Why do we resist going to the doctor?

I waited too long for my diagnosis: Whence such perversity? Childhood fears

Published November 25, 2009 1:25AM (EST)

Dear Reader,

Hope you enjoy your Thanksgiving. If you want some rather dark laughs in time for the turkey eating, you can instantly download my holiday collection "That Special Time of Year," or order the print-on-demand book from Lulu in time for that other big holiday that's coming up more quickly than any of us really care to admit. Either way, it's cheap fun!

Today I want to write about my reluctance to go to the doctor and in doing so tease out a paradox of personality by which our own self-destructiveness appears to us as self-preservation. This will take a lot of work so there will not be time to also answer a letter today.

Last week, knowing that I had a cancer that might have been detected as much as a year earlier, I was crushed with the weight of fate and my own fear and pride and resistance. My insistence that I knew what this pain in my lower back was, was groundless, born of wish -- in part a wish to avoid learning the truth but more, as I discovered, a wish to avoid doctors and hospitalization.

Basically I ignored the pain in my lower back for the better part of a year. I was strangely, irrationally evasive about it. I refused to see the doctor. I told my wife I would and then I failed to do so. I was even aware, myself, that I was acting irrationally, that I was avoiding and procrastinating.

Having since been diagnosed, aware that I had a tumor, I was writing last week when out of nowhere a phrase came to me about a boy's fear of going to the hospital, and I recalled that I had had a kidney ailment when I was about 2 years old that required me to be in the hospital for weeks.

When this memory came to me I was overcome with tears. An old, childish fear came over me, a fear of dying and being abandoned, and I remembered how I was put in the hospital when I was very young, perhaps 2, for a kidney ailment, and how I was left there.

This traumatic memory was enveloping, pre-verbal, pure emotion, pure fear -- fear of dying, fear of abandonment. As I choked my way through this, I became aware of a voice, or you could say a voice came alive within me. This voice I recognized as a protective entity, like an internal older brother that long ago, when I was very young, had made a pact with the even younger and helpless part of me, saying, "I will protect you; here is how: You must never tell if you are in pain or you'll end up in the hospital again."

And the younger, frightened voice was grateful. And the pact was made: Do not tell. Do not ever tell if you are in pain or they will put you in the hospital.

So it was suddenly clear to me that below the level of consciousness, my long and perverse refusal to see the doctor was a survival strategy adopted as a very young child.

This realization was very real and emotional, not an analytical thing: I thought I was saving my life by avoiding the doctor.

Perhaps I am not the only one who has had early traumatic experiences with hospitals and doctors, and whose adult behavior is rooted in an unconscious pact of survival through silence about pain.

I know that women also avoid the doctor, but not as much as men, it seems. So I wonder if girls in general have different early medical experiences. I know that in the rural and small-town South of 50 years ago, boys were supposed to be "brave." I remember that word "brave," when they stuck the needles in. I was not brave. I was in fear of my life. I was in fear of abandonment to strangers. I was afraid of pain. But I was supposed to take it like a little man.

Now, we know that the emotional life is fraught with paradox and mirroring, that what we seek in ourselves we find in others, that what we despise in ourselves we find in others. But still, suicide vexes us. Self-mutilation vexes us. Our own perverse, self-defeating behavior vexes us. Addiction vexes us.

I'm thinking that certain contradictions of self make sense if we view the self not as a unified being but as a collection of avatars. What if none of us is a unitary being? What if we are all collections of beings at different stages? The child who fears the doctor is still there, as is the older voice of comfort who promises delivery from danger: You will never have to go to the hospital again as long as you don't tell anyone that you feel pain.

But why? Why would this immature, illogical part of myself still be operating in my adult world? What good is it? Why hadn't I jettisoned this ridiculous, superstitious, illogical child-self long ago, in favor of a rational, grown-up, educated, modern perspective?

To jettison the child meant to jettison not just his irrationality but also the wonder and pure creativity that was embodied in the child.

A child can stare at a bug for a long time, enjoying it. A child can look at bubbles bursting on a foamy ocean surface, fully enjoying the miracle of it. This is something we would like to carry into adulthood with us but often cannot because adulthood requires us to mortgage our attention. We mortgage it to the bankers of adulthood. This wonderful, enriching practice of close, sustained attention to the wonder of the world is interrupted by the classroom discipline. Suddenly, the child's attention belongs no longer to him but to the teacher and the class. The child knows that this practice of wonder is a life-giving activity; the child knows that the world he has come into is marvelous beyond measure and that every inch of it deserves unbroken scrutiny. Yet he is upbraided for being dreamy or inattentive. He learns that his attention no longer belongs to him alone, but is now the property of the state, the school, the public. He must be attuned at all times to their instructions. He is called upon to abandon his inner world. If his obeisance to the glory of tiny naturalism is unrepentant, he may be labeled with a learning disorder. If he is so absorbed in the majesty of bugs and leaves that he seems resistant to contact, he may be sent to a hearing doctor or to a specialist in child development.

Something in us resists leaving all this behind. They try to scorn it out of us or beat it out of us but we children resist because we know, with the deep knowledge of our spirit, that the natural world is our home and our ally.

Science, at one point, appears as a possible avenue by which the child might continue his rapt worship at the altar of bugs and flowers. But as the child grows older he is told of the drudgery of science, that it involves long repetitive experiments, much waiting, much adult patience and hard work. So he despairs. Later he finds that even with all that drudgery, he still would be in the environment that he loves, but by then it is too late.

What would be necessary, in the child's life, for him to retain the creativity and wonder of a child but gently let go of the superstition and fear? He would have to go through stages of life consciously, letting go of certain things, acquiring other things.

As I went through this episode of crying last week, at the recollection of this early fear, it came to me that today I can address that child and say that these doctors we are seeing are going to help us, that they are gentle and loving and know what they are doing, that he is going to be safe. I can do that. I can reassure the child in me.

So as I walked on the beach along the ocean toward the cafe this morning, watching the waves, marveling at my good fortune in having this walk for a daily commute, and as I watched the sparkles of the waves, I entered into that childhood dialogue with the natural world once again, and wondered at the tiny explosions of light along the retreating wave-wash, and saw that they were the explosions of tiny bubbles, and looked with wonder at the small jellyfish that look like oblong glass marbles, and I thought of how the child's mind tries to categorize and understand. Things that look like glass must be glass. But what kind of glass is soft? the child would ask. When would glass be soft? And the adult would answer that glass is soft when it is very, very hot, too hot to touch. So the child would think that the jellyfish must be very, very hot. But it is in fact cool to the touch. So what is what? Such is the world of the child.

But how do we keep that childlike wonder and yet make good adult decisions? We must be in touch with that child.

One more thing, if you please. In the writing workshops I conduct, I read aloud every time the five essential affirmations and the five essential practices from Pat Schneider's book "Writing Alone and With Others." They are articles of faith and instructions both, and the only one with which I ever inwardly quibble is the one that says, "Everyone is born with creative genius."

How can this possibly be true? Does that mean that everyone is a Michelangelo?

I believe it is true that everyone is born with creative genius in this sense: The child has a capacity for sustained, uncritical attention to phenomena. The child has the ability to engage in unfettered fantasy and rearrangement of the world, to make up rules that defy what we "know" to be true; the child has the capacity to create whole worlds, and that can be seen as creative genius. That is not to say that the child will mature into an adult who is a recognized artistic genius. That is to say that the kernel of genius is in the preverbal capacity to see fully without thinking first, and to rearrange and hypothesize and create a world based on one's own system of causality and myth, however far-fetched and strange. And so, if we can find methods to reignite that capacity through supportive exploration, we can tap into some of that long-dormant genius.

So we might say that the genius of the child is that the child is not yet at war with himself; the child is completely of the world. And only later must the child create these chilling and baffling pacts to ensure his survival -- pacts that in fact do not ensure his survival but threaten it, and must be unearthed decades later like tombs in which the living are buried.

Thank you for sticking with me through this piece; we now come to a rather abrupt end. It has truly been, in the very French sense of the word, an "essay" -- an attempt, a stab at finding meaning in the void.

That Special Time of Year

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By Cary Tennis

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