FEBRUARY 27, 2020

Hope vs Denial

Isn’t hope a wonderful thing? It is part of the essence of the human condition.
Some of you that are Facebook friends will know that we have had some bad luck lately; nothing too serious but our appliances, cars and other electrical goods have conspired to ensure a co-ordinated draining of the bank account.

I heard an advert for the National Lotto today. Suddenly, I know I can win. I am plotting a way to stop and buy a ticket. The one thing I can remember from my statistics course is the following: “Statistically you are more likely to die in an accident involving a mattress or a pillow, than you are to win the lottery.”

Sigh, I still spent my lotto winnings in my head!
It’s hope. And we all need to have hope.
I saw a child and mother this week that have left me reflecting on hope and what it means.

The child is an insulin dependent diabetic. The blood sugar hasn’t always been easy to control and the child has had previous hospital admissions for this. The most recent admission resulted in such deranged blood sugar causing fitting and ultimately brain damage. The condition is bad, really bad. However, the mother puts on her make-up, comes to the hospital smiling and greeting us all warmly, in a heartbeat gets involved in the care her child.

Now, part of my job as a paediatric palliative care is to prepare for the worst while hoping for the best. Mom and I have a 90-minute heart to heart and we talk about everything. Mom doesn’t want to prepare for the worst. She knows her child will get better. Despite all the counselling to the contrary, Mom knows we are just health professionals; we are not God. So I try again. I ask her to consider the worst case; what if the sugar becomes difficult to control and her condition gets suddenly worse?

What I am wanting to do is write an advance care plan to ensure we only act in the child’s best interests and do not in any way increase suffering. Mom smiles knowingly, she says, “Doctor, I know what you are trying to do. I hear you. I am not in denial. We have a funeral insurance policy and will use it if we have to. When God wants my baby, He will take her. So until then, I will love my child and hope for my child as a mother should.”

I am often called to a parent “in denial’. It’s a term doctors love. But more often than not, during open and honest conversation we find that hope is not the same thing as denial. Hope is a coping strategy. It’s a survival skill and a parent’s drive to advocate for their child when the health professionals lose hope.

It’s not necessarily and certainly not always a bad thing.

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