Halloween Terrors
Witches and goblins and ghouls, oh my! If you believe in the supernatural, then these may well be real creatures to reckon with, and your fear is based on reality. But on the other hand, if you just get into Halloween for the fun of it, ie, a chance to play dress-up, then our fear is make believe.
A very interesting opinion piece in the NY Times, written by a medical doctor, points out the yearly Halloween ritual of the media, in producing one frightening medical crisis after another. Some are serious problems, such as the “flesh eating bacteria” but have remained obscure (thankfully) and never panned into the crisis that was predicted. Ditto for last year’s flu vaccine shortage. Well surprise, the death and hospitalization rate due to flu was unchanged, despite the lack of vaccine.
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.”
Thephysician goes on to say that this is a man who has been puffing away on two packs of cigarettes a day for half a century. He has emphysema. He has been wheezing and coughing for the better part of 10 years, and always gasps as he tries to make it across Third Avenue. So now why does this man think he has avian flu? Because of the fear factor, the news staring him in the face day in and day out.
But he doesn’t want to stop smoking, which may help his cough. Or help him get across the street. That is too real.
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.
This article points out how the media, the hot news of the moment, literally creates the problems that people think that they should be worrying about. It offers people something abstract to worry about, rather than the clear and present danger staring at them in the face. It is a lot safer to worry about getting avian flu, for instance, then making an effort to lose weight because your diabetes is out of control.
The public loves the sensationalism of a new illness. Ah, the thrill, the intrigue. So much fun to worry over what may be, or the tiny possibility of catching mad cow disease even though you’re a vegetarian, rather than the real, rather mundane problems.
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.
How many people are worrying about Klesiella? Not very many outside the infectious diseases community, that I can assure you. I remember how a Klebsiella outbreak in a newborn intensive care unit killed several of our patients. And then there’s methicillin resistant staphylococcus aureus, better known as MRSA, which as mutated beyond the hospital walls and out into the community. The community acquired form has the potential to attack with a fierce virulence, and quite a few people have died from a severe necrotizing pneumonia, courtesy of MRSA.
Does that scare people as much as avian flu? The real McCoy vs. the potential threat.
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.
I couldn’t have said it better.