Acid reflux, his colleagues said. More time went by. The pain persisted despite treating the acid reflux. So he went to see more doctors. Repeatedly over several months, multiple head and neck surgeons assured him acid reflux was causing the pain.
Finally, a resident performed a simple examination procedure which the surgeons over several visits hadn’t tried, and discovered a cancerous tumor the size of a peach pit.
The doctor with the throat pain underwent emergency throat surgery and had his voice box removed.
All because he spent months trying to fix something that wasn’t actually the problem.
I read it right here in the blog comments of a recent post. Someone wrote that her father was a doctor and often said: “An accurate diagnosis is 90 percent of the cure.”
Sometimes I read or hear something that sticks with me. This is one of those things.
Because, how do we diagnose the problems in our marriages or long-term relationships?
We mostly guess. And I think we mostly guess when we’re angry or sad or afraid.
At any given time, we have a certain amount of facts we know or at the very least, believe to be true. Certainty, real or otherwise.
Regardless, there is also a certain percentage of missing information. About everything. We constantly have expectations about what will happen next, or about what might be going on elsewhere, or about something we’ll be doing in the future.
When you’ve driven the same route to work for five years, you can predict with relative accuracy (even with all the variables) how long it will take to drive to your destination.
You can accurately predict how long it will take for your shower water to turn from cold to hot when you first turn it on.
We expertly perform countless little tasks every day that seem routine and inconsequential, but to someone who had never done them before, the experience would be much different.
Any time we’re missing too much information, our brains use every piece of input it can to try to guess what’s happening or will happen. We fill in all the missing pieces with guesses. Maybe we’re right sometimes. But we’re probably mostly wrong.
During most of my marriage, I would repeatedly choose things I wanted to do over being present and engaged with my wife. I’d sometimes watch movies or ballgames in a separate room, or play online poker or do whatever.
In moderation, two healthy people can have an amazing relationship balancing Together Things and individual pursuits. But outside of our social lives, we didn’t have a lot of Together Things, so I pursued many individual interests.
I made a habit out of leaving my wife alone in a separate room to watch TV or read a book or talk on the phone believing it was a simple matter of us both doing what we wanted to do. Everything’s cool! We’re just both good at letting one another do their thing!
But when you combine it with me not pursuing her intimately as a husband should, and me being disengaged and disinterested in some of her personal interests, and frequently demonstrating an unwillingness to perform household chores and projects, and of course ALWAYS messing up the empathy thing during disagreements, it must have looked and felt much different to her.
She felt alone. Unsupported. Unwanted. Unloved. Disrespected. Rejected.
I never realized people could feel alone with other people around. I didn’t know the typical “shitty husband” behaviors affecting so many marriages were the dangerous relationship killers they are.
There was a lot of incorrect guessing going on all around.
It’s hard to explain how many pegs I had to fall in my own mind to gain the perspective and humility necessary to eat the Crow, the Humble Pie, and the Shit Sandwiches I needed to be the me I am now.
How does one feel genuine gratitude for the worst thing to ever happen to them?
It’s silly for her to be sad and angry!, I thought. She’s misdiagnosing the problem!
And in a way, I was correct. Philosophically, my wife was mistaken. She was loved, wanted, respected, desired, etc. But knowing what I know now allows me to see how everything happened in a way that was impossible (due to ignorance and neglecting to educate myself) for me to see then.
She was missing information. And because our communication was so epically shitty (despite both of us being longtime communication professionals), I was never able to communicate the missing information effectively or convincingly enough to help her more accurately understand those unknown things we’re all constantly guessing at.
During the final 18 months of my marriage, I slept in the guest room, and our already substandard and ineffective communication had come to a near-standstill. Because I was fully disconnected from and disengaged with my wife, the Unknown piece of the Things I Know About My Wife pie chart was expanding.
That was very bad.
The Art of Guessing What We Don’t Know
Back to the example we started with, The Washington Post ran an article about medical misdiagnosis a few years ago. It somehow feels relevant.
“Misdiagnosis ‘happens all the time,’ said David Newman-Toker, who studies diagnostic errors and helped organize the recent international conference. ‘This is an enormous problem, the hidden part of the iceberg of medical errors that dwarfs’ other kinds of mistakes, said Newman-Toker, an associate professor of neurology and otolaryngology at the Johns Hopkins School of Medicine. Studies repeatedly have found that diagnostic errors, which are more common in primary-care settings, typically result from flawed ways of thinking, sometimes coupled with negligence, and not because a disease is rare or exotic,” the Post story said.
“The problem is not new: In 1991, the Harvard Medical Practice Study found that misdiagnosis accounted for 14 percent of adverse events and that 75 percent of these errors involved negligence, such as a failure by doctors to follow up on test results.”
I started to lose it.
I know people say that as a figure of speech to talk about normalish episodes of feeling upset or whatever. But I mean it a bit more seriously than that. I came undone. I became, to some degree, mentally and emotionally unstable.
I totally lost it during those months sleeping in the guest room while I watched everything break apart from the inside.
I started feeling immature jealous feelings which is something I hadn’t experienced much in life.
Every attractive guy on TV or in real life suddenly became an object of her sexual interest in my imagination. Every text message alert was some guy she probably had a crush on, I thought suspiciously. I’d make up all kinds of thoughts and feelings for her—all of which I was really afraid of being true—and I thought about and worried about these made-up thoughts and feelings so much that they became real for me.
When our friends would come over and we’d pretend to be cool, I secretly thought that the wife in those other couples had been talking to her about our marriage problems and that they were silently judging and thinking bad things about me with fake smiles on their faces.
I wasn’t kidding. I lost it.
Without ever having any sort of mature fact-finding, soul-searching conversation with my wife, I just kept letting my paranoid imagination tell me stories about her thoughts, feelings and dreams. About who and what she wanted. About with whom she was discussing our broken marriage.
It’s funny because I assumed everyone knew, but almost no one did.
Until it was all over, she barely spoke of it, and even then, not much.
I thought I knew my wife better than anyone, and maybe I did. But without communicating effectively or asking the right questions, there was still so much I didn’t know.
The truth is hard to write:
We both guessed incorrectly about what the other person thought and felt, we both did an awful job trying to bridge the communication gap, and the kiss of death was my assumption that My Way—the way I thought and experienced the world through my own individual perspective—was somehow “more correct” than her way. That inherently flawed belief helped me justify not putting in the work reading books and talking to people who knew better than I did what love really is.
I don’t know how long I believed my marriage problems were simple acid reflex instead of cancer.
Maybe if I’d started down this path sooner, everything would be different.
Maybe the misdiagnosing and early detection failures at the start of our relationships are ultimately the things that kill us.
There can be no answers when we fail to ask the right questions.
There can be no cure when we don’t even know what’s wrong.
We think it’s this thing. But really it’s something else. So we never get the medicine or treatment we need.
And then we die.
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