Real health terror?

[Guest guest]

Hi All,

From the NY Times this morning, is an article on misconceptions of health

hazards.

Discussing the risks of smoking was good. AIDS and resistant bacteria risks are

less than those concerned with overconsumption of food, it would seem to me.

The real terrors are at your face fed food?

October 25, 2005

Essay

Scare Yourself Silly, but the Real Terrors Are at Your Feet

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.

Al Pater, PhD; email: old542000@...

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