These days, what I find relatively scary is that we need paper work to start a sexual relationship. The lab test proof, that we don’t have gonorrhea, chlamydia, syphilis, herpes, warts, hepatitis B or C, or HIV. The paper trail to love and sex. Not like in the old days where it was don’t ask, don’t tell. Now it’s ask, tell, get the paper work and then, maybe. And what’s with the Internet—our new medium for provoking and exacerbating fear? Even before they arrive in the exam room, my patients are scared from the latest health care hype raging on those Net bulletin boards. What can you do? Everyone is afraid of cancer. It’s the ultimate scare. Cancer doesn’t fool around and people know this. It’s so challenging, when, after a breast examination, I have to say, “I’m a bit concerned about this lump.” When they are large, firm, and fixed there’s no mistaking them for cancer. Direct questioning about the ultimate scare is the biggest challenge for me as a health care provider. “Is this cancer?” the patient asks. “Well, I say, “We’ll need to do some further evaluation.” “But how could I have cancer? Nobody in my family had cancer.” It goes something like that. On a good day, I may be able to make the scariest thing seem matter-of-fact. I had a breast lump once and three doctors said it had to come out. It wasn’t cancer but even a matter-of-fact nurse practitioner is scared of cancer. |
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