A powerful story is hard to ignore. In fact, we're biologically wired to respond to storytelling. But it's important not to let a good story get in the way of good health decisions.
Consider three recent news stories about people with common symptoms, each of whom turned out to have a serious condition.
- A young mother has tried to ignore her headaches for months. She mentions them to a friend — a nurse — who convinces her to see her doctor. Soon, she has a CT scan and is discovered to have a brain tumor.
- A man who works long days at the airport as a baggage handler notices increasingly severe low back pain. He figures his pain is due to his work and treats it with a heating pad and ibuprofen. When the pain becomes so bad he begins to miss work, he sees his doctor, who orders an MRI. It shows a fracture in his spine.
- A woman has been taking care of her two young grandchildren while their parents are on vacation. She experiences episodes of palpitations, as if her heart were racing. She assumes it's because she's been running around with the toddlers all day. When she nearly faints, she sees her doctor. It turns out she has atrial fibrillation and a blood clot on her heart valve that could cause a stroke at any moment.
The core of each story is instantly relatable: a previously healthy person develops symptoms so common that most readers will have had them. Each downplays the problem at first, attributing symptoms to other, quite plausible, causes. They finally seek care after reaching a tipping point. In the end, a serious condition is found.
Compelling stories? Sure, but what's the take-home message?
Medical stories are highly selected
The medical stories that make it to screens or publications tend to be the highly dramatic — not highly typical, informative, or even useful. Can cancer cause headaches, or a spine fracture cause back pain? Absolutely. Can palpitations be a symptom of atrial fibrillation? Certainly. But the vast majority of people with these symptoms won't have cancer, fracture, an impending stroke, or any other serious condition. So, while it's fine to learn more about which headaches, backaches, or palpitations are likely to reflect a dangerous problem, not everyone with these symptoms needs extensive testing for these conditions.
Your symptoms, on first blush, may sound quite similar to the people in the scenarios above. But those stories may leave out or overlook important details: a headache with loss of hearing; a backache in a person who takes steroids, which can cause bones to break more easily; palpitations combined with shortness of breath. These details matter, and may make another person's experience quite different from yours. Certainly, these facts would increase a doctor's suspicion of a serious condition.
And face it: people with common symptoms who turn out to have a common, benign condition are much less likely to make in into print or televised media. You likely won't hear about the man with a stressful job and daily headaches who sees several doctors, has lots of tests, and is ultimately diagnosed with tension headaches, even though that diagnosis is far more common than a brain tumor.
Put it in context
Dramatic or unusual medical stories could bias you in an unhelpful — or even harmful — way. For example, stories like those described above may
- encourage unnecessarily worry: These sorts of medical stories can make it hard not to catastrophize — that is, your mind may go to worst-case scenarios. If you're a person with headaches, reading about a person with a brain tumor who had symptoms like yours isn't exactly reassuring.
- distract you from common and important health issues: A young person with palpitations due to panic attacks may not get the care they need for that condition if they or their doctors are overly focused on the remote possibility of a more significant health issue.
- misinform you if the big picture isn't provided: Some medical stories never get around to mentioning how unusual the condition is, or explain that it's rare for people with the symptoms described to be diagnosed with something serious.
- set the stage for unnecessary medical evaluation and tests: People may ask their doctors to test them for conditions described in a dramatic news story, even if those tests aren't really necessary. Extensive testing or imaging is more likely to result in finding insignificant abnormalities than in diagnosing an unsuspected (and serious) condition. This can lead to even more uncertainty, more testing, and more unnecessary worry.
Know the red flags — and don't ignore them
Many of us minimize, rationalize, or otherwise explain away symptoms. Sometimes, that's a bad idea.
Every person with a headache doesn't need a CT scan. But it's good to know red-flag symptoms you should report to your doctor right away, not ignore. In the story about the person with a brain tumor, hearing loss was the tipoff this was not typical migraines or tension headaches. The woman turned out to have an acoustic neuroma, a rare, noncancerous brain tumor that can affect hearing and balance.
So if you have symptoms that worry you, talk to your doctor to learn what's commonplace and which symptoms should prompt a call, an appointment, or an emergency room visit.
The bottom line
Beware the spectacular medical news story. More often than not, it's an exceptional situation that may not have much relevance to you. And it might even lead you away from what's most important to your health.
Follow me on Twitter @RobShmerling