or cure. People are deprived of the opportunity to become truly responsible. None of us are to be blamed if we succumb to illness and death. Any one of us might succumb at any time, but the more we can learn about ourselves, the less prone we are to become passive victims.