A diagnosis of chronic hepatitis C viral infection usually stirs up a range of emotions. People react differently upon hearing this diagnosis. Some respond with denial, dismissing the possible implications of carrying the hepatitis C. Anger is another common reaction. Patients are often frightened, especially since they know little about hepatitis C, the treatment, or the possible consequences of having a virus residing in the liver. For some, a hepatitis C diagnosis can be pivotal. A chronic illness may bring up issues of life and death, and the realization that life is indeed short.
Regardless of the severity of your particular case of hepatitis C, the diagnosis itself is never benign. Human beings are not prepared for “bad news.” Although life throws those proverbially curve balls at us, largely we expect life to go well. The will to live is innate and being told we have a virus that can lead to liver damage, cirrhosis, and possibly death challenges every morsel of life. Or does it?
When I worked at Stanford, I met a man in the cafeteria. We struck up a conversation and within a few minutes, he disclosed to me that he had recently been diagnosed with a very aggressive form of cancer. He had decided to undergo an intense treatment regimen. This man explained to me that he had learned to live his life by conquering difficult challenges and this was just one more. Since his diagnosis, he had completed a marathon and climbed Mt. Rainier. The determination he expressed seemed equal to the fear he felt. There was room for both fear and bravery to coexist in his heart. This man made a deep impression on me. Why did he act with such obvious courage rather than defeat? What could I learn from him that would be useful for the patients I work with as well as for myself?
Coping is a learned behavior. Humans learn how to react to life through their family and other social structures. Some learn to view hardship as something to conquer; where even the smallest obstacles defeat others. Learned behaviors can be unlearned, modified, or replaced by more effective skills. The following offers some suggestions of how to weather hard times.
- Avoid isolation. Self-absorption and self-pity are common reactions to crisis, but left unattended, can make matters worse. Find support through family, friends, support groups, clergy, or counseling.
- Examine your inner voice. What are you saying to yourself? Are you saying, things are never going to get better? Or are you saying this will pass? Are you saying, I can’t deal with this? Or are you saying, this feels awful, but I will learn to deal with this?
- Skip the guilt. If you acquired HCV by way of a voluntary act, such as through past injection drug use or failure to practice universal precautions, then self-blame may be an issue. Guilt can be self-destructive. Forgive yourself and move on.
- Take control. The diagnosis of chronic HCV infection is an unwanted discovery. Loss of control over health and the future are natural feelings that arise. Feeling powerless can cause a downward spiral. The remedy to this is to regain control. Ask yourself what you can control. In general, humans can control what they eat, drink, their level of activity, stress, and attitudes. After you have identified what you can control, then ask yourself how you will do this.
- Make a commitment. Once you have identified how you can control your life, make a commitment to do this. Renew this commitment on a regular basis.
- Look for inspiration. Many people have survived far worse circumstances than an HCV diagnosis. Some examples are prisoners of war and concentration camps, victims of violent crimes, and survivors of various atrocities. Find books, articles, and opportunities to hear their stories. Learn from their wisdom.
- Help others. Helping others prevents self-absorption and self-pity. The most resilient survivors of the Nazi death camps were those who helped others.
Learning to master crisis is not an overnight process. Be gentle with yourself. A favorite quote of mine is from an unknown author, “Concentrate on what you want to become, not what you are trying to overcome.”
(This edited excerpt originally appeared in the HCV Advocate July 2002)