Denial in Medicine

Happens with patients. Can it happen with physicians? Reflective intro from April 4, 2023 in italics

April 4, 2023: Upon reading this entry, I see that there is very controversial material here, which as yet is contested in the media and/or not addressed by any authorities. This is the question of physician mortality rates in 2022. One researcher on the issue, Dr. William Makis from Alberta, hypothesizes that 1) there are increased physician mortality rates in Canada for 2022, and 2) are caused by adverse reactions to covid vaccines. To date, no government or medical authority has agreed with Dr. Makis on the first point.

Denial in clinical medicine is a psychological defense mechanism that is used to explain why diabetics end up with toe or foot amputations. Basically, the person is sick, and does not want to acknowledge being sick. The solution is that they ignore their symptoms, ignore their deteriorating health, until the consequences are drastic.

This is seen in many other illness, such as emphysema and smoking, or obesity and consumption of unhealthy food.

As I learned of this in medical school, it was defined as a problem for patients. There was never a suggestion that doctors might use denial too.

In a conversation with a frustrated and somewhat despairing patient, who did not want to obtain a covid vaccine, I learned that his interactions with the health care system on the issue had left him with a feeling of disgust. While I often hear complaints about the health care system from patients (including people who criticize my attempts at delivering care to them), it is seldom that patients say they are disgusted with how they were treated.

The upshot of this conversation, which had initially been about the patient hiding from his diabetes, was the realization that some of my colleagues have been hiding from problems with covid vaccines.

I would propose that examining the behaviour of physicians in terms of this psychological defense mechanism - denial - is probably useful for many scenarios.

As for how disgust enters into the story. I find myself wondering if the disappointment I have felt for patients who were in deep denial of a health problem bordered on disgust. Perhaps this is a normal reaction when witnessing profound denial.

On a related note, it appears that the Canadian Medical Association has records of physician deaths in Canada, 826 over the past 4 years. This has been assembled into a spreadsheet and a variety of analyses can be performed. There is a concerning rise in deaths of physicians less than 50 years of age in 2021 and 2022.

At this point, I will observe that there are strong indications that Canadian physicians are being consistent in their beliefs surrounding covid vaccinations.