Projecting fears

An old post on a nursing blog honestly expresses some thoughts about severe disability. Geena, at Code Blog: Tales of the CCU, talks about her difficulty connecting to patients who are quads:

I have a small problem taking care of quadriplegics. Nurses, I think, enjoy caring for certain types of patients and dread caring for other types. I personally find it of the utmost difficulty to take care of people that cannot move.

Which isn't to say that I don't try my best and do a good job. I can attend to the physical aspect perfectly, but I find that I'm completely closed off emotionally. I always try to keep some emotional distance from every patient (although sometimes get sucked in when I least expect it), but with quads I find myself not only keeping distance, but building a big huge wall.

and

I find it difficult to even look a quad in the eye. I feel as though they are in a place that I can't even imagine, that I can't even begin with empathize with. Whenever I look someone who is a quadriplegic in the eye, whatever is staring back at me is simply too much to take on, and so I don't try.

and

But not being able to move yet being fully conscious... that's too tough. It's almost as if they're telling me with their entire being that I will never be able to understand, so don't bother trying.

To her credit, she also says she has educated herself about other situations in order to relate better to patients and she asks for suggestions of writings about quadriplegia. But the comments to her post include a couple by people trying to help her more directly:

I'm not a book about quads, but I'm the real deal. I broke my neck in a car wreck on April 6th 1975. I just passed my 30th aniversary as a quad.

At 46 I'm still very active and alive. I find it very sad that you can't look a quad in the eyes. Do you think we want your sympathy? We are human just like you, with have feelings just like you. I managed to except the life I faced very early on in my disability. Some never do except it, and thus live a very short misarable life. I have been very fortunate to have my family around me. I was lucky enough to also have found love we a beautiful lady. We hade several great years together. We had different ideas about what I should do career wise, so we went our different ways. She married another quad and they were very happy for the 20 years they were together, until he died.

Also:

Good Afternoon, I am a quad of 22 years who after injury earned bachelors and masters degrees, got married, have a child, and work full-time...

If you seek to tackle the issue, you do not have to identify with a quad as a peer-quad, but rather as a peer in life. I suspect that all peoples’ losses, including quads’, combine to frustrate many, including the quads you have met at an arguable low point. My “losses” and thoughts on them include the objective (walking, self-feeding, orgasm from intercourse), subjective (missed personal goal-setting and those losses outsiders think are important), and the reasons why there are losses, real or perceived, such financial or community resource shortfalls or individual internal motivational factors....

Next, if any person acts like they have lost so badly that they fail to be motivated, I’d have trouble identifying, too. If you fear quadriplegia as if it were a slow death of depravity, perhaps you have not experienced an acquaintance with a fairly “normal” quad (who, by the way, might end up in a hospital with pneumonia BUT with pictures and a story of his/her family), which is understandable in your field.

Geena's perspective is likely the dominant one, and I think it's pretty clear from her description of what she sees quadriplegic bodies are communicating to her (as opposed to the individuals with quadriplegia) that she's projecting her fears of paralysis onto her patients. Though it's surely hard in the setting where she meets quads (in a CCU they are probably often newly injured, trached, and cannot speak), the solution to her problem seems so obvious. Get to know actual people.

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