Patients probably bear the brunt of it. When they have to wait for the test results they know will determine their fate. When they face a painful or risky procedure. When the phone rings in the middle of the night, and it's the ER calling. They bolt out of bed and they are on their way. Fear can alert you to danger. It can deliver a jolt of adrenaline. It can be a great energizer, a motivating force.
Fear is also fertile soil for avoidance and denial. For procrastination. For the imagination. Take the case of the middle-aged man who presents to your office with chest discomfort he describes as "indigestion"...because he's afraid to admit it could be his heart. So he fails to mention that the pain gets worse when he walks uphill. That it radiates into his neck when he lifts something heavy. That antacids haven't helped. He's afraid, all right.
Imagine the fear a parent feels when his child is rushed to the hospital because of an illness, injury, or overdose.
What is it like for a woman in labor if she lost her last newborn because of a heart condition or some other unforeseen complication? What could be scarier?
As ordinary human beings trying to orchestrate our personal lives outside of the office or hospital, healthcare providers are prone to some of the same fears. I take good care of myself so I don't worry unnecessarily about my health. But I will admit to a twinge of anxiety when I was asked to return for additional views on my mammogram this year.
I wasn't worried when my PCP picked up a few irregular heart beats on my physical and ordered an echocardiogram. I drink a lot of coffee, so what did he expect? I wasn't worried until the tech started spreading the goop all over my chest. Suddenly, I was a bit anxious about what they might find. I had rheumatic fever as a child, by the way.
Once, when I was in medical school and my mother was out of town on business, I called my Dad just to say hello. He picked up the phone and greeted me, clearly pleased to hear my voice. Then the line suddenly went silent and I heard the receiver fall to the floor. Nothing. I knew he was alone and I was a three hour drive away. Panicked, I called a neighbor of his to check on him and to call for help. Fortunately, he'd experienced a simple fainting spell when he stood up to answer the phone. As it turned out, he was fine...but I feared for his life.
There's that...and then there's the fear that stalks us through the work day. Who hasn't felt it on the way to a "code"? Will the patient need to be intubated? Will I remember the dose of bicarb or atropine to give, and when to give it? Will we be able to save this life? Fear is never far away.
Will the Narcan work in time?
Patients would probably be surprised to know how fearful we can be. Deciding which tests to order and how to interpret them. Afraid of making the slightest mistake. Worried we might miss a diagnosis.
Fear is like a shadow on a cloudy day. It follows us through the day, unseen. Patients don't know it's there, but it is. It might reveal itself as frustration, impatience, or disengagement. It can cause headaches, rapid pulse, nausea, sweaty palms, or shakiness. Even in doctors. Like everybody else.
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