Blunters and Monitors
Jessie Gruman, President of the Washington-based Center for the Advancement of Health, wrote a very interesting article in the Washington Post on February 6th. Four times in her life, Jessie was diagnosed with life-threatening diseases. As she says, "Each time, the news stopped me cold...it forced me to rearrange my life and rethink my responsibilities while my body was battered with drugs and surgery." Clearly, Jessie understands what each of us has faced.
Her own experience as well as the hundreds of others with whom she has talked has taught her that people "are remarkably resilient once they gather the information they need to reconstitute their immediate futures." She further acknowledges that "people have very different ideas about how much they want to know about their diseases," and she quotes Suzanne Miller, a psychologist at the Fox Chase Cancer Center, who found that people are divided into two groups: Blunters, those who have little interest in seeking out information, or Monitors, those who track down the details.
Jessie suggests that whether you or a blunter or a monitor, there are "4 main reasons you need a basic understanding of your disease and its treatment." The following are quotes from her article:
Collecting information allows you to make decisions that are right for you. You can say yes or no to a doctor's recommendations, but you need some basic knowledge to be able to serve your own best interests.
You need a mental model of what is happening to you. Until you have one, it is difficult to make sense of the actions you must take to participate in your treatment.
You need to realize that what doctors consider state-of-the-art treatment in Connecticut may be very different from what doctors recommend in the Washington area. This means you may have more choices than you realize.
The fourth reason you need to know about your condition and its treatment is that you - and probably your partner or family member - will need to keep a vigilant eye on your care. Most patients do not have access to an electronic record that includes their entire health history, test results and treatment plan. Each new doctor and institution you visit may have to piece together the information that is relevant to your care. It is common knowledge that such decentralization can lead to mistakes.
The article went on to state that "blunters attempt to keep anxiety at bay by avoiding details that might be frightening...Monitors are uncomfortable with the unknown. Then tend to gain confidence as they gain understanding, even though the monitoring style can rouse anxiety. "
Jessie sums all this up nicely when she concludes, "In the end, whether you prefer to learn a lot about your disease or only the bare minimum, you need to know enough to make choices that are consistent with your preferences, that honor your values and that allow you to move forward, confident that you have made the right decision for you."
I couldn't have said it better. The fact that you are reading this blog suggests that you are a monitor, one who wants to find out all possible options. As Jessie says, you may have more choices than you realize. And there is no time in our lives when it is more important to find out what those choices are. As Mort and I have repeatedly stated, radioimmunotherapy is terribly underutilized in mainstream oncology. It may be a choice that has not been presented to you. If you need help finding a physician who will discuss it with you, please let us know.
Betsy