One thing I noticed, after we discovered my coronary artery disease, was my need to tell people how unlikely it is that I should have it. Whenever I mentioned my diagnosis I was compelled to point out that I am 34, take care of my heath, and have no family history of heart disease. I wanted people to know that I am an anomaly.
Wanting people to know that your medical condition makes you a statistical outlier does not make for polite social exchange. Someone I barely knew would ask me about a bruise on my legs. I would begin by telling her that I’m on blood thinners and five minutes later I’d gratuitously detailed my past exercise regime, my commitment to cruciferous vegetables, and the non-heart diseases that killed my grandparents. And as the listener slowly backed away, sorry she asked, I would think to myself, “where did that come from?”
I realized that, for some reason, I felt guilty for having heart disease. I wanted people to believe that the disease wasn’t my fault – that I didn’t cause it by a bad lifestyle or by disregarding a strong genetic predisposition.
Upon first reflection I thought I was being silly, because I am visibly young and healthy – without saying a word, surely most people would assume I did not bring about heart disease by my own debauchery. Then I realized that this mindset was even more ridiculous, because (and I can’t believe I had to say this to myself) heart disease is an awful, potentially-fatal illness, and no one who has it deserves it, even if she has made unhealthy choices. And yet, I clearly felt the need to distinguish myself from others who had not taken good care of themselves or ignored their predisposition to the illness.
Maybe I felt guilty because at various points in my twenties I ate fast food or smoked socially. Maybe that’s why I wanted everyone to know that, despite some mistakes when I was younger, I am genuinely committed to my health.
But I don’t think that’s it.
I think the real reason I felt guilty was because, without ever realizing it, I had always blamed people for their own heart disease – and I’m pretty sure I’m not the only one. We live in a world that tells us over and over again that heart disease is caused by an unhealthy lifestyle. Sure, some people are genetically predisposed, but even they can prevent incidents by eating right, exercising, and listening to their doctors. When I heard that heart disease was the number one killer of Americans, I thought, “Well that makes sense, Americans are overweight, don’t exercise, eat crap, and have a lot of unmanaged stress.” So of course I thought I was immune to it, because I did yoga and avoided processed foods. I was good so heart disease shouldn’t happen to me.
Do other people with heart disease experience this guilt? I wonder how it plays out for them. I also wonder if this attitude towards heart disease has an impact on the way we, as a culture, respond to it. Would we donate more money to research and treatment of heart disease if we were less judgmental of those who have it? Have more 5Ks? And this all raises a bigger question: How do we focus on prevention without placing blame on those who fail to prevent it?
Oh heart disease, once again you’ve given me a lot to think about. In the meantime, maybe I should start by making an effort to not give my full medical history to the person I’m sitting next to on the train.