Changing fear

Diane Kelsall

If you are afraid, change your way.
Inuit proverb

Fear is part of many people’s lives. Fears can be very personal—fear of becoming ill, fear of unemployment, fear of cancer, fear of disability, fear of loneliness, fear of death. Fears can be societal. Fears of global warming, destruction of the environment, terrorism, or war are increasingly prevalent in our society. Most of these fears are not new—they have been around a long time—but an atmosphere of fear is pervasive.

Fear sells books. Fear sells movies. Fear sells newspapers and magazines.

Today, even simple decisions are fraught with ethical and moral consequences. Will choosing a tuna-salad sandwich for lunch deplete the oceans? Will spraying my lawn for weeds today result in cancer in my children 50 years from now? Is the sparkling gem in my wedding ring a “blood diamond?” Fear. Fear. Fear.

What about family medicine? Many personal and societal fears have their roots in health concerns. Some of these fears seem insignificant, yet can have much larger repercussions. For example, many women fear the discomfort of having a Pap test. A small problem, perhaps, but these women might then avoid detection of cervical cancer.

As family physicians, we have fears about making the wrong diagnosis or prescribing the wrong therapy. I cannot biopsy every patient with nonalcoholic fatty liver disease, but what if I miss the patient who has steatohepatitis? Was I wrong to prescribe β-blockers for hypertension?

On a societal level, many fear that there will not be enough family physicians to go around. Or enough family medicine teachers. Others worry about the future of the Far North.

What can alleviate fear? Sometimes a better understanding. Sometimes new (or old) ways to address a problem. Sometimes simply acknowledging that fear exists. Changing your way.

I encourage you to leaf through this issue of Canadian Family Physician. A more comfortable Pap test ( page 835). The latest on managing nonalcoholic fatty liver disease ( page 857). More on β-blockers in hypertension ( page 800). Innovative thinking about marketing family medicine to medical students ( page 793). The importance of family medicine teachers ( page 881). Voices of Inuvik youth ( page 865). Plus articles on many other topics relevant to the practice of family medicine.

If you are afraid, change your way.