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The Good Patient Syndrome

Posted 1/25/2013

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Oh, how we all like to be model patients and A+ students. Years ago there was an essay in the New York Times about a woman going through chemotherapy who continued to put on her tennis whites, look perky, and win games. The writer, also going through chemo, was shuffling through the months in sweats and a bad mood. I think we all can easily identify with both women, and I know, for me, the struggle is to not feel I always need to be the racket-swinging champ. In my family, the rule was "Pull up your socks and don't complain". That is usually pretty good advice, but there surely are times when it is just fine to be grumpy. When women say to me--as they often do--"It could be worse", I always respond: "Yes, that is true. But it could be a lot better, too"

As women, we are particularly socialized to be polite and agreeable and nice to everyone. My mother, one of the last Great Victorian Ladies, was horrified once when she overheard me on a work phone call. After I hung up, she said something like: "I never raised you to talk that way, to be so authoritative." True. She raised me very well to know the rules, to be very polite, to know that tea ranks coffee (that is another story that I bet few of you know), but not to be competent in the work world or to talk back when necessary.

As patients, we may well have a fantasy that, if we behave really well and are super nice to our doctors, they will take better care of us. In Cancer World, this easily expands to the fantasy that the right behavior may insure good health. I can promise you that is not true. What is true is the basic rules of politeness work just as well in the hospital as anywhere else, and that the squeaky wheel gets the grease. It is also true that a truly obnoxious patient will be disliked, but s/he will still get good care. Moral of the story: Being nice is usually better, but there surely are times when the opposite is wise. Here is a great essay from The New York Times about this issue. I give you the beginning and then a link to read more:

Living With Cancer: The Good Patient Syndrome


I remember when being good seemed strategic.

After the technician took out a pad to draw an inscrutable diagram, I nodded and pretended to recognize a squiggle at the center of what looked like a snail. I discussed my oncologist's research projects, instead of complaining about pain. Generally I answered a nurse's opening query -- "So how are you?"-- with a cheery "Good! How are you?" Grumbles about waiting interminably for a scan in a freezing room never rolled off my tongue. When an interventional radiologist managed to remove two stents from my body, I didn't fault the surgeon who left them there to trigger a massive infection followed by an allergic response to antibiotics: I sent a thank you note to the radiologist.

What was wrong with me? Outside the medical sphere, I am prone to impatience, candor and bouts of argumentative fervor. Had feminine socialization kicked in? As a girl, I was trained to be courteous to people in positions of authority and to revere the saving knowledge of physicians. But men also exhibit symptoms of the good patient syndrome.

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