[Paleopsych] NYT: Scare Yourself Silly, but the Real Terrors Are at Your Feet

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Scare Yourself Silly, but the Real Terrors Are at Your Feet
http://www.nytimes.com/2005/10/25/health/psychology/25essa.html
[I have not read this article, since I'm trying to cut back on my reading. It 
should be of interest to several people on my list, and it takes only a few 
seconds to send it. If it's really good, let me know.]

    By ABIGAIL ZUGER, M.D.

    Just in time for Halloween, the usual yearly ritual of terror by
    headline is now playing itself out in medical offices everywhere. Last
    year it revolved around flu shots; a few years ago it was anthrax and
    smallpox; a few years before that it was the "flesh-eating bacteria";
    and before that it was Ebola virus, and Lyme disease and so on back
    into the distant past. This year it's the avian flu.

    "I was crossing Third Avenue yesterday and I was coughing so hard I
    had to stop and barely made it across," a patient told me last week.
    "I'm really scared I'm getting the avian flu."

    I just looked at him. What could I say? He has smoked two packs of
    cigarettes a day for the last 50 years. He has coughed and wheezed and
    gasped his way across Third Avenue now for the last 10 years. His
    emphysema is not going to get any better, but it might stop getting
    worse if he were to stop smoking.

    He made it clear long ago that this is not going to happen. When it
    comes to the whole cigarette/health question, his motto, apparently,
    is "What, me worry?"

    But the avian flu - now there's a health scare a person can sink his
    teeth into. So scary and yet, somehow, so pleasantly distant. So
    thrilling, so chilling, and yet, at the same time, so not here, not
    now, not yet. All in all, a completely satisfying health care fear
    experience. Unlike his actual illness.

    Scary movies give children nightmares. Scary health news gives adults
    the extraordinary ability to ignore the immediate in favor of the
    distant, to escape from the real (and the really scary) into a far
    easier kind of fear.

    A few years ago, a young woman waited patiently to be seen in our
    office after hours. She was a patient of one of my colleagues, but she
    couldn't wait for their scheduled appointment; she needed to see
    someone right away.

    "I'm worried I have Lyme disease," she said. "I have all the symptoms.
    I think I need to be treated."

    "But you have AIDS," I said.

    "I'm tired and weak and I have fevers and sweats. I've lost my
    appetite. I can't think straight. I'm losing so much weight!"

    She had seen a TV news report on Lyme disease, and then she had
    checked the Internet. All her symptoms were right there.

    "But you have AIDS," I said. "And you don't want to take meds. That's
    why you're feeling so bad."

    "I'm really scared about Lyme disease," she said. "I really need to
    get treated."

    "If you want to be scared, how about that untreated AIDS of yours?"

    We looked at each other. It was an impasse. The fact that logic was on
    my side mattered not at all: evidently the real was just a little too
    real for her. How much better to find another illness to be scared of,
    obsess over, get treated for, get rid of.

    Eventually she coerced my colleague into testing her for Lyme disease
    and treating her despite negative tests. Then she decided her symptoms
    might actually be due to a brain tumor, instead. And so it went, until
    she died of AIDS.

    Of four patients I saw in a single hour last week, three announced how
    scared they were of the avian flu. I reassured them, but there was
    quite a bit I did not say, and here it is.

    I did not say: If you want to be scared, then how about that drug
    habit of yours you think I don't know about? How about the fact that
    you are 100 pounds overweight and eat nothing but junk? How about the
    fact that in a few short months Medicaid is going to stop paying for
    your very expensive medications and no one knows how just high that
    Medicare Part D deductible and co-payment are going to be? I did not
    say: If you want something to be scared of, how about the
    drug-resistant Klebsiella that is all over this very hospital, an
    ordinary run-of-the-mill bacterial strain that has become so resistant
    to so many antibiotics that we've had to resurrect a few we stopped
    using 30 years ago because they were so toxic.

    That Klebsiella is one scary germ. It's in hospitals all over the
    country, and by now it's probably killed a thousandfold more people
    than the avian flu.

    But you don't hear much about our Klebsiella. Like our bad habits and
    our dismally insoluble health insurance tangles, our
    antibiotic-resistant bacteria are with us, right here, right now.
    Apparently they all lack the drama, the suspense, the titillating
    worst-case situations that energize our politicians and turn into a
    really newsworthy health care scare.

    They're all just too real.