I could never forget her, nor would I necessarily want to forget her.
Clinically, she had a horribly destructive left breast cancer, which was the intense discussion by the medical team, which included me. She was poor, as was typical patient at the University Hospital, and largely related to that, she had delayed seeking expensive care. That’s just one of the of unchecked cancers of America’s healthcare system, but it was also a seemingly inseparable subject of discussion by her medical team.
Remember, whenever there is a problem, the most important thing to do is establish blame.
But my silent drummer was pounding away at a different beat. I noticed that she was completely unphased and not even sure why her family had brought her in to see doctors. I was fascinated, and relieved that the Psychiatrists were consulted because she did not seem to be taking this seriously. That of course did not solve the immediate problem, but it did start working on the urgent difficulty with obtaining her informed consent to attempt to halt the ongoing damage to her body.
The psychiatrist asked her to draw a stick figure of herself. We all looked puzzled by this odd request, but she obliged without hesitation, and proudly presented her effort (this is how I will never forget she drew it):
In medicine, it is said we get dressed in the mirror - left is right, right is left. The missing part above is her left side.
My heart silently broke. I was after all a toughened medical student who could take a beating and ask for more, please. And she was a beautiful woman, but it was also quite apparent her external beauty was surpassed by the beauty of her person.
As the psychiatrists explained to mostly superficially interested ears, she was affected by la belle indifférence, and we would like never see another such remarkable case of it.
For the uninitiated, academia is the place where patients go to become a “case.”
La belle indifférence is the paradoxical absence of psychological distress despite a serious medical illness -- not just ignoring that illness, but an unshakable unawareness of it. Yes, that degree of dissociation is indeed possible.
In my lowly medical opinion, the term is more often misapplied to patients with Conversion Disorder/Functional Neurologic Symptom Disorder, where there are often identifiable stressors, but there is no discoverable medical cause and symptoms are incompatible with any known medical disorder.
For those interested, the psychiatrist was able to help her, and the oncologist was able to help her too. I have no idea how it all turned out, but in my mind, everything turned out beautiful.
Or as Paloma Faith might sing, do you want the truth, or something beautiful? Just close your eyes and make believe, ...I am happy to deceive you... I didn’t want to speak the honest truth so I spit out lies that aimed to soothe... Secrets, lies and telling tales, I can be who you want me to be... but do you want me?
As my usual readers know, I continue to struggle to understand MAGAs.
My current working theory for the imperturbable MAGA voting base is a mass Conversion Disorder/Functional Neurologic Symptom Disorder, where there are definitely identifiable stressors, but there is no medical cause and symptoms are incompatible with any known medical disorder. Note that those stressors are mostly not unique to them, but their coping with them is.
Once more, without feeling:
do you want the truth, or something beautiful? Just close your eyes and make believe, ...I am happy to deceive you... I didn’t want to speak the honest truth so I spit out lies that aimed to soothe... Secrets, lies and telling tales, I can be who you want me to be...
The cause of those identifiable stressors? Recent memory includes the million dead Americans killed by Covid-19, compounding an already gestating economic crisis but which never materialized into the feared recession, thanks to efforts by President Biden and his skilled team, a grossly corrupt rule of law, a dysfunctional MAGA House frequently threatening to burn it all down, and ballooning income disparity, to name a few.
But who continues to push a slate of fake stressors, instead of reporting the truth? MAGAs and their complicit media/press, solely for the secondary gain they achieve from creating and maintaining chaos. We all feel that on some level.
But I happen to think the current journalism creed is a false dilemma. I happen to think they could profit from reporting America’s success story, and still report on the chaos and destruction created by the world’s dictators. Who’s going to tell them there’s another way? They’re certainly not listening to any of us:
I am a psychologist and the picture of half a woman brought up more questions than answers. The diagnosis is also disturbing. When I learned of.”la belle indifference “ in graduate school, it was pretty much dismissed as a type of hysteria. I intuitively felt that it was a response to some traumatic event that had been successfully repressed. When I brought this up with my professor, he thought it was “interesting“ and then dismissed it. The way women are constantly being dismissed. This is a brilliant article by Dr. Rochat!
I can see what you are saying about that possible diagnosis of Conversion Disorder/Functional Neurologic Symptom Disorder - but I have no medical background. It just makes sense to me. As you pointed out, the journalists in this country are not doing their job. How to get them to do that? Follow the money. Damn.