Haslam D. Haslam’s view: Combatting fear and uncertainty. Practitioner Mar 2020;264(1835):31

Combatting fear and uncertainty

24 Mar 2020


Sir David Haslam CBE FRCGP, Past President BMA, Past President RCGP


Few such serious global health issues as coronavirus have appeared in my entire professional lifetime.

The astonishing speed of developments means that what I write today may be outdated tomorrow, let alone in a few weeks when you will be reading this.

 However, if I ignore the topic, it’s all too clear that I’m not living in the real world of contemporary healthcare. I can only hope that by the time you do read this, I’ll be living in the real world – full stop.

For clinicians, their families, indeed for great swathes of the population, these are incredibly difficult times, combining uncertainty with fear.

About 18 months ago, after I had been diagnosed with tonsillar cancer, I was thrilled and relieved to be told that I had a 90-95% chance of making a full recovery,  which is what indeed has happened. Today I feel intensely anxious about an entirely different 90-95% expectation of survival, and I’m struggling to make sense of how I am seeing these statistics so very differently.

It reminds me of a consultation I had with an elderly patient shortly before Christmas about 15 years ago. Mollie had consulted me for a number of medical conditions over very many years, but on this occasion she had a friend with her.

‘I hope you don’t mind,’ she said, ‘but I’ve brought Christine to come and see you. She’s one of my very oldest friends, and she doesn’t know what to do. I thought you might be able to help her.’

Like Mollie, Christine was in her mid-eighties, and she explained her situation. ‘I didn’t know where else to turn,’ she said, ‘and Mollie always speaks so highly of you, that I hope you don’t mind giving me some advice.’

It turned out that Christine had been diagnosed with inoperable cancer a couple of months previously. Her surgeon had been kind and he had been honest, and she knew that no treatment was likely to be of any benefit. This had left her floundering, not knowing what to do, and overwhelmed by anxiety.

I listened, and we talked it through, and Mollie occasionally chipped in. I recall saying: ‘Christine. I know this is terrifying, but to be absolutely honest, I don’t know who is going to die first, me or you. It’s not that I’m aware of anything being wrong with me, but as a doctor I know that things just happen. Heart attacks run in my family. Who knows what might happen? So I’m just going to get on with living my life to the full. Maybe you could try to do the same.’

They left my consulting room, and I sat there wondering exactly how trite and unhelpfully patronising I had managed to be in a single sentence. Then I went to fetch my next patient and eventually forgot all about it.

However, a year later, just before the next Christmas, Mollie booked to see me again. In she came, accompanied again by Christine.

Christine was glowing. ‘I just had to come and thank you,’ she said. ‘That was the best advice anyone has ever given me. I’ve had a lovely year.’ Then she stood up to give me a hug.

I’ve no idea what had happened to her terminal diagnosis but I do know what had happened to her spirit. As I continue in my coronavirus near isolation, I will try and remember this story.