FROM MEMBER: 'CWILLARD'

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Dear Dr Dismissive...

"I appreciate that you've known my family forever and have taken care of me since I was a young girl. However, that relationship only seems comforting when I'm in good health and have no concerns.
    I get anxious trying to prioritize the things I need to tell you because I know you will not spend enough time with me for me to really share what I'm concerned about. I want you to stop saying, 'It's not _______' and telling me why it's not and what it is, instead.
    If it truly is Health Anxiety at the root of the physical symptoms I'm suffering from, I don't want you to write a prescription for Xanax and Lexapro and send me on my way. While that helps the symptoms and I appreciate that, it doesn't actually cure anything. I want you to refer me to a mental health professional just as you would refer someone with a disease beyond your expertise to another specialist."

"I want to be respected. I don't want you to dismiss me because you have patients who REALLY need you. I REALLY need you, it's just in a different way! I don't want you to make inferences to the fact that you believe I'm young, healthy and have everything going for me as though a few trite statements are going to whip me into shape and I'll see the light and walk out of your office with a smile on my face. People commit suicide for less emotional stress than I feel 5 days out of 7, listen to me!
    I need you to not share 'sometimes as doctors, there's nothing we can do' stories about the man who was allergic to a common antibiotic and died within hours of taking it, or the 29-year-old breast cancer victim who died 6 days after giving birth to her first baby, or the various other stories that follow the 'I'm not God' plot line..."

"...I know that..."

"...but, it seems to me that, in the middle of 'totally and utterly useless' and 'GOD', you have a job to do! That's all I'm asking!"

"If you've been in the practice long enough now that you've become more interested in the business aspect of it (like when you talked about being President of the Board at the new hospital as you were assisting my OBGYN sew me up after a C-section) then please, bow out respectfully. Do not make your patients pay for you not making a decision that perhaps you should."

"Lastly, and most importantly, know that I'm a person with a family and responsibilities and loves and joys just like you are. I have two little girls who call me 'Mom' and to them, I'm the most important person in the whole world. I have a husband who counts on me as part of a team and, without one of us, there feels like there isn't the other. I have parents who sacrificed to give me the best they could and loved me like no other set of people ever could and they are getting older and need more of my help now."

"I am a teacher to emotionally and behaviorally disabled, poor, inner-city 4th- and 5th-graders who I know feel the most love they ever do the 7.5 hours a day they are with me. When I am paralyzed by my affliction, I do not give these people what they deserve and what I wish I could. When I look at the people I have in my life who make my heart overflow with love every minute of every day and then, when my mind takes me down the road that convinces me I will not be around for them, it is unbearable. I don't mean 'hard' or 'difficult', I mean soul-wrenching, begging-for-mercy unbearable!"

"Please begin to be willing to see that part of me instead of stopping short like you always do because until you do that, nothing you do is worth the time either of us put into it."

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FROM MEMBER: 'BUTTERFLYEX'

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TO MY GENERAL PRACTITIONER...

"I love the way you have dealt with my anxiety."

• "You have always been so understanding and have never thought that I was strange or crazy just because I'm scared.
• You have understood that I have an anxiety problem and have always approached me kindness and caring.
• You have been the only doctor that I have trust and never been afraid of.
• I feel like I can always go to you with any problem and you will be supportive of me and take my fears into consideration.
• Every time I have come to you with a problem, you have always shown me your concern."

"At the same time, you have always approached my problems and fears with a smile but not a patronizing one of mocking my condition - just a gentle one of truly caring."

• "When I have wanted to have tests performed for my peace of mind, you have allowed them to be done and have always given me the results with the same kind and caring smile.
• You are gentle always and not cold and uncaring like so many doctors are.
• You have treated me like a friend instead of a patient.
• Your touch has always been gentle and not intrusive and you have never pushed any procedure on me that has scared me.
• You have let me go through my exams at my own pace and never told me I had to do something that I wasn't comfortable with."

"Everything that I have had to tell you about what I fear or what things I'm not willing to go through, you have listened to and you have acknowledged me. You have understood, from an emotional point, my fears."

"I have been truly lucky to have met a doctor like you!"

"You have allowed me to bond with you, which is so important for people that have anxiety like me.
    I see you as the person that is holding life and death in their hands but you have been kind and made me feel like you don't just stand in your office wielding that power at me.
    You are humble and considerate of my feelings and thoughts. When a test result has been a little off and I have been overly alarmed by it, you have always told me of alternative benign explanations for the outcomes instead of coldly telling me that they are off and I should be scared.
    I completely trusted you with the medications you prescribe me and I know that they wont make me sick or give me scary side effects because you always look into it first and tell me everything about them and what they do."

TO MY CARDIOLOGIST...

"You're very scary to me! I think that you are more skeptical of my anxiety and assume that it can be solved just by thinking logically. I think you see me as very fragile and not emotionally able to cope with things.
    I don't like it when you share with me heart X-Rays and other things that I don't like to see. Seeing things like that won't help my anxiety be reduced, especially when it's my own heart. I don't like so much information. I would much rather have you explain very simply, verbally, without visuals.
    I don't like to go too much into medical explanations. A simple one I can understand is much better for me because, that way, I don't begin putting too many pieces together in my mind that scare me, even though they may be medically incorrect."

"I don't like the way you kept pressuring me to not be scared and to 'work' on my problem as if I wasn't already."

"What I did like about you is that you always would tell me to calm down in a very gentle way and not threatening way when I was too scared during a test. You let me know ahead of time everything that the test would need so that nothing took me by surprise.
    You always walked me through the procedures beforehand and I liked the way you use humor to break my fears and get my mind off the horror. I like the way you would always tell me that you didn't expect anything bad to be found during my tests. A lot of doctors refrain from saying things like that but you didn't. It made me feel more than just a patient which you need to follow protocol for."

TO ALL OF THE NURSES OF MY MEDICAL CENTER...

"I like the way you have all treated me and how you have taken my fears into consideration.
    The nurse that has always taken my blood has done so very gently - always finding the vein quickly. You have always spoken to me about your own battles with panic and anxiety in the past, and this has always relaxed me while you have been taking blood. I like the way you have always talked to me like a friend instead of some patient. You have acknowledged my fears without making them into a big deal that everyone else had to know about. You never have embarrassed me while in your office."

"And, to the technician who has always been very good to me: I like the day that you showed me how the sonogram worked and how you lowered the volume during the test of my heart so that I didn't have to hear it. Making me understand the machine more and become familiar with it, myself, took away my fear of it. That helped me be relaxed during the procedure, instead of afraid. You always did everything to try and make me not be so scared and be comfortable while you preformed tests. You always had a smile for me and didn't mind given me an EKG a million times if I needed them that often."

"All doctors out there should learn how to be more humane and compassionate, instead of hard and cold with their patients. People with anxiety need this a lot. When you feel that you are in a familiar environment and with people that care about you, you are more likely to not be so scared during tests and procedures. This is much more important to me than being a hardened professional who takes the rule book too seriously."

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FROM MEMBER: 'SPINELLA'

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Dear Doctor...

"I am writing to you to let you know how I feel, right now."

"I am very frustrated as to why I have to keep coming back to you, again and again. You are a nice person - don't get me wrong - and, you can see that I am very shaky when I step into your office. You seem to know that I am looking for comfort and reassurance as you always tell me 'everything seems fine, you are fit as fiddle, come back in a month's time', which does send me skipping happily out of your office, only to realise when I get home you didn't actually do anything to make the pains and symptoms go away..."

• "...I'm not getting better;
• ...nothing's changed since I came to you for help; and...
• ...now I have to work up the courage to come back again."

"If you would have just done everything that needs to be done in the beginning, I wouldn't have to stress anymore and I wouldn't have to keep coming back again and again. You know I hate annoying you with my problems and I know you are probably sick of hearing problems all the time, So why not do something about it straight away, then problems wont keep coming back to you.
    I (and others, I'm sure) am not a patient you can just send home and tell to 'Keep an eye on things for a month and come back and see me, then'. This will only cause me an abundance of stress and cause me to concentrate mostly on the problem for the whole month.
    And finally when the month is over I have definitely convinced myself that I have something wrong with me because It did not get any better. So, there's no way I'm coming back into your office to have you tell me I'm dying or whatever.

    If you would have dealt with me when I came to you the first time then the problem wouldn't still be here. I came to you because I needed fixing, but you've only made it worse, just like a rotten, money-hungry mechanic."

"Oh well...I've had my winge! I hope you take more care in the future!"

Signed...

"...A Very Angry & Frustrated Health Anxiety Patient!"

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FROM MEMBER: 'FAIRYJILL'

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Dear Primary Health Care Physician...

"I just wanted to thank you for the past 12 years of your services and friendship. When I met you in the Emergency Room, 12 years ago, I had no idea we would form the relationship that we have, but I will be forever grateful to you.
    I am so glad you were able to go into your own practice and take me on as a patient. From the moment we met (and you were the only one to be able to correctly diagnose me in under a minute), I knew I had found the doctor I needed.
    You have been patient and understanding through all of my ups and downs and have always pointed me in the right direction. You have never failed to take the time to explain all of my feelings and symptoms in detail to ease my fears.
    The hour wait in your office to see you can be frustrating but I know that you will take all the time I need with you when it is my turn so I am thankful for that.
    You have also been plenty tough when I needed that too. I am not going to say that it has all been perfect...there were many times I was so mad at you I was never coming back there because you failed to return my call when I was having a stroke, or when I discovered a tumor, or when I was sure I figured out exactly what was causing all of this!
    I know now however that that was your way of telling me 'Hey! Calm down! I can't reassure you every time you have an anxiety attack - that is what you have a therapist for. I do have other patients!'
    So, in the end, I just want to say thanks for being so good at your job and I am so glad We found each other."

Sincerely...

Jill.

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FROM MEMBER: 'ANONYMOUS (1)'

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Dear Doctor Primary Care Physician...

"I've been coming to see you for a long time and I really like you as a doctor. We both know I am a hypochondriac. I am perpetually worried about having cancer of anything and everything. Please, maybe we could make a few changes in our visits to make things easier and better for both of us.
    When you listen to my heart and chest tell me what you are listening for and what you hear. Maybe even let me listen. If things sound okay tell me so, it will make me feel better to know that something is working right. If you say nothing, I assume you heard something bad and are not telling me because you don't want to scare me. Or, you might be putting it on your 'watch' list for next time...the same with throat, ears, etc., and..."

"LET ME KNOW WHAT YOU SEE!"

"There are lots and lots of things you aren't checking, on me that should be part of a yearly physical!"

"Could you please do a complete check up on me?"

"For instance you never have me follow your finger with my eyes. If you aren't sure what a complete check up consists of look it up."

"Ask me how some of my past problems are!"

"If I am there, in between visits because I have an earache or hurt my back or something, next time I come in..."

"...ask me how that problem is!"

"Go over my blood work and any other test results with me line by line, show me what is good and what isn't."

"This one is really important!"

"If I have to be called about test results..."

"DO NOT CALL ME AT WORK!"
"Call me, personally, at home after 6:00 pm-
and, be ready to answer my questions!"

"I cannot take bad news at work! Do you understand that?"

"Or, better yet, If I need to go for a test, please arrange it so that I can go that same evening (no more time off of work) and arrange things so that I can get results immediately, as in...while I am still there!"

"I always have to sit in your waiting room for 1-hour-plus before I can be seen."

"I AM ON TIME!   WHY CAN'T YOU BE?"

"Your office could at least give me the courtesy of calling to let me know you are running late, that way I won't lose time from work. When I finally get in to see you and it is RUSH-RUSH-RUSH!"

"Not fair to me at all!"

"If I tell you something is wrong with me don't just shrug it off. Listen to what I am saying and ask me what I think the problem is. Don't ignore me when I tell you something is wrong. I don't know what I am supposed to do with all of these problems I have - I need to you to talk to me about them."

"And lastly, I want to say thank you for that one visit you had with me when I was so terribly depressed - you spent a good half hour talking to me and didn't rush the visit at all. I really appreciate the time and care you gave to me that day."

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Further sentiments from this Member...

Dear Oncologist...

"Thank you so much for taking me on as a patient."

"When I made my first appointment with you, I was told you are retiring soon and aren't taking any more patients and this would be just for a consultation.
    I felt heartbroken and lost and almost canceled. I had already been through 2 oncologists and 'fired' them both."

"I kept the appointment and, after spending an hour with you, you said of course you will take me on. I was so grateful for that that, I almost burst into tears. You were the first doctor in quite a while to listen to me and answer my questions, after almost a year of feeling helpless and hopeless."

"I finally felt that there was
someone I could talk to!"

• "Thank you for calling me at home in the evening to discuss test results.
• Thank you for following up with my other doctors about things I don't understand.
• Thank you for answering my other health questions that are for things totally unrelated to what I am visiting you for.
• Thank you for being so patient with me and not making me feel like we need to speed things up so that you can get to your next patient.
• Thank you for always being on time.
• Thank you for sending me for an MRI (which insurance covered even though my previous oncologist said there was no way it would be covered)."

"I don't know what I will do when you retire!"

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FROM MEMBER: 'GALOWAR'

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Dear Doctor...

"I'm a reluctantly avowed, obsessive-compulsive, health-anxious, illness-phobic, cancer-worrying Hypochondriac and...you are an ER Doctor!"

"I suppose we were destined to meet!"

"I came in to see you after losing myself to utter panic.
    I had woken up one morning (about two weeks earlier) with a very pronounced buzzing / ringing in my ears. I didn’t like that, one bit. I decided, after a very short time of logical thinking, that I probably had a brain tumor, because I couldn’t imagine a single thing that would cause ringing like that out of the blue.
    After spending my days trying to convince myself that I was okay, but not believing it, I finally gave in to my fears and lost it.
    My husband decided it was time to take me in - to the Emergency Room. I don’t think he believed I had a brain tumor. I think he saw me freaking out, completely, and knew there was nothing more he could say or do to help me."

"We got to the ER and filled out the necessary paperwork. I told my story to the lady at the front desk. Then, we found two chairs, side by side, and we sat. There wasn’t much to say."

"I was rocking back and forth slightly, staring at the floor. In my mind I was watching myself. I was watching myself go crazy. I hated all the people around me who were in the ER, too, for problems that couldn’t be as bad as mine. They were making me wait, furthering my torture.
    I probably sat around with my husband for two hours, trying to keep myself from climbing the walls. Finally, a nurse called me back. With a mixture of relief and fear, I got up, and we both went into the back."

"THE NURSE LED US INTO A PADDED ROOM!"

"(Now I knew what they thought about me, there!)"

"The nurse took my vitals, and then left us to do more waiting. At least I could laugh with my husband about where I ended up."

"Another nurse came in, a very friendly lady. She was actually there to assess my mental state, rather than my physical state. I suppose she wanted to determine whether I needed to be sedated and admitted to the hospital or not. Upon deciding I was well enough to avoid all that, she told me that you would be in soon. More waiting.
    When you came in, I certainly expected you to be rushed, hurried, aloof, and just plain too busy to spend much time with me. What surprised me was that you came in, gently closed the door, and sat down next to me with a smile asking me what you could do for me today.
    I explained the tinnitus and my fear of what it could mean. You asked me a couple of questions and took a peek in both ears. You told me that you could find nothing obvious. You felt that I had some sort of inner ear infection that would probably take some time to resolve itself.
    But, you said something that still sticks with me, today. You said, 'I’m more concerned about your anxiety trouble than I am about your tinnitus.' That changed the tone of the whole visit there to the ER. I wasn’t there because I was going crazy due to a tumor growing in my head: I was there because I was scared to death of something that probably wasn’t, and I didn’t need to be."

"You asked me if I’d ever been to the ER before. Well, yup...I had been there once, a few years before, thinking that a small lipoma in my arm was hurting which mean it was really a malignant tumor. And then, another time, thinking I was having a heart attack. Both of these events happened when I was just barely into my 20s.
    You didn’t seem surprised. But you didn’t seem mocking, either. You nodded your head, as if you expected I would say something like that. I do have something wrong - something that needs to be treated. It’s as bad and debilitating as any disease."

"And you told me that you felt that way, and...

...you told me in a way that gave me dignity!"

"You laughed and chatted with my husband and me, and you told us about Cognitive Behavioral Therapy, which was something neither of us had heard about. You mentioned that it is a form of therapy best suited for people with anxiety disorders, and some people thrive on it enough that the find they can go off their medications.
    You asked me to please not worry about a brain tumor, that what I had was simple tinnitus.
    You gave me a couple of names of therapists who might be helpful, or at least might be able to point me in the right direction.
    When you left, my husband and I walked out of the ER feeling like we were befriended and cared about by someone who was obviously very busy with his job. You sat down with us, you talked with us both, and you were there for me when I really needed you."

"I’ve had a lot of trouble with my anxiety, since and I’ve only recently begun Cognitive Behavioral Therapy, since I had a difficult time finding it in my old town where you worked. We’ve moved to a bigger city, and the place seems to be crawling with people who specialize in CBT."

"During the ride with Health Anxiety that I am taking, and it’s about a 15-year one, you are one of the shining stars among a smear of events. You don’t know it. I had a chance to review you when the hospital sent a 'How Did We Do' card a week later. I tried to convey my total gratitude and respect for you in my report. I hope you saw it."

Thank you, Doctor.

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FROM MEMBER: 'MOMINAZ'

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Dear Doctor 'PAST'...

"I left you for several reasons. You know I have Health Anxiety, so you should know enough about it to know how to help me avoid becoming non-functional with fear.
    I don’t need you to purposely try to scare me into living a healthier lifestyle. Don’t focus on the worst possibility, especially knowing it (99.9%) isn’t the case.
    When I call your office for results after being scared by you, I expect a call back. I don’t need to live a week not functioning because your MA is too busy to call. I have a right to know my results in a timely way.
    When you are on vacation, have someone cover for you. I don’t like to go to the ER and I don’t like to choose between the ER and waiting 2 weeks to see you. You aren’t the only doctor in town."

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Dear Doctor 'PRESENT'...

"Thank you for being nice and calm. Thank you for reassuring me when I ask you to tell me if there’s anything you can think of that would make me worry less while we figure out my problem.
    I am so glad that you tell me your nurse will call me promptly with results (the NEXT day!) and she does. I like that you listen and, even though I haven’t fully explained my anxiety yet, you have treated me well and given me good answers, without scaring me.
    Thank you for not making me wait days, or weeks, for appointments. Thank you for not making me wait in your waiting room for hours."

"Finally, I am so happy that you are not
an arrogant jerk, like Doctor 'PAST'!"

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Dear IDEAL Doctor...

"You are a combination of the good in all my doctors. I would be able to reach you the same day I call and you would be happy to answer my questions and reassure me. Maybe this isn’t realistic, but it is my dream."

"You would have all sorts of equipment in your office and I would be able to get tests and results the same day. No more non-functional waiting for a week or a month."

"I would have one-stop shopping!"

"Finally, I would like you to really know what’s wrong with me- not make a 'guess' because you aren’t sure. I really want to know and...

...I want it explained to me how you know!"

"I also include, in this, that you have a thorough understanding of Health Anxiety!"

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FROM MEMBER: 'EDUCAND'

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Dear Doctor...

"I appreciate that you’re not an alarmist, and that you’re very grounded when I come to see you. There’s very little that is more terrifying to a person with Health Anxiety than a doctor who freaks out over every tiny thing as much as we do.
    I appreciate that you are willing to administer the tests I request, even when you don’t absolutely think they are necessary. It helps my peace of mind to know that I am receiving adequate care and not having anything important overlooked."

"I appreciate that I’ve had reasonably good care from you, at least as far as I can tell. I have had no obvious negative experiences in this regard. I hope that you will understand if I cannot completely trust the quality of my care.
    It’s not your fault! It is the nature of my Health Anxiety always to fear that something has been missed (or considered unimportant) that turned out to be an early sign of a terminal illness."

"I wish that you understood Health Anxiety and general mental health better, or were more sympathetic about it. I get a strong impression that you dread my visits and find my worries and me needlessly crazy."

"I wish that you understood that it is very hard for me to go to see you, because...you will either tell me that I am going to endure an early and horrible death, or you will tell me that I spent a lot of time fearing something trivial.

    

I wish that you understood that I do not fret over my health because I am seeking attention, or to annoy you, but because I have a form of Obsessive Compulsive Disorder that manifests in this way - and that, when I feel a loss of control over other aspects of my life, I feel a loss of control over my body’s continued functioning, as well.

    

I wish that you understood that, while I can (and do) improve with therapy, on some level, I have a neurological predisposition to anxiety that I cannot control any more than I can control my astigmatism.

    

I would love to be 'normal', just as I would love to have 20/20 vision. I neither enjoy worrying about small physical symptoms, nor wearing glasses - and, I never enjoy going to the doctor for either reason, but these are both physical facts that I would hope you could understand equally well, since you are a physician."

"I have an opthalmologist right now, in fact, who has been very understanding of my Health Anxiety, and has been willing to answer my questions, no matter how crazy, without any kind of implied judgment!"

"I know that you do not intend to judge me, and I probably do make you a little crazy. I’m sorry for that!
    I’m sure I’m not the only patient you have with Health Anxiety, and it must be annoying that we are in your office when you have 'actually sick' people among your clients. However, perhaps it would help how annoying we are to you if you consider that anxiety is, itself, a chronic illness."

"Finally, I’m very happy that you have a new online system where I can check my test results and send you email if I am worried about something.
    It is much less intimidating for me to contact you over email because I’m less concerned about wasting your time for a quick question, since I know you can answer at your convenience, and I’m less mortified by any note of judgment in your voice.
    I’m also able to get more complete and faster information about my test results, so I can see clearly that my blood tests all came out normal, for example."

"That does help my peace of mind, fragile though it may be!"

"You’re a good doctor, and I’ve been your patient for a few years, now. I should be grateful, and I am. But I do think that statistically, Health Anxiety is something that undoubtedly affects several of your patients, whether they are aware of it or not, and it ought to be something you take into account as part of your patient’s complete profile."

"We’re not in this to waste your time or unnecessarily consume resources any more that someone with chronic pain who frequently needs your help to manage it would be."

Sincerely: Educand

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