I really, really hate going to the doctor. As a doctor, you know exactly what you should be afraid of having. You’ve seen it all happen to other people. Personally, when something new and weird happens to me my fears always irrationally gravitate toward the following three things:
- Cancer of any kind (despite the fact that there are almost zero cases of cancer in my immediate or extended family
- Brain tumor
- Multiple Sclerosis
This is called nosophobia, “fear of disease.” And I’ve got it. Absolutely. So much so that about two years ago I developed this little blind spot in my left eye (that little red spot up in the photo of my second favorite dog in all the world, Doctor Teeth, is how it looks to me). I’m a regular migraineur and typically get all kinds of blind spots in my vision almost every day due to these migrainey things that happen to me. But my normal spots come, and go. This one stuck. Like a region of dead pixels on my computer screen. Two years ago, I was convinced I had some sort of eye/brain tumor. So I didn’t go see a doctor, I just waited it out knowing that time will tell if it’s going to be something bad. Nothing changed in two years, despite the two years of unnecessary anxiety of “knowing” that something bad was happening to me.
So I finally went to the ophthalmologist yesterday and got a thorough exam, which was absolutely 100% perfectly normal. I saw the photo of my retina which didn’t show that retinal melanoma I was convinced I had. The doctor reassured me that this is extremely common and she “sees this at least once a week."
But then I asked her, "But what is it?” She said she doesn’t know nor does she feel the need to know. The course of my spot hadn’t changed in two years. It’s there and she can’t see it with a comprehensive exam. She said she could do a very specific test and look for microscopic variations on my retina, but what would that do? There’s really nothing to be done for the spot. It’s just there. It always will be. It’s never coming back. And it’s really not big enough a deal for me to want some doctor to do something about it.
But, again, “What is it?” I wanted the doctor to give me a diagnosis. I left the office without a diagnosis. The diagnosis she gave was “You’re fine. You’re not going to die. You don’t have a brain or eye tumor. Although you’ve never seen this happen to you, I see this all the time and my experience is that it’s absolutely nothing to worry about.” That was comforting to me, but I still wanted a diagnosis— something that could 100% completely alleviate my anxiety.
So many people (including myself, friends, and patients I’ve seen) have had weird, scary things happen to them only to go to the doctor to be told “We have no idea what’s happening to you. We just have to wait this out and see what happens. You may be completely fine or you may have to face death.” The psychological comfort of having a diagnosis, something to hang your hat on, is far, far better than an unknown. A diagnosis gives us something concrete. It’s an answer. Answers give us comfort. As humans, we’re actually really great at dealing with stuff, even when it’s horrible stuff. And we’re even better at dealing with stuff if we can define what that stuff is. It’s very similar to a family who has a child go missing. The pain and anxiety that stems from the immediate days, to months, to years of the questions, the unknown fate, the fear of bad news and the hope of a safe return. It’s psychological torture.
So, doctors, never underestimate the psychological power of a diagnosis. Even when it’s bad, it provides a framework for us, as patients, to wrap our heads around, and build the skills we need to deal with whatever’s thrown at us.