A tale of two women: how we react to a heart attack diagnosis

by Carolyn Thomas

Although I’d been having increasingly debilitating cardiac symptoms for two weeks, when the cardiologist in the E.R. told me that I clearly had “significant heart disease”, I almost fell off the gurney. That diagnosis started a roller coaster of reactions in the days, weeks and months ahead: shock, disbelief, fear, denial, gratitude, anger, inspiration, despair, hope, anxiety, relief, self-pity, determination – well, you get my drift.

Welcome to your ‘new normal’.

Dr. Charlotte Thompson, university professor at the University of California at San Diego and a practising physician for over 50 years, has had her share of observing how patients react to a devastating diagnosis. She says:

“I am always amazed at the different ways that patients respond after a serious diagnosis.”

She gives this example of how two different women demonstrate what works – and what doesn’t:

“One woman has changed her life so that as much stress as possible has been eliminated. She is taking more time for her creative work, continuing with her exercise program, taking a special, long-planned trip, and receiving counselling. Her serious diagnosis has a good outlook at this time.

“But the other woman is doing everything possible to make her condition worse. At the end of her workday, she is stressed and very tired. If she were my patient, I would say: ‘Either you make some drastic changes or I cannot care for you.’ I wonder if her doctor has even talked to her about what she does each day and how she is coping.”

Dr. Thompson insists that any woman who finds out she has a serious illness must immediately take charge of her own life.

“Most doctors today cannot be counted on to sit down and talk about how to make the best choices for your survival.”

At the University of Washington Medical School’s Ethics in Medicine program, med students are taught that patients hearing a serious diagnosis can often recall decades later in exquisite detail how the news of their diagnosis was delivered by their physician, even if they remember little of the actual conversation that followed. Patients also report that physician competence in these situations is critical to establishing trust and reducing anxiety about the future.

A study in the Netherlands of women with chronic disease diagnoses found these strategies in common for those who were most successful in adapting to their diagnosis:

keep active
express emotions
take control
think positive

In about 30% of cases studied, those with chronic conditions don’t make the transition to their ‘new normal’ well. But most patients eventually adjust, and in fact may even tend to achieve a quality of life that is remarkably similar to that of healthy people, say the researchers.

Some report that their illness helps them grow as individuals, endowing them with more courage, resilience, patience, tolerance, compassion and empathy for others.

In fact, the Dutch research shows that about 60% of patients with breast cancer, 73% with rheumatoid arthritis, and 58% with heart disease report at least one positive change in their life as a result of their illness.

Find out more about this research.