![]() Though New Yorkers always cough and kvetch, I've never heard so much nervous coughing before. A few weeks ago, to widespread amazement, the city's Department of Health and Mental Hygiene released statistics showing that despite all the stress of city living, the average lifespan in New York is higher than anywhere else in the country.ĪND so, in the new era of fear of SARS, we molt and adapt, and before long we develop a new sort of shtick. Our method of coping seems to be more successful than it gets credit for. We seek out doctors more, and use elaborate health care nets to protect from the ultimate free fall. New Yorkers compensate for the pressure they feel by paying more attention to their symptoms, to every itch and twinge, as if this vigilance might protect us from an ever hostile environment. After studying this phenomenon, the journal Psychosomatic Medicine reported in 1999 that these conditions were due to the strain of life in New York itself. The scientific literature analyzing the health of the city's residents shows, for example, that a disproportionately high percentage of adult New Yorkers suffer from heart disease related to a higher level of stress. The stress of living in New York helps distort perceptions. The city felt this fear and vulnerability for many months pre-SARS now the fear of bioterrorism has been converted into a fear of a deadly mystery virus. In this case the global health alert and travel advisories that are meant to contain the droplets of the virus also spread virulent fear by word of mouth. Most of us, doctors and patients alike, are medical Zeligs like Woody Allen's character, we take on the symptoms and even the personality of the latest threat. New Yorkers are a nervous bunch to begin with, and their doctors are no exception. So why is the architect smiling? In my consultation room he confesses that he was actually afraid he had SARS, but now that he knows he doesn't, even though he is not working, he believes his future is bright. I can see this occurring in my waiting room, where the other patients now deliberately avoid not only him but anything he has touched. Here in New York, he thinks people are taking into account his Asian features and coloring and avoiding him on the street. Though no new cases have been reported in the city, New Yorkers are increasingly frightened, increasingly wary.Īsia is more isolated than before, and the architect has no immediate prospect for work there. During that week, the specter of SARS has spread through the world more rapidly than even the disease itself. It is the same thing I used to do for AIDS in the 80's, scrubbing my hands after every encounter with every patient, whether or not they might have AIDS.Ī week later, the architect has returned to the office with a smile rather than a cough. The concern doesn't go away completely until I have taken a shower and irrationally washed away the psychological remnant of my fear. Doctors are not immune to worries about contagion. I give him an antibiotic and send him home.Īfterward, I am suddenly nervous, thinking of my two young children. Without saying the magic word, I reassure him that what he has sounds not like something sinister but like simple bronchitis. ''It was going away, then it came back a little. My patient plays down his symptoms, clearly realizing I may be worried about SARS. On the plane bringing him home, he says, no one would sit with him. He travels to China and Hong Kong on business every few weeks, but because of the effect of the SARS scare on the economy there, he has lost his latest architectural job and has had to come back. ![]() ![]() In my examination room, the architect announces that he returned from Hong Kong a few weeks ago. ![]() No one sits next to him in the waiting room, and when he coughs, the room empties out altogether. Unsolicited, an office secretary replies, ''You must ask the doctor.'' Meanwhile, the 13-inch television set in the middle of the room is playing all SARS all the time and updating my patients on the virus every hour.Īn Asian-American architect has come to see me for the first time. ''Could I have SARS?'' a patient blurts out. My waiting room is filled with patients brimming with the same question. The stress of living and working in the city may make it seem so.Īdded to this mix we now have the tangible-seeming risk of SARS. But whether the risk of catching something from another patient is real or imagined, one thing is certain. As with the subway, it feels as if germs here might spread more quickly than other places, and I half expect my patients to catch the bug their neighbor is harboring. THE small waiting room in my office near New York University Medical Center is just as congested as the rest of New York, with patients sitting practically on top of one another. ![]()
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