What's Riskier Than Weird? Ordinary.
(June 8, 2021)
In the last couple of months I have been going on quite a bit about "risk" as it relates to medical procedures. I originally took up that subject because I became annoyed at reading so many dire warnings in clickbait articles by lazy internet columnists that doing thus-and-such would "double your risk" of some catastrophic illness or another. That idea of "relative risk", you will recall, turns out a good bit of the time to be negligible because if you actually do this terrible thing that you are being warned against, your chances of death or illness will increase approximately from that of being killed by a comet to being maimed by a meteor. Meaning, if you double next to nothing, you got -- next to nothing.
But! If I had been a little more thoughtful about this, and stood back calmly and decided I was going to tackle the general subject of medical risk logically instead of haring off after yet another internet irritant, I would not have started with that particular aspect of perceived risk. It would have been better to first discuss something that is a lot more common, less nit-picky, and -- lo! -- can be applied to normal life in other ways too! And THAT would be the odd human psychological quirk that causes us to judge something unfamiliar as more dangerous than something familiar.
"Familiarity breeds contempt" doesn't just apply to celebrity crushes and exotic drinks. We do things every day that are flat-out dangerous, and we take them for granted just because we've done them so often. Things that because we're used to them, we think of as safer than something that sounds weird but is in fact less dangerous. That dog that we don't know looks very menacing -- just because we don't know it.
The example usually given to illustrate this is that many people fear flying, but blithely drive to work every day when they're far more likely to be killed or injured doing the latter. This is a "thing" in risky jobs as well, where workers soon begin to look at the safety measures they are mandated to take as nuisances rather than protections. But I want to discuss it here specifically as it applies to medical procedures.
Most people are familiar with, and thus pre-disposed in favor of, drugs and surgery. Although it's possible that they might even tell you otherwise, they don't feel like there is really any risk in getting surgery or taking a medication because both of those things are so commonly done. So it's usually very easy to talk someone into them (especially if they are frightened by what they think is happening to them) and equally hard to persuade them to try something else first. (People who are scared tend to opt for the familiar because it makes them feel safer. That's another thing to look out for here.)
People worry about the "risks" of taking a nutritional supplement or an herb that's been around for millenia and instead blithely swallow whatever prescription medication they've been offered. Or they'll go for steroid injections or neck surgery for neck pain because they're afraid of getting a stroke from a chiropractic adjustment (note; possibly one in a million people may get a stroke from a traditional chiropractic adjustment of the neck, whereas about 5% of the people who get neck surgery suffer one).
This logically unjustified freakout becomes even worse when you get onto the subject of acupuncture. I wish I had $10 for everyone who's confided to me that they'd like to try acupuncture, but they're afraid of the needles. Here's this about that: Many years ago when I was still a simple chiropractor, one of my patients asked me "for a friend" about acupuncture for sinus problems. Their "friend" was contemplating their third surgery for chronic sinus infections and was thinking about trying acupuncture instead, but was "afraid of the needles". I blurted out, "so your friend isn't afraid of being knocked unconscious and having holes drilled in her skull, but she's afraid of an acupuncture needle?" Most impolite of me, but nevertheless accurate, if for no other reason than a third surgery for something is going to work out about as often as a third marriage.
I keep repeating that medical error is the third leading cause of death in the U.S. Remember that that statistic does not include people who died from a medical procedure that was performed properly. I once had a young patient who refused to have a loose bit of cartilage removed from her knee because her best friend in high school had died of a blood clot while undergoing the same surgery. And there was (presumably) no error there. It was simply a bit of bad luck, and she wouldn't even be memorialized in a statistic.
Just because something sounds weird does NOT mean that it probably is weird (although that is a cherished saying of mine). What's weird (and thus scary and dangerous) very often has more to do with your experience and perception than it does with actual reality. Read about insect behavior if you need a lesson in just how bizarre normal reality can be. If you need to, that is, because if you've been on earth forty years or longer, that lesson is probably unnecessary.
Anyway, in an era where medicine is not just leaping forward in technology but also has finally acquired the humility to give a second look to many of the old ways, you can't go by what you're used to. That's why it's important not to assume that a medical procedure that's been recommended to you is a "what have I got to lose?" kind of proposition. You have QUITE a bit to lose. So please do look into alternatives to drugs and surgery whenever possible. Your life expectancy may thank you for it.
--dr. diane holmes
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