I lie to my doctors and I think that probably other people do as well. Not when anything is particularly life-threatening, like when they ask, “how high was your home blood pressure?” or “are you experiencing any pain?” But I might lie when my doctor asks something, something else, something other than the thing they are asking, asking behind me, asking about me, asking for me, on behalf of me, supposedly, to get to the truth, the truth that is the health of me, if only I could get out of the way. I’m in the way.
Elaine Scarry, in her book The Body In Pain, describes how doctors, while in a position meant to speak for those in pain (“as many in the throngs of pain can’t speak for themselves in moments of pain”), commonly see themselves rather as detectives searching for truth beyond the patient, the “unreliable narrator” in the story of their own body. Scarry elaborates: “…for the success of the physicians work will often depend on the acuity with which he or she can hear the fragmentary language of pain coax clarity and interpret it…many people’s experience of the medical community would bear out the opposite conclusion, the conclusion that physicians do trust (hence hear) the human voice, that they in effect perceive the voice of the patient as an unreliable narrator” of bodily events, a voice with must be bypassed as quickly as possible so that they can around it and behind it to the physical events themselves.”
Medical professionals ask questions like: “You sure?” “These results don’t make sense. Can you tell me why these numbers are this high?” Every symptom is a mystery, and they are Dr. House on the case, ‘cause they are the “best damn doctor we got.” When I get questions like these, I lie. I tell them anything. Cause I know the real answer, and they don’t want that answer. I’m ill. It’s an answer my doctors don’t want, because it might not be solvable, it might not be a problem, it might not be the right problem. Doctors lie too. They look at you, at your face, in your eyes, (or not at your face or in your eyes), at your chart, your blood work, your numbers. They’ve got your number. They say, “that’s normal, don’t worry about that.” But you know it’s not normal. If it were normal, you would have experienced it before, when you were normal, normal-er. And you know you aren’t normal because you are seeing an onco-cardiologist, who is in contact with your PKD nephrologist, who saw that you visited the rheumatologist, and when you met with your oncologist, they didn’t refer you to an endocrinologist, because in her words, “you already have quite a few doctors.” When your doctors ration your referrals because they understand you are over-burdened with “care,” you know you are no longer normal. More importantly, I reserve the right to worry. Liar.
Lying to your doctor is a delicate thing. Surely it weakens the bonds between patient and doctor—the magical strings of light tied by a winged Hypocrites. That bond gets strained after describing your level of physical activity as “pretty good” instead of “work from home okay.” Sometimes, you will need to ask something that lives outside of your doctor’s knowledge, something your doctor doesn’t know. Sometimes your doctor will take this as a threat. Because they’ve trained for this! They’ve trained for years, sussing out silly non-cooperative patients, silly patients that don’t know any better, silly patients that do know better but don’t know best. Then, you get more questions, or you get more tests (take home tests, home work, proof work, show your work, show your proof). “I want you to bring in your blood pressure monitor.” “Bring your blood sugar monitor.” “I’m going to test it against ours.” “I’m going to compare those to a blood test.” “Let’s add a hemoglobin A1c test to your next labs.” “Why don’t you take a 24 BP monitor.” “I want you to track all of your food for the next week.” Some tests are best done at home, because home is where normal happens. White coat syndrome—the name given to the condition of someone’s blood pressure being higher at the doctor’s office than at their home—is common. But home blood pressure readings are subject to patients, patients are subject to error, to failure, to tampering, to lying.
The only doctor I accused of lying to his face was a resident at the pediatric hospital I was in. I was in a tiny room for cancer patients (certainly not for bodies, as the 16 room had no running toilet. Instead, a bed pan was lovingly placed in the shower.) A small window was in the upper right corner of the room, I corner I couldn’t reach. The location of the window mattered very little. It wasn’t much larger than a piece of paper—and it had metal bars installed in front of it. There was a small TV in the same corner of the room. A shit show. The resident treating me that day, (I do not remember his name as he took no time to remember mine), told me I should eat a diet of leafy greens. This is not unusual. Except I was on a strict diet—an immunocompromised diet, a decontaminated diet, an anti-fresh diet, a processed or expertly cleaned diet. The hospital opted for processed. This was one fact I was hyperaware of, as I had not eaten greens in months. Notorious for microscopic bacteria (that might normally be safe to eat), leafy greens were literally and metaphorically off the table. The resident doctor, empowered, bolstered, and emboldened by his status, his student debt, his title (he was a resident and he resided here, this was his house), directed me to eat this green meal. I was like Daniel of old, who, when offered meat from the Babylonian king, ate only the pulse and wine and was not sick. I abstained from the devil’s salad. I rebuked this leafy fiend, this food felon. I scorned this man, this child. His supervising doctor shook his head at him and regretfully confirmed the truth, a truth—my truth. The doctor to be, the doctor in training, the doctor in training wheels, the big-wheel doctor left in shame with his tail between his legs. I knew the truth, because I honestly would have loved a salad.
Lying is a defense mechanism. Like flinching, or screaming. A question out of the blue, out of the sky, out of an ass, out of hot air, a question that comes at you that throws you and you have to flinch. “Umm, nothing happened.” “Yeah I’ve eaten perfectly this month,” Because the honest answer is more like: “I couldn’t afford all of these different treatments, so I stopped taking one medication (against your recommendation) because talking to you about my material conditions is truly more painful.” Or “I ate quite well this month, though I did eat out, I ordered out, I ordered in. I ate frequently, infrequently. What did you eat? What do you want me to eat? Will you cook for me? Will you buy my groceries?” Doctors are lying because they aren’t asking you what you ate; they are asking why you ate what you ate, because they know you ate what you ate because they know, because they are doctors and doctors know and patients do not because patients are liars.
Julian Harper 