I apologize about mixing science fiction classics here. The title of this piece is the name of one of Robert A. Heinlein’s best novels. (And I recommend this to you if for no other reason than to read the interludes which are excerpts from the notebooks of Lazarus Long…BRILLIANT stuff!) The Litany Against Fear is from the Dune series originally created by Frank Herbert. Although one of the great classic series of science fiction, it is long, involved and you really have to want to read it. But it is a GREAT series that has been continued and extended by his son. So, having gotten the literary issues out of the way, it’s time to confront, well, FEAR.
Some of you already know that in my last physical, my blood work indicated a potential prostate problem. The fact that I am a 57 year old male, in and of itself, also indicates the potential for problems. I know you ladies have certain “unique” medical issues that crop up as you age. Well, prostate issues are the male counterpart. Surely, you’ve seen the commercials for Flomax. You know, the four past-middle age white guys (ever notice it’s always white guys?) hanging out, going to the ball game, fishing, riding 4-wheelers, doing all sort of male-bonding bullsh*t. (Why is it that they never show four guys sitting around a strip bar getting drunk? One would think that showing potential male problems when lap dances do nothing for them would be more to the point. But I digress.) Other than the blood marker, I have shown no other signs of prostate issues But between that marker and my age, the urologist decided that better safe than sorry and decided to do a prostate biopsy. Yeah, that scary word. And it’s a needle biopsy. Two scary words, especially for me the “n” word. That, of course, set me off on a trajectory of crash and burn anticipating the worst. No, not cancer. I hadn’t even gotten that far in my mental processes. It was fear of the procedure, fear of pain, fear of having to endure the procedure. I wallowed in this fear for about a week or so. I sought reassurance from friends and family. I fretted incessantly. I worried about the worry. Then one day last week, something clicked inside my head (I have a lot of clicks up there) and I decided that I cannot allow fear to paralyze me, including not having the wherewithal to write these blogs. And I have felt much better about everything since that moment. That got me thinking about fear and what it has done in and to my life.
If you’ve followed along here, you already know about my trypanophobia, the irrational fear of hypodermic needles. Where this came from, I really do not know. I do remember that my pediatrician nicknamed me “No Shots” because those were the first two words out of my mouth when I saw him. This would continue throughout the examination right up to the point of getting my lollipop at the end. I never met the man, but I would have given a certain part of my body to Dr. Albert Sabin for inventing oral polio vaccine. There have been times that I almost passed out from having to go through a blood test (and the Air Force is not particularly amused at flying officers passing out for any reason). So there we have the crux of why certain medical procedures scare me.
Webster defines fear as follows: 1 archaic : frighten; 2 archaic : to feel fear in (oneself); 3 : to have a reverential awe of
But let’s look at this a bit closer. In much the same way that we exercise a muscle to make it stronger, we also mentally experience things to reinforce them. I’m trying to learn German right now and I realize that (despite what Berlitz and Rosetta Stone will say) some memorization is necessary. Constant repetition has taught me that “lachen” means to laugh and “das Zimmer” means the room. The fear response in my life has reinforced itself many times over. It matters not if it was fear of needles, fear of failing exams, fear of striking out, fear of disappointing people or any number of other fears. Every time I indulged in it, I was reinforcing the response.
Fear originates in the Amygdala and is one of the basic emotions that have allowed humans to survive and evolve into people who can sit at a computer and write about fear, among other things. The fight or flight reaction is connected with this. My response has always been flight. I have a long history of avoiding conflict of any sort except when pressed to the absolute extreme and cornered. Give me an avenue of escape and I’m a member of the “Discretion is the better part of valor” club. While it has given me a highly refined sense of fear, it has not done much to help me cope with it.
As a former professional aviator and someone who loves the feel of being in an airplane, I have never suffered from any concerns about being in a metal tube with wings and a propulsion system (alternatively known as aerophobia, aviatophobia, aviophobia or pteromerhanophobia). But my daughter suffers from it as do several of my best friends. I have talked with them and understand their fear is as real as is mine of needles. One of the most basic underlying premises of this fear is loss of control. You are 100% dependent on a couple of strangers in uniform up front to get this aerodynamic vehicle safely from one place to another. Some people experience a similar thing as passengers in a car, but in a car we seem to understand the risks better. We can see what is going on, we generally can see the driver and cars generally crash in only two dimensions where aircraft have that whole third (vertical) dimension. It is the loss of control that induces fear. And having to put your welfare into the hands of a medical practitioner is yet another form of loss of control.
I count myself blessed to have served in the military but to never have had to go to war. I have several friends who were not as fortunate as me and have suffered grievous injuries. I wonder how I would have reacted in their place. I am extremely pain-averse and fear the experience. One of them tells me that there is nothing wrong with being afraid of pain. In the mini-series Band of Brothers, one of the members of Easy Company talks about being afraid constantly but not wanting to let down your buddies. (Oddly enough, fear of death has never been an issue for me. It’s inevitable at some point. I fear losing friends more than my own demise.) I have no buddies to let down by being afraid and giving in to those fears. But I do have family and I do have friends. Heaven knows, my dear wife has been through it with me enough times. The worst that I can remember was when I had to have a venogram. I turned into a quivering mass of sobbing, terrified, Jello…literally. And when it was over, I had to admit it was not so bad.
This last point has been a recurrent theme that I have never been able to put into perspective. I will freely admit that my list of medical issues have been, mercifully, short. I have been quite healthy throughout my life and have not had to endure many procedures of any sort (with the possible exception of dental issues which has been a chronic problem since my first visit to a dentist). But every time I have wallowed in one of these fear cycles, the reality has NEVER approached the expectation of it.
Anticipation, while it may be a great song by Carly Simon, is a torment I allow myself to experience. Let me give a few examples. When I had my vasectomy, I fretted for weeks before. Before heading to the doctor’s office, I took 15mg of valium. I have a clear memory of lying on the table while the doctor was operating and singing along with the radio to which I was listening. When it was over, my reaction was, “Is that it?” When I had a parathyroid gland removed, I worried the whole summer about what it would be like. A little bit of Ativan and a nurse who obligingly put the heparin lock inside my elbow made the pre-operative period…well, a nothing. After that, I was out and it was over. Before my colonoscopy, I had a flat-out panic attack. Fortunately my daughter and the friends I was with got me calmed down. A little Ativan and the knock-out stuff later, it was over. Every dental procedure requiring Novocain has always been a carnival of anticipatory fear of the twenty seconds or so of the feel of a needle in my mouth, always ameliorated by nitrous oxide and often by pre-visit Valium. I know that once past those painful seconds, it is nothing.
Knowledge is power. In my case, the knowledge of how I have reacted in these situations has allowed me to sit back and coldly examine what I have allowed myself to do. And that’s the bottom line. I have allowed myself the luxury of wallowing in fear like a pig wallows in mud. No amount of anticipatory fear is going to change the reality of what is to be endured. Yes. I intend being tranquilized before the biopsy and I will have my iPod to listen to and sing along with. But I can no longer give in to letting fear paralyze me. I have two dear friends one of whom recently endured a painful medical procedure. I am told that she was extremely brave throughout it. The person who told me about that has been through, in the last year, untold numbers of serious, life-threatening surgeries, injections, medical tests and life-threatening illnesses. She tells me that she, too, is afraid of needles. But you need to just get on with it. Her father is one of those soldiers I mentioned who was wounded. They are wonderful role models. And I am bound and determined to not let them down or make them ashamed of me, not to mention not wanting to put my wife through that sort of thing again. So I return to the Bene Gesserit Litany Against Fear and understand that science fiction may be its origin but it is wisdom with which I can identify.
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