Some diseases are incurable — but we can still provide healing
My childhood memories are full of the battles my parents fought with cancer. I wonder if they got the care they truly needed.
In my family, cancer is an heirloom. Passed down from my grandmother to my father and his sisters, the cancer ultimately spared my aunts but not my father, who died at 47 years old. I was 14. then there is my mother, a two-time breast cancer survivor whose most recent battle brought us into chemotherapy wards during the height of the CoVId lockdown.
It is clear that chronic or terminal illness strains the psyche: People with a range of conditions from diabetes to Parkinson’s to cancer experience disproportionately high rates of depression and anxiety. A life-altering diagnosis by itself can cause significant grief and trauma.
And yet most physicians, including oncologists, spend less than 25 minutes per visit with a patient — not nearly enough time to work through the social and emotional consequences of chronic illness. I’ve seen how depression and anxiety screenings become filling out worksheets by rote or a hasty referral, while real emotion in the doctor’s office becomes a burden — a sign to sweep that person away to psychological services.
separating physical from mental health care comes at a cost. My parents dealt with cancer at a time when the mental health impacts of their disease were more stigmatized, but we now know that patients are more likely to be honest about their health if they have supportive relationships with their physicians.
Such relationships require doctors and patients alike to acknowledge and normalize the emotional impacts of disease. Researchers at Massachusetts General Hospital have even found that good patient-doctor rapport “can produce health effects as beneficial as some common treatments, such as taking a daily aspirin to prevent heart attack.”
This doesn’t mean turning medical consultations into therapy sessions. but studies show that even small shifts in physician communication — making more eye contact, naming emotions, or asking patients open-ended questions — can foster a deeper sense of care and connection.
I’m the first in my immediate family to go to therapy, where I’ve grappled with the impacts of chronic illness on my and my family members’ lives. In that work, I consider how disease can break us down — and yet in the words of author and cancer patient suleika Jaouad, it also “breaks us open” and makes us more human.
As I process my experiences of chronic illness, my memories are mixed. I think of fishing with my father, him threading gummy worms onto the line when I was 7 years old to appease my concern for real, living worms. I can see my mother picking petunias before the school bus arrived in the morning. but I also remember my parents enduring chemotherapy in tandem, my mother bald, holding hands with my father, her high school sweetheart, in our dining room-turned-bedroom in the final days of his life — paragons of their vow “in sickness and in health.” I think of the oxygen tanks and wheelchairs that cluttered our home in my father’s final days.
I think about how some physicians encouraged them to stay positive — and I wonder what would have happened if their providers had made more room for their sadness. Maybe my parents would have been more likely to accept the doctors’ offers of a referral to a therapist.
Part of the problem is that doctors are overwhelmed. the pandemic exacerbated already high rates of depression and burnout among health care professionals. one survey in 2023 found that nearly 25 percent of physicians were depressed, and another survey found 6 in 10 doctors were experiencing burnout. Physicians and other health care workers are also vulnerable to secondary traumatic stress, or compassion fatigue, which can occur from routine exposure to death and disease. No wonder health care professionals are not meeting the mental health needs of their patients — they are struggling, too.
Research shows that there’s now less stigma around therapy in the United states, but it still remains out of reach for many, especially those from marginalized communities. Increasing the availability of mental health services is necessary in the long run, and merely the availability of mental health support has been shown to boost well-being.
There are steps health care providers can take to better meet their patients’ needs in the meantime.
Consider narrative medicine — a practice developed at Columbia University more than 20 years ago that teaches doctors to really listen to their patients and use storytelling as integral parts of care. this might mean a doctor would practice deep listening strategies that center the patient’s experiences, intentionally share a bit about themself in ways that facilitate a connection with the patient, or take a few minutes to engage in a brief writing exercise after seeing a chronically ill patient.
Nontraditional forms of care, like spending time in nature — an approach championed by neurologist oliver sacks — as well as mindfulness, somatic practice, or pet therapy are other tools patients and practitioners might use when coping with disease. some researchers have also found that training physicians in basic cognitive behavioral approaches may help them better communicate with and support their patients.
The call for compassionate, patient-centered care is not new yet is itself sisyphean. We must push that call up the proverbial hill over and over again to pursue lasting change within the medical system. In doing so, we embrace a more holistic definition of what it means to heal. even when the disease itself is incurable.