In a recent episode of our podcast, we spoke with Allison Sweet Grant, a psychiatric nurse practitioner and author of Lump, a memoir about breast cancer treatment and motherhood. Allison shared her experience of what she calls the “perfect patient” and why the desire to be liked can sometimes get in the way of getting the care we need. This is a great episode so please check it out! Here are some highlights:
Allison’s relationship with the healthcare system began long before her cancer diagnosis. Born with a congenital malformation that left one leg shorter than the other, she underwent an extensive leg-lengthening procedure as a child. Much of her treatment took place when she was around eleven, an age when children are already navigating a particularly vulnerable stage of life.
As a young patient, Allison felt she had little say in what happened to her. Adults discussed her condition, medical professionals examined her, and she was expected to cooperate. Her job was to sit still, comply, and not make trouble.
Decades later, when she found herself back in medical settings as an adult, those old feelings returned. Despite having a background in healthcare herself, she still struggled to speak up, communicate her needs, and question authority.
The internal rules were familiar, and very Type C: Don’t make trouble. Don’t ask too many questions. Don’t be difficult.
As we know, these rules can begin as ways of navigating childhood environments in which keeping the peace feels important. A child learns to stay small, avoid upsetting others, and become the easy one. Over time, those adaptations can become deeply ingrained. Even when circumstances change, the rules remain.
A medical appointment can be the perfect environment for those old patterns to resurface. There is an inherent power imbalance, the setting can feel intimidating, and the patient is often frightened, uncomfortable, or overwhelmed. For someone accustomed to putting others first, speaking up can feel almost impossible.
Allison described a particularly revealing pattern: Before an appointment, she can find herself worrying not only about the medical issue at hand but also about whether her healthcare provider will like her. Her husband has repeatedly asked her a simple question: “Why do you care if they like you?”
It’s a reasonable question. Yet for someone with strong Type C tendencies, the desire to be liked can be persistent. Being agreeable feels safer than risking disapproval. Cooperating feels better than challenging authority. And asking for more time or attention can trigger guilt. The problem is that when we focus on being a good patient, we can lose sight of why we are there in the first place.
We may downplay pain because we don’t want to seem dramatic. We may leave out symptoms because we don’t want to sound as though we’re complaining. We may accept an explanation that doesn’t sit right with us because questioning a medical professional feels disrespectful. In trying so hard to make the appointment easy for everyone else, we may make it harder for our healthcare team to understand what is actually happening.
Allison shared a striking example from her first chemotherapy appointment. She experienced a severe reaction to a chemotherapy drug, leaving her in immense pain and requiring nurses to rush to her side. Once the immediate crisis had passed and she was able to speak again, her first response was to apologize. She hadn’t done anything wrong. She had experienced a medical emergency. Yet, seeing the worry and commotion around her, she felt she had become a burden.
This is the perfect-patient trap. The impulse to soothe, accommodate, and apologize can be so automatic that it overrides our own needs, even when those needs are urgent.So how can we begin to change this pattern?
Allison’s first suggestion is to ask a question before entering the examination room: What is my main goal here? The answer is to address the medical concern that brought us there, not to win the provider’s approval. We don’t have to eliminate the urge to be liked. We can simply try to put it aside long enough to focus on our health.A few practical strategies can help:
Write down questions in advance. Allison brings a physical list of questions to medical appointments. Adding to it in the days or weeks beforehand helps ensure that important concerns aren’t forgotten in the moment.
Bring someone who can advocate for you. A trusted friend or family member can offer emotional support, help remember what was said, and ask questions when it feels difficult to speak up. As Allison pointed out, an advocate may find it easier to raise a concern because they don’t carry the same fear of being perceived as difficult.
Keep track of symptoms and experiences. When we are accustomed to second-guessing ourselves, written notes can help us describe what we have actually experienced rather than talking ourselves out of it. Be specific about what happened, when it happened, and how it affected daily life.
Remember that your perspective matters. Healthcare professionals bring essential training and expertise. Patients bring something equally important: firsthand knowledge of their own bodies and experiences. Good care depends on bringing those forms of expertise together.
These strategies may sound simple, but putting them into practice can take real courage. Awareness doesn’t instantly undo years of learned behavior, but it creates an opportunity to respond differently. The goal isn’t to become demanding or confrontational. It’s to recognize that being cooperative does not require being silent, and being considerate does not mean putting our own needs last.
For Type Cs, learning to advocate for ourselves may mean tolerating the discomfort of asking one more question, requesting clarification, or saying, “I’m still concerned about this.” It may mean accepting that a healthcare provider’s momentary inconvenience is not more important than a patient’s health. Most importantly, it means recognizing that needing help is not the same as being a burden.
The perfect patient may be pleasant, compliant, and easy to care for. But the patient who shares concerns honestly, asks questions, and speaks up when something doesn’t feel right is giving their healthcare team a much better chance of providing appropriate care
To listen to the podcast, click here.