Case Study:  55-year-old man with abdominal pain in the right lower quadrant for over one month.  No nausea, vomiting or diarrhea, no fever, no urinary symptoms.  No foreign travel.  No trauma.  Pain non-radiating.  No exacerbating or palliating factors.  He was very vague.  His wife says ‘it’s been 5 weeks, but he won’t go to the doctor.’

Well, after a benign physical exam, I ordered labs and a CT of the abdomen.  His labs were generally normal, along with his CT.  No chronic appendicitis.  No diverticulitis.  No mass.  That was it.  No mass.  No tumor, no death sentence.

He broke into barely muffled sobs.  He had a strong family history of cancer.  Since Christmas he had been convinced that he was dying.  He wouldn’t come to the hospital for fear of confirming that fact.  Faced with hope he wept and shook with his weeping.  He admitted that he needed some counseling.  His wife said, gently, ‘it’s like this whenever he has an illness.  He always thinks it’s cancer.’

I suppose he lives his life under a constant shadow.  Even when the Sun creeps in, he hears the voice that says, ‘sure it’s sunny and you’re happy, but you still may have cancer…are you getting thinner?’

We all have that death sentence, don’t we?  But in his family, death comes too soon, and comes in the form of creeping, life-draining malignancy.  He was petrified.  I didn’t really treat his symptoms.  But I treated his mind and heart.

Much of what we do is just that.  Alleviate worry.  For all that we pronounce dead in medicine, for all the bad news we give, we probably give far more good news.  It isn’t a tumor.  You’ll get through the heart attack just fine.  Your baby just had a febrile seizure, it’s not a huge deal.  It’s sprained not broken.  It’s just the flu, not pneumonia.  The list goes on and on.

But I think we should remember, often as we can, how important it is to give hope and comfort.  And how enslaved to fear and anxiety we are!  Oddly, in a culture with awesome medical capacities, in which we live longer and longer, better and better, we are consumed with fear and anxiety about the well-being of our bodies.  You’d think we’d fear less, but we fear more.  Maybe our expectations are higher.  Maybe we want to avoid suffering.  Maybe we want to see our great grandchildren.  Perhaps, we’re just cowards when it comes to death, as if it were a new plague that had just arisen, and about which we knew nothing.

I know that if I made a man stand up straight under the burden of fear, then I accomplished something.  I suspect he’ll find another thing to be afraid of until he gets the therapy he needs for his mind, and for his heart and soul.

The real battle over worry, however, is not one for physicians or even psychiatrists or counselors.  It’s a battle only God can win for us.  He and I discussed this a bit.  I’m certain he needs that view.  He needs to sit down with a wise Christian counselor in his church or affiliated with his church.  Because only with an eternal perspective and the tools of scripture can he, or any of us, endure the fear that swirls all around, and that is such an effective tool of the devil.

‘Do not worry about anything…’  Jesus said.

I think he meant it.

Edwin

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