The cost of never wanting to be a burden
Self-Erasure Is a Symptom. We Reward It. Patients Pay My grandmother refuses to go to the hospital even when care is free.She says her pain is “not serious enough.” She worries about wasting doctors’ time. She apologizes for being unwell. Clinically, she looks stable. Medically, she is not. What she has is not stoicism . It is self-erasure. Self-erasure is not a personality trait. It is a learned belief that one’s needs are a burden and must be minimized to deserve care. It develops under scarcity, violence, gendered expectations , and chronic guilt. It is common. It is dangerous. And medicine keeps missing it. Patients with self-erasure do not say “I am suffering.” They say “It’s okay.” They say “Others need it more.” They say “I’ll manage.” Clinicians often hear these as reassurance. They are not. They are warning signs. We call the outcome late presentation . We blame awareness, access, compliance. But the delay is not logistical. It is moral. These patients ra...