The Hierarchy of Disease: Whose is Worse, Yours or Mine?



Today I heard from my friend at Heart Sisters, Carolyn Thomas. She was commenting on my article, "Celebrities Talk About Their Illness in Vanity Fair." What she had to say is worth repeating so I reprinted it here in its entirety.

Hi Dr. A,

I had to laugh at Christopher Hitchins writing: "One almost develops a kind of elitism about the uniqueness of one's own personal disorder."

I have found this to be very true for heart disease, which I was diagnosed with two years ago.

I call it the "Hierarchy of Heart Disease". I think I invented the concept, but many heart attack survivors like me have reported experiencing a similar reaction when telling others about their own diagnosis.

For example, on my very first evening attending our local Heart & Stroke Foundation's 'Heart To Heart" Cardiac Support Group meeting, the man sitting next to me asked me, basically: "What are you in for?" When I told him that I had had a serious heart attack and now had a stainless steel stent implanted in my Left Anterior Descending coronary artery which had been 99% blocked, he chirped: "ME TOO! Except I have THREE stents!"

Well! What could I say? How could I possibly compete with THREE stents!?!

Five months after my heart attack, I met a wonderful group of women survivors like me at Mayo Clinic in Rochester, Minnesota, and we immediately began comparing cardiac notes, who had what, who had more than the rest, whose story was most dramatic, when one woman simply said: "I've had a heart transplant!"

Transplant is the highest level of elite cardiac event in the Hierarchy. All other cardiac events pale pathetically by comparison. I think the rest of us just sat quietly and ate our breakfast in silence after that. Let's face it, nobody wants to hear your puny little heart attack story when there's a heart transplant at the table!! :-)

More on this at: "The Seven Levels in the Hierarchy Of Heart Disease".

Cheers,
C.

Dr. Aletta here. Let me just add that even though we play these comparison games, everyone's unique story is top on the hierarchy for that individual. Too often I have self-deprecating clients say something like, "Well, that's my story, but I shouldn't complain. So-and-so has it so much worse than me." Pain is totally subjective. No one can feel it for us, therefore it is top priority for us, as it should be. Having compassion for the other person shouldn't mean diminishing the relevance of your struggles.

My pain is not yours, and neither is more important than the other. It is all important.

2 comments


  • I think there’s a hierarchy to just about everything that at least seems like it can be compared. In college it was how little sleep you got. On facebook it can be how many friends you have. There’s probably not much that can escape comparison.
    You’re so right in saying pain is subjective and shouldn’t be compared. Our tolerances are different. What’s debilitating for me may not be much more than a nuisance for you. As I look at having surgery and a painful recovery this week, I’ll keep your words in mind. Thank you.

    2010/11/22
  • Sheryl,
    Just about anything pain related can be turned into a competition. Take labor, for instance. Have you ever been in a room with mothers talking about childbirth? Not pretty, let me tell you.
    Take all the time you need to recover from your surgery. Whatever your surgeon says your recovery time will be, add a couple of weeks. That way, should you get back on your feet faster, you will be pleasantly surprised. Do not be a hero. Take your pain meds as prescribed and let others baby you a bit. And let us know how you are doing!
    Be well,
    Dr. A.

    2010/11/22

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