The (Very) Worried Well
By Janice M. Horowitz
“Every time a physician writes a prescription, orders a test, or dispenses medical wisdom, there’s something else going on behind the scenes,” says Janice M. Horowitz, author of the forthcoming book, Health Your Self: What's Really Driving Your Care and How to Take Charge (May 18). Horowitz, a longtime health journalist with Time magazine, shows in her new book the hidden forces at work whenever medical consumers receive health care–and how to successfully navigate around them..
It started with what’s now a familiar scene. My husband and I were working together at home, he, on his computer at the desk, and me on my laptop on the couch. Suddenly I felt sick and as if I were going to throw up. Off I bolted to the bathroom, and there, in my wretched state, I shouted out to my husband: Is vomiting a symptom of Covid-19?
“Yes, I see it. It’s on the list!” was his answer from down the hall. With that, panic set in, made worse a couple of hours later when I developed a fever. Food poisoning, stomach flu, both reasons for gastrointestinal distress, are upsetting enough. But now there’s barely a symptom that doesn’t bring on a deeper level of anguish. We have become a new breed of worried well, the very worried well, and we’re all fretting about the same malady.
For me, I was up most the night, not just making use of an old pot placed near my bed, but ruminating about what I had done that might have given me Covid. Maybe, my mask wasn’t tight-fitting enough? Maybe I had gotten too close to that woman in the tiny bakery I never should have gone into? I spent even more mental anguish blaming myself for having been careless. The deadly disease I had thus far averted was now ever more real and terrifying.
Given how broad the symptoms of Covid are, from respiratory ones such as trouble breathing, to benign-seeming ones like a runny nose or a headache, we are making ourselves sick with worry, even when we’re not so terribly sick. As it turned out, I had food poisoning from tainted arugula, an ordeal that would resolve in a couple of days. Not nothing, but in those moments of distress, I had every reason to believe that I could wind up at death’s door from Covid. With allergy season on its way, someone could go down the same spiral of anxiety over a bout of sniffles.
The worry is bad for us. Anxiety pumps out stress hormones such as cortisol, which left unchecked, famously contribute to a lowered immune system and poor health outcomes. A report in the British Medical Journal found that health-related anxiety increases the odds of experiencing a heart attack or angina by 70 percent. Meantime, more than half of Americans are reporting that the Covid crisis is harming their mental health, according to a Kaiser Family Foundation tracking poll. Surely what’s contributing is the ample time we now have at home, ever more preoccupied with ourselves, lost in our own desperate thoughts. For the new very worried well, it’s the perfect setup for every ache and pain to loom as a catastrophe.
And we can’t catch a break. Trying to quell our coronavirus concerns is an exercise in even more worry. Before Covid, if you felt sick, you went to the doctor, got examined and maybe had blood drawn for a ready explanation. But now, you have to fend for yourself, ramping up all of your energy just to learn what you’re facing. Figuring out how to get a test for Covid, weighing the options and navigating that provides enough consternation to flood your mind so you wind up with a worry within a worry. Urgent Care, for example, often means waking up early to wait on line and you have to decide whether you want a less reliable, but speedy, antigen test, or wait days for the results of a gold-standard PCR test. There are home PCR tests, too, but they are only optimal if you thought ahead and had a testing kit already overnighted to you; then, you still have to wait days for results. If you can find one, rapid test centers are able to give you the result of a PCR test in a matter of hours. Then there are tests in doctors’ offices, under tents and even nurses can make house calls. Try sorting out all of this when you’re sick and overwrought.
Now, of course we have the stress of finding a way to get vaccinated. But, unlike the possibility of a positive Covid test, at least the end result will be, by definition, a good one:: not just an inoculation against a virus, but an inoculation against worrying about it.
Janice M. Horowitz, the author of the forthcoming book, Health Your Self, covered health for Time magazine for nearly two decades. She also created and hosted the public radio segment Dueling Docs: The Cure to Contradictory Medicine; and contributed to The Economist, Allure, and The New York Times.