Too Busy to Die & Too Sick to Live

Women are judged, preconceived, and mislabeled daily.  But there is a particular misconception about black women being historically viewed as ironclad beings who are too independent and have enormous strength that plow through adversity, strife, and illness that I find extremely dangerous.  It is one of those misnomers that isn’t usually defined as a misnomer because it is so close to being accurate that we sometimes forget that not any of us are without pain and suffering that cannot always be handled or dismantled.

You may be the “pillar of strength” and family matriarch I speak of.  Or you know her.  She is your mother, your grandmother, friend, or aunt.  Whoever she may be in your life, you’ve met her.

I have certainly encountered this woman time and time again and I sometimes fear that I may even become her at her worse.  We are the women who take care of everyone and everything all while purposely or accidently neglecting our needs.  We do it because it’s what we were taught as we watched our mothers and elders take care of the family on little sleep and little support not always for lack of helping hands but for lack of asking for help or simply refusing the offer. 

In my line of work I encounter patients of all ages, ethnicities, gender, illnesses, prognosis, and socioeconomic status.  But more often than not I see the same patient.  Her name may be different.  Her diagnosis not identical but she is a matriarch and often times looks like me: African-American, Black, brown…

A colleague and I worked on her case offering supportive counsel to her and her family and then bereavement to her 3 daughters, 8 young grandchildren, and longtime boyfriend.  After one particularly rough day my colleague, exhausted not because of lack of sleep but because of the failure we sometimes feel when we offer interventions that simple don’t substitute for prevention and medical compliance, turns to me and asks why might this woman – this woman whose ethnicity I share – and other “African-American” women patients tend to hide their illness from their families.  “Why,” she asked, “do they ignore the signs and symptoms and their condition to the point of no repair?”

Of course I can’t speak for these women.  “These women” can’t even speak for the number of women and men who allow their health to plummet without ever seeking medical attention despite actually having health coverage and access to healthcare. I could have offered my colleague an entire host of reasons so many of “my people” fail to seek help from healthcare professionals but I choose to only offer a few:

Fear of death – Yes it sounds odd that one chooses to forego medical attention because one fears death but being diagnosed and dealt a poor prognosis makes ones symptoms very real.  Once diagnosed symptoms are no longer feelings that can simply be shelved as something that will go away when “the weather heats up.”  It is real and it is something that must be dealt with and despite ones efforts to “deal” with the illness one may fail.  This sort of failure is not a simple failure one can walk away from.

Distrust for medical professionals – There is a longstanding history of mistreatment and distrust between healthcare and Black people.  The perceptions have changed for the better over time but there is still some distrust that has yet to be mended.

Religion – “God will take care of me.  When it’s my time, it’s my time.”  I hear this and a variation of this quite often.  I cannot say that I disagree but I can say that seeking help does not mean that you’re putting your trust in man.  

The best example I could offer as a reason for the complexities of the decision to hide an illness from family or not comply with the advice of medical clinicians was a story that consistently helps me to not only understand and communicate with my patients but to understand myself and why even I tend to ignore physical pain and put off scheduling preventive procedures and appointments though I have adequate health insurance and access to care.

There was an elderly female patient whose selflessness was her Achilles heel.  For reasons that I’m not sure of this woman was the guardian of her grade-aged grandchild.  Nervously and impatiently she sat in the ER undergoing a workup that would result in hospitalization.  She adamantly refused.  She verbalized understanding that she was on the verge of having a stroke if she did not agree to be admitted for monitoring and progressive care.  With tears in her eyes and evidence of a strength that quickly turned into a weakness she said, “But who’s going to feed my grandchild dinner tonight?  How can I feed him and care for him if I am here?”  She had no desire to think about what would happen to him if she didn’t care for herself.  According to her she’d be just fine if only she could care for her grandchild.  Of course her logic was mind boggling to me and to the others who unsuccessful tried to persuade her to allow for us to care for her and put resources and a plan together for her grandchild for the duration of her hospitalization.

But then…

I thought about my own child and family.  How I elect to go without for the sake of my daughter and family.  I thought about how I forego sleep to chase the excitement of pressing fingertips to keys and eagerly awaiting the moment I can share my thoughts with those who actually find the time and desire to read and chime in on my thoughts.  It’s a matter of sacrificing the thing you believe you can overcome or live without for the thing that fills you up when you’re running low.  For some, there simply is no death when you live and thrive off of the people and things that give you life.

Think about this:  What if that thing or person(s) you neglect yourself and your health for is living and thriving because you are here to be with them?  Isn’t that enough of a reason to take care of yourself?

Be Well.  Be Blessed.  Be Encouraged.