Mar 10, 2008

A Tough Case

by Rene Allen

You may recall my last blog was about the monsters who live under our beds. This was in response to my having a cardiac stress test. Today’s blog is about what happened when I went to a cardiologist for results. I told the doctor he should be honored. “My blood pressure is only 150 when I see my internist. For you, it is 175.”

You may think that because I am a physician it is strange I have such a bad case of “White Coat Syndrome.” Usually, knowledge brings power. In this case, knowing the what-ifs of stress testing and what might come next (angiograms, angioplasty, stents, by-pass, sudden death) brought terror and I felt silly about it—until the cardiologist, a friend from way back, told me about his experience with a lung tumor. Even when he was coughing up blood, he was convinced he had Valley Fever and ran a hundred tests which all came back negative. Such is the power of denial. Without denial you have reality: Valley Fever is a lot better than a lung tumor.

For those who need to know how the story ends, my friend had surgery and is now healthy enough to laugh about his experience and to tell me my stress test was fine which is another happy ending, perhaps not exactly happily ever after, but enough to bring my blood pressure back to normal.

I would really like not to have this problem with “White Coat Syndrome,” principally because I feel like an idiot trying to explain it. How much of the story do you tell? “Well, I had a bad experience with anesthesia when I was four, and the nuns at the hospital made me stay in a crib so I threw a fit and tossed all the bedding on the floor . . . which is a true story by the way, although I can’t remember what the sisters did after my tantrum.

This problem with blood pressure has a lot of angles. For the time being, I have to accept the fact that it is part of who I am and until I find a cure – nothing comes to mind except avoidance and death, neither of which is particularly practical at this stage of my life – I will continue feeling like an idiot whenever I go to the doctor and try to explain my maverick nervous system.

What is the lesson here? Well, one lesson is that life is a grand comedy. If I were on the other side of the blood pressure cuff, I would smile at the middle-aged woman with the red face and bounding pulse. “I know you don’t want to be here,” I’d say. “Do you really think I’m going to do something to you that would justify 170?” That would make me – the woman laugh. Seeing the ridiculous is good for blood pressure.

Me, my friend who had a lung tumor, and all the rest of us ordinary people who inhabit this good old place called Earth manage our stress in unique and creative ways. (Ask me about a couple of macho patients who two days after major heart attacks, in order to prove they were okay, raced their wheelchairs down the sidewalk in front of the hospital!) What I know is, the more I can accept that I am more human than impossibly strong, the less I will feel like an idiot about my “White Coat Syndrome.”

A psychologist once told me that vulnerability is a hard one for all of us. There are many ways I, you, we—am and are vulnerable. Threats to security, personal safety, to our ability to control our lives and environment are plenty enough in our day and age. The seesaw between the seeming control of denial and anxiety ridden reality bounces up and down and whether we like it or not, we are often its passengers.

Not everyone of course is on the denial – reality ride. There are some who invite faith into their lives and demonstrate great courage in the face of adversity. I am reminded of a patient, a young woman with deer-like brown eye and an appealing, soft-spoken calm. She related her adversities: a husband with a chronic illness who might never work again, three children, two of whom had severe attention deficit disorder and learning disabilities, her own prolonged bout with mononucleosis that made it difficult for her to complete a day’s work.

I listened amazed at her equanimity. “How do you do it?” I asked. “You have so much going on in your life.”

“I know God loves me,” she said.

I felt an immediate peace when she said it, and I feel it now. The seesaw stops. It is after all else, the best solution. “Be still and know that I am God.”


  1. I busted out laughing before I got past white coat syndrome. I worked for about 9 years in 2 different hospitals in the business area. But boy do I remember getting that syndrone. Funny stuff and glad you're ok!!!

  2. I've often heard that doctors and nurses make the worst patients because they know how bad it COULD be. Still, I'd never before considered that merely seeing a 'white coat' could be intimidating, when I find them comforting -- just one step lower than the comfortable touch of mother, friend, spouse or elder. Above all, no matter what one's status, the scripture you quote still fits: Be still, and know that I am God.

  3. I'm curious. What is your specialty / area of practice? Have you written down your memoirs to pass on to your posterity and colleagues? It seems to me that your personal experiences would be very inspirational.
    I'm a nurse. I know for a fact that doctors and nurses make the worst patients. Doctors almost always disagree with the orders that are issued in their behalf and so contradict them in their diligent path of denial.
    I'm the kind of person that thinks the worst, knowing just enough of what something could be, and hoping that it isn't, but looking at all the signs and symptoms that could possibly be related to and confirming the most horrendous outcome. Then I start feeling guilty and or unworthy of assistance from on high and shun any help offered from those who surround me.
    The scripture you quoted is the one that gives me the greatest comfort along with Proverbs 3:5-8. "Trust in the Lord with all theine heart; and lean not unto thine own understanding. In all thy ways acknowledge him, and he shall direct they paths. Be not wise in thine own eyes; fere the Lord, and depart from evil. It shall be health to they navel and marrow to they bones."
    When I remember this, then I can finally calm my heart and kneel down to pray and if needed ask for a priesthood blessing acknowledging the greastest physician of our universe.

  4. Rene, I love the way you always manage to teach and entertain at the same time. I am in that "the more I learn, the more I see I do not know" stage of life. Is that the beginning of wisdom? I hope so. Otherwise it is terrifying.

    I think that the denial-reality ride you mention can wake us up to the need to put our faith into action...or even to kick it up another level. Thank you for your words today. I am going to take time for being still today.


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