When the Truth Trickles In

I work in the world of patient safety. Care delivery processes in health systems sometimes break down. As a result, patients may be harmed by preventable, medical errors. Clinicians and organizations respond after an event to learn what happened, how it happened, and how to prevent it in the future.  One of the most important parts of the event analysis process is trying to involve patients and families as true partners in the healing journey. It hasn't always been that way. Historically, health systems had a tendancy to "deny and defend." They put up walls to truth-telling and patient involvement in an effort to protect the organization from lawsuits and tarnished reputations. They may fail to disclose an error due to a faulty belief that it would cause more harm than good. Particularly, this occurred in cases for which the patient may have been terminally ill or had a poor prognosis anyway--thus, the consequences of the medical error may likely go unnoticed in an acutely ill or terminal patient. 

Enter this concept--Benevolent Deception--when a physician or care team may not be truthful with a patient about diagnosis in an effort to be caring and not to cause additional stress, anxiety, or harm. It's more recently applied to organizations' not disclosing medical errors to patients for the same reasons. Only half-truths may be told, or facts are withheld. Simplistically, medical teams may decide for the patient that "ignorance is bliss." 

This is, of course, wrong. Health systems are changing these ways. We now know better. Through both research and anecdotal experiences, in the face of medical error, truth-telling must guide all conversations. Patients and families want and need to know, and it is an organization's duty to disclose the error and proactively address what happened. 

Reflecting on this concept, I realize that my ex-husband likely engaged in "Benevolent Deception" in the times following the discovery of the affair.  In fact, this affair phenomenon has a formal (and I think dumb) nickname, the “Trickle Truth”. The Trickle Truth is when the wayward partner withholds the full truth about what happened, and it slowly trickles out over time. It may come from a good place in terms of not wanting to inflict more pain, but it often backfires, and it's painstaking. 

Early on, I clearly remember a marriage counselor advising him to disclose the full truth as quickly as possible. But, we did not go through that "ideal" disclosure. Instead, truths of what happened over the course of 5 years came out achingly slow, and often only in the face of my discovery of evidence over the course of 8 months.  At each new truth, I thought I had hit the bottom of the facts. But, I was repeatedly shocked, surprised, and traumatized to continue to learn more information I previously didn't know. Every time I found out something new,  my ex-husband would say, "I didn't want to hurt you more."  In what I imagine was his effort to be benevolent, he continued to be deceptive.  

This is, of course, wrong. The Trickle Truth is completely destructive to the couple's ability to heal. It should be re-named the Traumatic Trickle Truth, because that's what it felt like. It significantly decreases (if not eliminates) the chances of reconciliation. It was a hurtful re-run I couldn't get out of.

In short, it was a boomerang of emotional assault that damaged my sense of safety, self-esteem, and sometimes made me question my intelligence. How could I be so dumb? I believe love can be blind, but my problem was that I kept getting blindsided. For me, it was the number one determining factor of moving forward to divorce. Continued lying, after years of lying, left me with no hope for the future. There comes a time when the wayward spouse shouldn't get the luxury of controlling the narrative anymore. He shouldn't have been able to determine "ignorance is bliss" for me. More likely, it was his bliss. The facts are what they are at the point of Discovery, and the sooner a betrayed spouse knows them, the faster healing can start. 

Benevolent Deception has no place in the aftermath of an affair, the same as it doesn't have a place in the aftermath of medical errors. Both experiences are highly emotional, intensely personal, and equally require the most rigorous, complete, and genuine process of truth-telling.

No one is entitled to a "risk-free" marriage, but in the face of numerous risks that can enter a marriage (e.g. financial, fidelity, health and fertility, parenting), I would argue that marriage vows at least entitle each partner to the truth of the other. 

“I'm not upset that you lied to me, I'm upset that from now on I can't believe you.” ― Friedrich Nietzsche