Data Driven Doc: Denial & Detachment


In Berkeley, Calif., Hope Friedman, a 62-year-old retired nurse, said she was also stunned by the result…As she described her reaction to Mr. Trump’s victory, she wept.

“It kind of felt like being punched in the stomach,” she said. “It feels like when you get a cancer diagnosis and you are sick to your stomach and you can’t believe it and your mind is spinning” (NYT November 11, 2016)

Denial is a powerful emotion. Recently, Navya processed the case of a 28 year old with cancer matting his lymph nodes even after surgery. Navya had to write, heartbreakingly, in response to every one of his questions. “Do I still have cancer?” (Yes, you do.) “Will I survive?” (Let us recognize the inability to predict the future of an individual and just try and focus on onward treatment, knowing that data shows most patients in your situation do not outlive their disease for 5 years.) “Is the CT scan truly confirmatory of recurrence” (Yes, unfortunately, it is.)

 Hope is the ultimate enemy of cancers

Imaging, evidence and experience review had certainly helped this young man. We had identified immunotherapy and radiotherapy as an option for him. But it didn’t feel like a victory. For a 28 year old, it was cold comfort. An extension of life through the misery of treatment. Something about life itself was unfair and wrong.

Trump’s victory feels the same to many in the country. A diagnosis sunders reality apart, and fear sets in. While things may turn out all right, the chances that they would are much lower than ever before the diagnosis of President Trump. Now all one can do is be watchful, and be ready to do battle at every sign of encroachment and assault.

I’m thankful for denial. When reality makes me sick to the stomach, denial and detachment allow me to function. It allows me to plan, to research and to execute. It maintains hope. And hope is the ultimate enemy of cancers – of the physical body and of the body politic.

-Dr. Naresh Ramarajan

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