Tuesday, July 16, 2013

Denial - it's not just a river in Egypt




"I live in a grassy hut high on the hill of denial" - patient in the hospital where I work. 



For those of you who don't know, I'm a hospice and palliative care physician.   Palliative care is a new specialty in medicine that focuses on supporting patients emotionally, spiritually, physicially and socially as they deal with advancing illness.   I see a lot of people in the hospital that are facing the last chapter of their lives or in the lives of their friends or family members.    As you can imagine, people facing terminal illness respond with varying degrees of acceptance of their prognosis.  Some respond in truly remarkable ways, with total acceptance and willingness to face the reality of their situation.   I am always in awe of those persons and wonder how they gained that level of resiliency in their lives. 

Others cope by using varying degrees of denial.  I don't think that denial in and of itself is a bad thing.   Denial allows some people to function, to take each day at a time and not get overwhelmed at the inevitability of their own mortality.   However, denial also comes with its downside.  If a person's level of denial prevents them from letting others know about their preferences for care at the end of life by avoiding completing advance directives, they run the risk of having unwanted treatments in the last days and weeks of their lives.     Even more importantly they risk not having resolution with their family members and loved ones. For example they don't get to say the four things that matter most that Ira Byock a hospice doctor talks about - Thank you, I love you, please forgive me, I forgive you.   Denial is not always a good thing.




I think runners can cope by using denial as well.   Anyone that's trained for a race has been in denial at times.   Whether it's denial about the worsening knee pain that won't go away, denial that skipping several training sessions in a row is no big deal, or that 26.2 miles really isn't that far - denial can help a person keep running.   I'm certainly in denial about a few things with this race:

1. Running at nearly 8,500 feet shouldn't be that different than 5,280.
2. I'm not slowing down as I get older
3. Even though I'm not hitting my goal times in my workouts, I can still make my goal time for my race at 3000 feet higher in altitude. 
4. Many people are reading my blog
5. I look darn good when I run

It's hard looking this good when I run . . .



See, denial helps me keep going, it helps me function.   It's what's gonna get me up in the morning tomorrow at 5:55 AM so I can run 9 - 400m repeats at 7 minute mile pace, which really means 7:20 pace, but that's not what I'm gonna tell myself.

But, denial can also be a problem.  Denial is what keeps you running when you have nagging injuries that turn into full blown overuse injuries like shin splints or plantar fasciitis.  The theory no pain, no gain doesn't always work in running.


I also think we live in a healthy state of denial about the tremendous injustice in this world . . . more to come on that tomorrow . . . tonight I better get to bed or I'll have to be in denial that lack of sleep makes it harder to run.

I shouldn't have stayed up so late blogging!



Addendum: For those of you who don't get the title of this post (ahem . . . Karyn), this illustration below will hopefully help









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