Why me

Monday, November 23, 2009

It’s an unasked question that seems to cause the most grief for patients. Why did I get sick? What did I get injured? The answer is often just as difficult to understand. Just because… People want a reason for why things happen and sometimes there isn’t any.

A philosophy exists that there is no such thing as a motor vehicle accident and that accident should be replaced with crash; that all crashes are potentially preventable and therefore no an accident at all. Explain that to the people who were injured and killed in a tour bus rollover in southern Minnesota this past week, when the driver blacked out when he suffered a ruptured cerebral aneurysm. Brain aneurysms may be asymptomatic for a lifetime and are found only on autopsy. The timing of this aneurysm rupture is difficult to predict and wonder why it didn’t happen while he was asleep or eating lunch, instead of driving a bus at 70mph on an interstate highway.

Al Harris of the Green Bay Packers might be wondering the same thing about fate. The season ending knee injury occurred while he was running down the field during a game against the San Francisco 49ers on Sunday, when he fell because “his foot caught in the ground”. Football is a violent game where bodies collide and arms and legs are twisted in the pileup of players. But Mr. Harris, torn the ACL in his knee running untouched on grass, no different than in practice or while playing with kids in the backyard.

Illnesses are no different. Why one person can suffer from the flu while a family member remains well is a question with no answer. Kids who catch a cold, get strep throat or develop pneumonia get sick because they were in contact with another person who was ill. Not everyone in class gets sick and parents want to know why it was their kid that was unlucky. And then they want to know if their kid will pass the infection on to somebody else. That answer is perhaps a little easier because the child has likely been spreading the virus or bacteria for a few days before becoming symptomatically ill themselves. It takes time for an infection to take root and cause symptoms and in that time, the body tries to repel the infection; sometimes it wins, sometimes it doesn’t.

Timing is everything when it comes to explaining injury and illness. Perhaps Mr. Harris would not have been hurt if he had stumbled in the first quarter when his leg muscles were fresh and strong instead of in the fourth when fatigue might have prevented the muscles from protecting his knee. Perhaps the bus driver had had a previous warning headache of a cerebral aneurysm and had failed to notice it. “What if” is a difficult game to play. The answers are hard to find because the questions are so vague. What if the bus tour was cancelled because of poor weather or lack of interest. What if some people had missed the bus because they had a family obligation that made them run late. What if the people who were not injured had chosen a different seat.

Answering the patient and family member who asks “why us?” or “why now?” isn’t very satisfying. Perhaps people who are healthy and well should remind themselves that those same questions allow us to enjoy that health and well being that is present. Who knows how long it will last.

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