The Myth of Normal 37

conflict, and the superautonomous self-sufficiency we saw embodied by Caroline. Based on the interview results alone, both the interviewers and “blind” raters who had no direct contact with the women were able to predict the correct diagnosis in up to 94 percent of all cancer patients, and in about 70 percent of the benign cases. [2] In a previous British study at King’s College Hospital in London, it had also been shown that women with cancerous breast lumps characteristically exhibited “extreme suppression of anger and of other feelings” in “a significantly higher proportion” than the control group, which was made up of women admitted for biopsy at the same time but found to have benign breast tumors. [3] In 2000 the publication Cancer Nursing surveyed the relationship of anger repression and cancer, often noted by, among others, the cancer nurses themselves: “Somehow, nurses had an intuitive understanding that this ‘niceness’ was deleterious. [This] view now is being supported by research.”[4] The nurses’ insight reminded me of a paper on amyotrophic lateral sclerosis (ALS) [*] presented by two Cleveland Clinic neurologists at an international congress in Bavaria in the 1990s. [5] Their staff, too, found that their ALS patients were extraordinarily nice—so much so, that the staff could in most cases accurately predict who would be diagnosed with the condition and who would not. “I’m afraid this person has ALS, she is too nice,” they would jot on the patient’s file. Or, “This person cannot have ALS, he is not nice enough.” The neurologists were dumbfounded. “In spite of the briefness of [the staff’s] contact with the patients, and the obvious unscientific method by which they form their opinions, almost invariably they prove to be correct,” they remarked. I interviewed Dr. Asa J. Wilbourn, senior author of the paper. “It’s almost universal,” he told me. “It becomes common knowledge in the laboratory where you evaluate a lot of patients with ALS—and we do an enormous number of cases. I think that anyone who deals with ALS knows that this is a definite phenomenon.” Such anecdotal observations have since been reaffirmed by more formal research, as seen in the title of a recent paper from a neurological journal: “‘Patients with Amyotrophic Lateral Sclerosis (ALS)