Shirah Vollmer MD

The Musings of Dr. Vollmer

Medical Fright

Posted by Dr. Vollmer on January 13, 2015

Lydia, forty-two, noticed a lump in her neck. Hodgkin’s Lymphoma was her first thought. Her sister had Hodgkin’s so she was “sure” she had it too. She watched her sister go through chemotherapy, with much psychological trauma and fear. The wait, forty-eight hours, to see the physician was enormous. Her life flashed before her eyes. Would she see her children grow up? Would she be able to see them graduate high school or get married? Should she tell her husband about the lump or should she wait to see what the doctor says? The prospect of a foreshortened future creates a laser focus on where the meaning lies, where one’s core values land. How will she get through the next forty-eight hours? Should I give her medication to ease her anxiety or should I encourage mindfulness and meditation so she can become curious what occurs to her during this waiting period? Or, can both be true, that medication can calm her down so that she can focus on her thinking? What about my fear for Lydia? Should I express fear or hold the hope that it is either benign or treatable? Lydia’s world has slowed. Every minute causes her to think she may have limited minutes left. I listen. I care. I am curious what pops out of mouth, the order that things occur to her, and how she manifests fear, both conscious and unconscious. I am a safe place for her. She has gratitude for my medical background “just in case it is bad news,” she says. I avoid the platitudes, but I am tempted to remind her that medical frights help us to gain gravity because it pulls us towards things we consider important. It is reminder, I want to say, that paying for parking, maybe annoying, is not a game changer, but a scary diagnosis certainly is. In other words, maybe this reminder of the “big picture” will help her be  calm with the “little picture”.  I don’t say any of that. I just sit and listen. That’s what Lydia needs today.

6 Responses to “Medical Fright”

  1. Shelly said

    Shirah, I really liked this post. It made me really wish I could be your patient. It made me feel as if you cared about me personally as if you were there, holding my hand. I’m sure your fictional patient Lydia could feel your presence too, with her fictional lump and fictional medical fright. I wonder if this is how it feels to be in therapy with a really caring, qualified therapist/psychiatrist. As if you are not alone and that someone really, really, deeply cares.

    • Thanks, Shelly. Clearly, eveyone deserves this experience while waiting for results. Today, I learned a term “natural helper” meaning that psychiatrists can train family members how to help their loved ones in times of stress. I thought that was interesting, but it also brings up issues of confidentiality and reliability. Thanks again.

  2. Eleanor said

    Shirah, the list of “not so good” ways we could come up with that help us avoid experiencing some degree of anxiety could go on and on. In my opinion we live in a world of “over medication” for one….Anxiety, while not at all pleasant, can be “growth promoting” and lead us to greater understanding not only of ourselves and priorities, but in addition, wisdom in a boarder sense. Not a bad thing in the long run.

    • Yes, anxiety can be the trigger to deeper understanding and more compassion for others. These two issues go hand in hand. Medication can create avoidance which not only hurts the person cope, but it also limits the depth of their own experience, and hence limits their compassion. However, it is an inverted U, in that a little anxiety is stimulating, but too much is paralyzing, and so the discussion becomes more nuanced as the intensity of the anxiety is a key variable.

      • Eleanor said

        Thanks Shirah…yes totally get it about paralyzing anxiety working against, rather than for, ultimate growth and progress. As an aside, while on this subject, sometime I would love to hear a blog post about what you think about parents who protect their growing and developing children to the extent where children are completely protected from anything that might create any anxiety…ie: helicopter parenting, etc. I realize there is a fine line between protecting children enough so they mature with self confidence and that parenting that is so overprotective that children have unnecessary difficulties later on. Thanks again.

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