Denial; cancer and global warming

Denial: The refusal to admit the truth or reality.  The assertion that an allegation is false.

Cancer patients depend on denial.  Without its protection, we would be overwhelmed by terror.  Denial filters and slows bad news, so we can digest reality in the merciful morsels; thus, we cope.  Without denial, we would shut down, withdraw, and lose hope; healing would not be possible.  However, if we do not move beyond denial, accept the diagnosis and loss, make a plan, we die.

Allen, a 43-year-old man, came to me after an insurance physical showed anemia.  He felt well.  His exam was normal.  However, Allen’s blood chemistry showed an abnormal protein, in addition to the mild anemia.  I recommended a bone marrow biopsy.

Was I certain that anything was wrong, Allen asked?  No, I was not sure; which is why I suggested the test.  What if he exercised more and improved his diet?  Took vitamins.  Did focused meditation.  What would happen?  Since I did not know what was wrong, it was very hard to predict.  Well, Allen announced, if I could not be definite, he would not do the marrow.

Two years later, Allen was back.  He was more anemic.  The abnormal protein was higher. He had back pain.  After three visits over four months, to discuss the possibilities, he agreed to the bone marrow biopsy.  He canceled it two times, blaming pressures at work.  I called him. Allen did not return my call.

One year later, I saw Allen in the emergency room, paralyzed, a mass in his mid-spine.  Surgery was advised, to get a biopsy and relieve the pressure.  He declined.  Allen received emergency radiation for the unknown cancer.  Blood tests showed a large increase in his abnormal protein consistent with myeloma.  He desperately needed further tests and treatment.  He declined, refusing follow-up, planning instead an “anti-cancer vegan low sugar high vitamin C diet.”

Tragically, there are many Allens.  Either, they do not trust doctors, do not understand science, or are too frightened to accept that their bodies and lives are changing.  They focus on any uncertainty, inconsistency or the unknown nature of the future, and they deny what is blatantly and simply obvious.  It cannot happen to them.  Denial becomes pathology, a disease itself.

It is remarkable to me is how closely cancer denial parallels the near complete lack of action that we see on climate change and global warming.

Unlike Allen, the earth has allowed extensive testing regarding its health.  Thousands of studies show that the world is warming, global disruption accelerating and the cause is massive burning of fossil fuels.  The probability of annihilation by our own hands within a short number of years is high.  However, like Allen, we deny.

We distract ourselves with details.  The warmest 10 years in recorded history have been since 1997, but not EVERY year was warmer.  CO2 is higher than at any point in the last million years, but the measurements around the world are not rising at the same rate.  The ozone hole is actually getting better and didn’t the satellites miss it at first?  Moscow was 105, New Delhi was 120 degrees last summer, but New York was cool.  What about that volcano in Iceland?   The hottest years were from El Nino.  There have been warming cycles before.

Like a frightened, confused, overwhelmed cancer patient, we cannot face the blatant and simply obvious reality that our world is changing and that it is our fault.

Allen said, “Doctors are trying to get rich, sell drugs.”   We deny global warming as a hoax perpetrated by scientists.  “They are trying to publish and make a name for themselves. Control our minds.”

Allen did not understand biology, so instead of taking medical recommendations, he took vitamins.  We deny global warming by pleading ignorance to science and data.

Allen would say that chemotherapy is a poison, worse than the disease.  Climate deniers talk about hundreds of bats and birds killed by wind turbines, not the billions of animals dying from the obliteration of their environment or extinction rates a thousand times normal.

Allen refused care because it would disrupt his life, take him from work, and disturb his plans.  We deny our role in global warming because any solution will require changes in how we work, live and the very nature of society.  We focus on the threats to today’s jobs, short-term economic loss, and fail to realize that the greatest threat is to life itself.

Allen did not trust me because I could not tell him exactly what would happen.  We discard the idea of warming, because the complexity of the weather on a whole planet is not completely understood.  An unknown tomorrow is apparently not a tomorrow worth considering at all.

Allen said, “I feel fine.”  Most of the world’s people “feel fine,” so it cannot be happening to them.

Allen died.  He was admitted with kidney failure from florid multiple myeloma.  Last minute chemotherapy could not rebuild multiple system failure.  His disease, which could have been treated with a long survival, did not respond to denial.

Allen was upset that a disease was going to change his life. Therefore, he did nothing.  Every sane person is upset that climate change will radically alter human life.  Nevertheless, denial is no longer a reasonable, healthy or rational response.  We must move on, accept the obvious, and act.  Fail and denial will be the instrument of our end.


  • This is a very good analogy. Thank you! All we need now is to procure a lobbyist... :) :)
  • Maybe when doctors and patients are rewarded for being proactive - there will be less denial. And sometimes the memory of how doctors have spoken to me and other loved ones - makes me want to bury my head in the sand too.
  • boblosan
    Thank you for speaking of both denials. I see the correlation and I applaud your voicing a sane opinion of global climate change. We need you - both patients and citizens of this world. Please keep on fighting the good fight.
  • alyce
    Denial is also the longest river in Egypt. I hate talking about cancer. I have had too many bouts with it. Now I have Rheumatoid Arthritis I am once again taking chemo drugs.A weekly shot of methotrexate and have started on Rituxan. I also have a quarterly infusion of Zometa . This is supposed to keep my plasmacytoma from becoming miultiple myeloma. I love my oncologist and rheumatologist. However I am old and losing patience with the whole thing. Sorry for the moan. Climate change deniers are Ill informed or on the longest river in Egypt.
  • D Someya Reed
    This piece can be read a number of other ways. You could just as easily be saying: - I told you so (Allen and "Allens" of the world) now that I know the outcome or... - You need to listen to me and do what I say (in a paternalistic fashion) even though I don't know what is wrong with you or... - I suspect you have the beginnings of multiple myeloma (that protein) but I'm not going to tell you or ask you any questions (such as if any family members had been diagnosed) because I know it's incurable, the treatments are long and brutal and I don't want to make you feel bad and there may be negative repercussions for me if I bring it up too soon or...etc. You categorize all patients (wrongly) when you state, "Without denial, we would shut down, withdraw, and lose hope; healing would not be possible." Not everyone shuts downs or withdraws at bad news yet still may not do as you say. Are they then in denial? Others will heal (a few perhaps even miraculously defying the odds). Some will carry that same protein and never feel any effect. Are they in denial or just risk-takers? Then you add "...if we do not move beyond denial, accept the diagnosis and loss, make a plan, we die." It's arrogant (at minimum) to say that a patient must accept your diagnosis and move on. In the end, we all die. That's the only real science fact and someday even that may be proven wrong. Many will be misdiagnosed and put through horrible treatment options or will you deny that this does indeed happen? Why is it impossible to believe that "Allen" wasn't making a Quality of life(style) choice consistent with the way he always lived his life for as much remaining time as he could have while feeling good? Isn't this what we all say now?. Isn't this the core of hospice and palliative care? Don't we say "make the most of the time you have remaining" and "it's your body and you should have control over what's done to it?" Or do we not really mean it or not when it conflicts with what we want or want someone else to do? Agreed, his disease could have been treated and possibly he would live much longer. But, would it be a "good" life? Not per your opinion, but his? Seems reasonable considering that to the last (paralysis) he didn't ask you to "fix him" or give in to treatment. Per your writing, it sounded like he just wanted some relief (palliation). As to global warming, it's now called "climate change" because of the lash back for record cold temps though the core issue is the warming of the oceans. But, annihilation? Do you not believe in the adaptability of life? Did you not read about life found in the ocean deep below the arctic ice where life was always thought impossible? Are you not engaged in your own form of denial? Has denial made you a "closet pessimist?"
  • J R
    Doctors do engage in denial. I was at the bedside of a cancer patient whose family was not informed he was dying until palliative sedation was being administered. My first response would be to think that it must have been the patient's wishes. However, upon further investigation, I learned that the doctor decided to leave for the day without saying anything.
  • cindy eggert
    Liked your message. Hope you've read ' The Sixth Extinction '.
    • J R
      I'll have to check it out!
  • Excellent piece and fascinating analogy! I'll share it on social media. It is painful to see how much of the human population (both in the U.S. and globally) chooses to be in denial about all sorts of things besides personal health and global warming: racism, religious intolerance, global poverty, corporate greed, etc., etc. It's sad, and likely to limit human well -being on this planet.

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