There’s a quiet superstition that some people may carry about themselves – a private conviction that serious misfortune is something reserved for other people. It’s a comforting illusion, this sense of personal invulnerability, and most of us cling to it even when the evidence suggests we shouldn’t. It’s human. It’s universal. And it’s dangerous not to be honest with our doctor.
But every now and then, someone’s life collides with reality so abruptly that the illusion shatters. And when it does, what’s left behind can be unexpectedly illuminating.
This is one of those stories.
A shock diagnosis
Catching up with John, a former police colleague, after far too long, our conversation naturally drifted toward filling in the gaps. And then he told me he’d navigated a near-death experience. Not just any diagnosis, but an extremely rare blood disorder. The shock wasn’t only in the medical detail; it was in the way he spoke about it. Illuminating. Pragmatic. The kind of clarity you only earn by walking right up to the edge and peering over.
He described how his mind behaved when life and death hung like scales above him. Instead of clinging to family, his thoughts drifted toward work – the job, the uniform, the identity we once wore like armour. And then came the realisation that floored him: he saw that the job would honour him in the same way a finger removed from a glass of water leaves no impression – a momentary ripple, then perfect indifference.
Anger followed by pragmatism
That truth ignited an anger so fierce it almost consumed him. He should have been a better father. He should have been a more attentive husband. Yet at the moment of reckoning, his psyche reached for the wrong anchor. But the fury ebbed quickly and something quieter took its place, a kind of internal absolution. A recognition that self-forgiveness wasn’t optional; it was survival.
John decided that if he was going to be dragged through this rare medical labyrinth, he’d at least make the journey useful. He became, in his words, the professional patient. No stiff upper lip. No British cultural choreography of “I’m fine, honestly”. He answered every question with brutal honesty because he believed – correctly – that accurate data saves lives.
When the accepted wisdom of his condition didn’t match his reality, he challenged it. The doctor’s oft-cited symptom of “stiff fingers”? Not quite. For him it felt like wearing thick woollen gloves that made his fingers itch like hell.
It was refreshing. It was perplexing. And it was a mirror held up to the rest of us.
Why we lie, even when the stakes are existential
Humans can be astonishingly bad at telling the truth about their own bodies. Humans can be astonishingly bad at telling the truth about their own bodies, even when the consequences are catastrophic. The reasons are depressingly familiar:
- Embarrassment: bodily functions remain taboo, even in clinical settings.
- Fear of diagnosis: if you don’t say it, maybe it isn’t real.
- Stoicism: especially in Britain, where suffering quietly is practically a national sport.
- Optimism bias: the belief that serious illness happens to other people.
- Not wanting to be a burden: a social instinct that becomes self-sabotage.
I was reminded of my late mother-in-law, who faced bowel cancer with a smile so convincing it fooled even the professionals. She didn’t want to be ‘a problem’, even as the pain pinned her to the bed.
The cost of not being honest – to us and to the NHS
Research into patient honesty paints a stark picture. One study shows that 60% – 80% of patients withhold or distort information during medical consultations. Reasons range from embarrassment to fear of judgement. The consequences are significant:
- Misdiagnosis: incomplete symptom reporting leads to incorrect or delayed diagnoses.
- Ineffective treatment: clinicians can’t tailor care without the full picture.
- Higher healthcare costs: the NHS absorbs the fallout: repeat appointments, unnecessary tests, emergency admissions.
- Reduced survival rates: particularly in cancer care, where early and accurate reporting is critical.
A 2018 study by Andrea Gurmankin Levy and others, published in JAMA Network Open, found that patients commonly hide symptoms, medication non-adherence, and lifestyle factors. The authors concluded: “The clinician-patient relationship requires honest and open communication between both parties to maximize the therapeutic benefit and avoid potential harms.” In NHS terms, that translates to avoidable deaths and millions wasted annually on complications that could have been prevented.
The irony is painful: the very system designed to help us is undermined by our reluctance to tell the truth.
A patient’s honest reflection
I shared the first draft of this piece with John, and he was moved to add the following reflection:
“Why we lie: I realised I lied because I loved the people most affected by my diagnosis. I wasn’t coerced into it – I participated willingly. For years I believed my mum and dad were indestructible; it took me a long time to understand they weren’t. I’m happy to let my children hold the same illusion about me. I reframed what was happening to protect them, and perhaps to protect myself. People often describe illness passively: “I’ve been diagnosed with X.” Instead, I told my kids that my illness had contracted a dose of John. And John, frankly, is deadly. Really, we should feel sorry for the disease.”
Our minds deceive us too. Maybe acting as a ‘professional patient’ helped me see through my own self-deceit – revealing who I really am. Serious illness strips you naked. It removes the layers of identity we use to define ourselves. Money, education, assets – none of it mattered. All I had left were the people I loved, and the people who loved me.
A final thought on optimism, pessimism, and the old ‘glass half full or half empty’ cliché: I learned that the glass is neither. Whatever is in your glass is all you’ve got. Others may have more or less, but that’s irrelevant. Whatever I have is everything I have, so my glass is completely full. I’m neither an optimist nor a pessimist. I’m a relentless realist.
The quiet heroism of the professional patient
John’s approach – radical honesty, even when uncomfortable – shouldn’t be exceptional. It should be standard. His willingness to be fully transparent wasn’t just an act of personal courage; it was a contribution to collective knowledge. Every truthful answer helps refine treatment for the next person unlucky enough to share his diagnosis.
He understood something many of us don’t: the truth is not a burden in medicine; it’s a lifeline. And perhaps that’s the quiet heroism of the professional patient. Not the stoicism. Not the suffering. But the decision to be fully seen, fully heard, and fully truthful, even when the truth is frightening.
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