Age of angst (book excerpt: False Alarm)

In his first non-fiction book, False Alarm: The Truth About the Epidemic of Fear, New York internist Marc Siegel, MD, examines how disproportionate attention focused on some diseases creates a culture of fear. This excerpt describes his experience with a patient shortly after 9/11.

By Marc Siegel, MD, AMNews contributor. Feb. 27, 2006.

Book Excerpt
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I barely recognized the patient, though he had been coming to see me for almost 10 years and I knew him well. It wasn't just that his appearance had changed, though the baseball cap pulled low over his eyes and the workman's shoes were not his usual attire.

Under the lights of my examination room, I realized that it was his manner that had altered the most: formerly confident, even strident, now he leaned against the counter, not wanting to sit. He hunched over, wringing his hands, looking toward the window every few seconds.

Seeing me, he seemed to calm, and I reminded him that the visit was a simple follow-up for a prostate infection. He needed to leave a urine sample and he could go, and I would call him in a few days with the results. He could stop taking his Cipro.

"I've renewed it," he whispered, though his voice usually boomed.

"Why renew it? I gave you the refill in case the infection flared up again and you couldn't reach me right away."

"Why should I stop now?" And then came the words that were supposed to explain everything: "There's a war on."

I could see him eyeing the closets in the examination room. Was he wondering what medicines were there? I put my hand on his shoulder and we looked at each other. I realized that I had always treated this patient more like a friend. He knew my home phone number; he was free to page me when I wasn't on call. We liked to talk about sports. It was painful to consider this new source of tension that had come between us.