I was sitting in my hospital bed as the doctor and her throng of interns and residents came in to deliver the news: surgery, a PICC line, and no end to the hospital stay in sight. Disoriented from pain medicine and sleep deprivation, I wasn't sure how many days I had been in the hospital, and I was worn down and crushed, but not surprised. But the worst part of this news wasn't the news itself; it was the half dozen medical strangers fixed with a look of pity and my doctor's reassurance: "Sarah's a brave fighter; she will be just fine." I was in pain, physically and emotionally, but under the watchful eyes and my doctor's expectations, there was no way I was going to be dissolving into tears before they left the room.
Society loves the idea that a person with an illness is a heroic fighter in their own personal sickness war, and on the surface, this perception is not only a positive image of persons with illnesses or certain disabilities, but a massive compliment. This image is adopted by the masses: touted by pink-clad women during Breast Cancer Awareness month as they tell their stories, and used as a descriptor for "inspiring" people who are "battling" diseases (the late Stella Young immortalized how the equating of disability or illness to inspiration is problematic in itself). But although they harbor good intentions, the war/illness metaphor and the assumption that persons living with illness are more courageous than others create unachievable expectations.
When illness is equated to war, patients are transformed into soldiers in their own metaphorical battlefield. While this vision may be a badge of honor for those who survive, what about those who succumb to their disease? The unlucky are described as "losing their battle," an unjust phrase that unintentionally characterizes patients who were victims of more unfortunate medical diagnoses as failures. Additionally, for the vast number of individuals with non-terminal, chronic conditions, the idea of a war is simply untrue. Millions of people have conditions that will stay with them for their entire lives. They do not rebel against these conditions, but learn to adapt to their own realities and limitations, while growing in many other ways.
The problem of the war metaphor in medicine ties into the greater issue of expecting persons with illnesses to be selflessly brave and stoic. The picture of a patient putting on a brave face is heartwarming, but it is far from reality. Sickness means pain, complications, exhaustion, and fear, and holding these emotions back to meet the expectations of friends, family, and doctors can cause serious problems, such as unaddressed depression or further strains on health. Recognizing fear, frustration, and even weakness is far healthier than trying to act like these feelings don't exist. In fact, it takes bravery for patients to confront their vulnerabilities, and for their support system to acknowledge uncomfortable emotions.
The picture of bravery needs to make room for vulnerability, but this shift in perception will not come easily, especially since it involves criticizing a trait that is largely viewed as positive and making room for something that is perceived as negative. One can continue to call patients "brave" and "fighters" all they want, but this often reinforces the idea that they must live up to the expectation of being strong. Instead of treating patients like heroes, treat them like regular human beings, with regular strengths and weaknesses, and recognize that it is okay to feel scared. Medicine isn't war, and no one should face the expectation of being too strong to cry when they are truly in pain.