Wednesday, January 19, 2005

Stockholm Syndrome

My doctor is the best. He's wise, witty, compassionate and an expert on lymphoma. He taught at Case Western Medical School. My two favorite oncology nurses, Jeanette and Pamela, have a combined total of over forty years experience in nursing, most of it oncology. And they a sharp, deft and funny. My doctor and my oncology nurses like me a lot. They are invested in my cure.

I believe all of that.

What I know for certain is that I am invested in them.

Classically, Stockholm Syndrome describes the reaction of people who are held captive and threatened with death by someone--but that person shows them some acts of kindness as well. Captives often grow to identify more with their captors than with the people who might be trying to save them--like say, the police. My doctor and my nurses (note that my doctor and my nurses) neither hold me captive nor threaten to kill me. But they do threaten me with death in the sense that they have told me I might die. And they do things to me that are painful and distressing. And they show me lots of small kindnesses.

Most importantly they are going to save me.

When I read other people talking about their experience with Hodgkins, I see that many of them are very attached to their doctors and nurses as well. I read a post where a woman said her oncology nurse was leaving, and how she couldn't type that without crying. I've had jobs where people left, I've had friends move, and while I might have been sad, I've rarely cried. But I wasn't as afraid as I think I would be if Dr. Schnur quit practice. Or Jeanette and Pamela left.

Now Dr. Schnur is perfect. But for hypothetical reasons, lets assume he was like everyone else's oncologist. And remember that 50% of all doctors are, by definition, below average. That means that some of the doctors those other people with Hodgkins have are below average. In fact, I know some of them are prescribing treatments that are no longer current because first of all, it's not the chemo regimen that Dr. Schnur is prescribing, and well, it's also not the regimen described as current on the National Institute of Health's pages of information for medical practitioners treating Hodgkins.

What would I do if my doctor seemed to be doing something that felt wrong? I'd like to say that I'd get another doctor. But there are articles that indicate that radiation treatment after a course of chemo does not seem to improve chances of survival in Hodgkins Stage Ia and IIa. What will I do if Dr. Schnur prescribes radiation? He has told me that the Lymphoma Oncology community is split down the middle about the issue, and he has told me that we'll talk about it after eight doses of chemo. And if he prescribes it, I'll do it, despite my worries about secondary cancers later on. (Secondary cancer--leukemia as a result of treatment for breast cancer--is probably what killed Susan Sontag.)

Why? Transference. Stockholm Syndrome.

Because I am in the wilderness, and Dr. Schnur is my guide. I am emotionally attached. Because deep down I know he loves me and he's going to save me. Because otherwise, it's pretty lonely out here, even with Bob and all you guys.

(Poor Dr. Schnur. If he ever read this he'd probably be mortified.)


Blogger Madeleine Robins said...

I don't think he'd be mortified. Dr. Schnurr has doubtless encountered the same feelings in all his other patients (although he doubtless loves you best).

How else could you take this journey if you didn't love your guides and trust them?

January 19, 2005 1:28 PM  
Blogger Maureen McHugh said...

I dunno, Mad. Students sometimes assign me more power than I really have and it can be a bit frightening.

January 19, 2005 4:04 PM  
Blogger Madeleine Robins said...

Well, yes. A friend of mine became a doctor (nephrologist, or "a student of the nepher," as he styled himself once). I asked him if he ever got scared of how much power he had, and he looked at me funny. "I don't think about that. If I did, I'd have to be a postman or something."

A woman in my workshop had extensive orthopedic surgery, and among other things later wrote a story in which a character has extensive orthopedic surgery and falls in love with her surgeon. I don't think this is a new trope.

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