Critical thinking is not just thinking, but is thinking which entails self-improvement. Most people with cystic fibrosis whom I have known are experts in their own body, their experience with CF, and fine tuning of treatments and medications to maximize their own quality of life. They posess critical thinking skills: "self-directed, self-disciplined, self-monitored, and self-corrective thinking", qualities that are all conducive to living successfully with a chronic condition.

This past Saturday, I was sticking my arm down a 4 foot sinkhole that also was much wider below the surface. I have been struggling to find the cause of this recurring problem. I awoke at 3:00AM - startled with a moment of clarity about the connection between several smaller issues around our building that seemed to be unrelated to the sink-holes. But all of a sudden my realization was that the multiple issues were indeed all interrelated and several pieces of a puzzle came together in forming one big picture of the overall problem. It was an 'A-Ha!' moment when you find the one piece of a puzzle that had been missing for days, and now with that single critical piece, the picture was making sense. 

In living with CF, critical thinking is essential to ongoing assesment and adjustment, and not just responding RE-actively after problems arise, but also living PRO-actively to consider with foresight the consequences or benefits of our choices.  

Critical thinking should not be confused with being argumentative or being critical of other people. Although critical thinking skills can be used in exposing fallacies and bad reasoning, critical thinking can also play an important role in cooperative reasoning and constructive tasks. Critical thinking can help us acquire knowledge, improve our theories, and strengthen arguments. We can use critical thinking to enhance our working relationships with doctors and other health care providers that contribute to improving our overall well being.

 

Critical Thinking As A Learned Skill

Years ago when I was in the hospital for a tune-up, I learned that my nurse had recently adopted a little girl with CF who had been admitted months ago, and her parents never returned. At first I responded very judgementally about what a horrible action this was and that they should be hung! But the nurse explained to me that in the years of this girls life coming into and out of the hospital, that the parent's attitude was very much that "Her life is painful and short enough. We are not going to ruin it further by forcing her to swallow pills, pound on her chest, or make her do things she does not want to do." While I found their actions completely immature and irresponsible, I realized that they may not have posessed the critical thinking skills to teach their daughter the impact and outcomes of her actions.

The point of that story is that critical thinking skills can be taught and learned and are a critical part of living with CF as best as possible.

I remember being taught in a college psychology class to always question information before just assuming it to be true. When something says '9 out of 10 doctors recommend this', you should ask: Who the 10 doctors were? Why they recommended it? Were they paid to recommend it or were there other reasons? Or if something claims to be 'clinically proven': What clinic proved this? How big of a group of subjects were used to prove this? And what criteria was it studied under to determine it is effective?  

Likewise, when I am prescribed a new medication, I always research what the side effects may be or what the interactions with my other medications may be to at least be aware of the possibility incase I do ever start to experience some of them. Inquisitiveness can lead to better understanding, and learning more about individual pieces can start to build a web of interconnections between ideas, topics, conditions, or problems. 

For example: Years ago when I started to require calcium supplement for issues of bone density with CF, my research helped me to understand that vitamin-D is a large factor of metabolizing calcium for strong bones and teeth (which I've also had a horrible history of cavities despite regular brushing). So I realized that my vitamin levels were important to make the calcium work right. But I also started having more and more back pain and cramping. I did more research and found that calcium supplementation can contribute to increased achiness, and a beneficial supplement to counter that is magnesium. So ever since, I've been taking magnesium every night. Just recently I read an article that areas of the world with high magnesium contents in their soil and drinking water have a near zero occurance of cancer.  So this may be another piece of the puzzle that contributes to my picture of being healthy. But that picture has many different, yet inter-related pieces.

 

Solving Puzzles

Puzzles may be one of the best activities to identify and foster critical thinking skills on a very basic level. The skill, patience and persistance to continue to evaluate and analyze based on shape, size, color, pattern and orientation helps to connect seemingly unrelated pieces into a bigger picture. However, any problem solving game including playing cards, scrabble, jenga, cross words, word finds, Sudoku, Chess, Rubic's Cube and many others all help sharpen and maintain that skill of critical thinking.  

Practicing that skill on a small 'game' scale, will help to think critically when it is necesarry in situations that may have greater consequence such as with our health, our home, our family, our diet or our jobs.

 

Foresight

The more clearly we are aware of ourselves, our strengths and weaknesses, the more likely our critical thinking will be productive. Perhaps the most important element of thinking critically is foresight.

Almost all decisions we make and implement don’t prove disastrous if we find reasons to abandon them. However, our decision making will be infinitely better and more likely to lead to success if, when we reach a tentative conclusion, we pause and consider the impact on our health, and the people and environment around us.

The elements needing consideration are generally numerous and varied. In many cases, consideration of just one element from a different perspective will reveal potential dangers in pursuing a decision.

For instance, moving to a new location may improve environmental impacts on health, but may also lead to the loss of a well trusted and established CF care team, the loss or gain of support from nearby family and friends, more or less challenge with employment opportunities or state funded health benefits. Which of these factors are more important considerations? Is there some way of lessening possible conflicts?

Another example is that many young adults with CF are faced with in considering a major life decision such as getting married is the impact will have on their eligibility for Medicaid coverage. Foresight is a significant skill in considering the many factors associated with considering such significant decisions and how to aim for the best possible outcome..

 

In Conclusion

Critical thinking is aimed at achieving the best possible outcomes in any situation. In order to achieve this it must involve gathering and evaluating information from as many different sources possible. It requires a clear, often uncomfortable, assessment of your personal strengths, weaknesses and preferences and their possible impact on decisions you may make. Critical thinking requires the development and use of foresight as far as this is possible, and decisions must take into account an assessment of possible outcomes, inlcluding ways of avoiding (or lessening) potentially negative outcomes. And finally, critical thinking involves reviewing the results of the application of decisions made and implementing change where possible, and is truly an ongoing cycle.

 

                                                                                        Help Others to Live Stronger and Longer!

                                                                               

 

 

 

Brian Callanan recently turned 40-years-old, and was diagnosed with cystic fibrosis at birth and with CF Related Diabetes at the age of 31.  Throughout his life with CF, Brian has experienced the lows of depression and anxiety to the highs of hiking and snowboarding at 13,000 feet and cycling 2,000 miles down the East Coast. He is the Founder and Executive Director of the CFLF, and practices an active lifestyle primarily through swimming and cycling on and off road, but also enjoys snowboarding, hiking, sailing and rock-climbing. You may email him directly at brian@cflf.org.

 

 

 

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