Denial

Denial is a psychological defense mechanism in which confrontation with a personal problem or reality is avoided by denying the existence of the problem or reality. We frequently see patients in denial about their health problems. Just recently we had a patient in his fifties who ignored his sore toe. By the time he sought medical attention the toe was gangrenous and he ended up with a below the knee amputation. Post-surgery he became depressed and refused to follow Medical advice. This led to further problems and it was decided he could not go to rehab so he was sent to a nursing home to recover. He was at the nursing home exactly one week when he developed pneumonia and was admitted to the hospital in Septic Shock. That's when I first met him in ICU.
When a patient is first admitted to ICU we attach them to the monitors, we then assess them and they're seen by their admitting doctor. We receive orders to get blood cultures and other labs, start IV's, and give the medicines that have been ordered by their doctor. It's a very busy hectic time especially if the patient is very sick like this gentleman was. As nurses we are responsible for the admitting paperwork. This is a tedious task, none of us like it but it has to be done. So once the patient is settled we will generally get the family to assist us with this. This patient was sedated on a ventilator, he looked horrendous far older than his actual age. His 2 daughters in their mid to late twenties came into the unit. They both stood at the end of his bed in a state of shock. The younger one put both hands to her face took a big gasp and whispered Oh Daddy...she then bowed her head and sobbed. The older one trying to be strong bit her lip. They were a sad sight to see. I'm a seasoned ICU nurse but sometimes it just hits you like a bat. It was all I could do not to cry.
Refusing to admit the truth or reality of something unpleasant is amazingly common it's almost a defense mechanism for some. You see people with advanced cancers they admit they haven't felt well for a while, they've worried they might have cancer and yet have not seen a doctor. Often they haven't spoken to family members about it. It's like they think if I don't talk about this it will go away or get better on its own. The ulcer stinks to high heaven and they put on perfume or cologne to hide the stench. They use peroxide and an assortment of creams and portions and it continues to get worse. After a while they're too embarrassed to go see a doctor because they fear their reaction at letting it go so long. They don't want to be thought a fool. They live in denial a negation in logic.

Dora Meulman