Watching our current president has caused me to reflect on fear. He rallies support for a cause by appealing to fear. Fear is primal, our fright and flight response. Dawn, the horse I am leasing, operates from fear. She observes her surroundings with ears perked, looking to the right and left, and is quick to become light footed if she sees something unfamiliar or foreign. I can feel her back muscles tighten and she starts to tap dance. She is ready to bolt and I work to calm her with my voice and take a deeper seat in the saddle. At times I’ve felt my own fright response, it’s physiological‑‑the adrenaline pumping, my heart racing, I start to sweat. It takes time to diffuse the fear surge.

Fear also tends to make things black and white: the good guys and the bad guys. Currently, to gain support for the border wall, we hear about the migrant caravan, the criminals, the drug cartels, safety and jobs at risk, etc. Fact checkers tell us this is exaggerated and untrue. My recent blog looked at medical activities at the border.

This is an interesting debate to be having at this time of year, for Christians like myself we have just reread the Epiphany story. King Herod the Great, a Roman king over Judea, was threatened by reports of the birth of some magi in the East. Worried that this newborn might usurp his power as King of the Jews, Herod encouraged three wise men to find the newborn and report back to him with the location so he too could pay homage, as the story goes. Thanks to a dream, the wise men were warned of Herod’s mal-intent and returned home another way.

Fear is very real for both physicians and patients. We talkabout malpractice worries, or cover-your-ass medicine, especially in the US,where tests are ordered to avoid law suits if something goes wrong. Uncertaintyand human frailty both feed fear. The lack of control that comes with the ambiguityof what is really going on with a patient and the fact that I am human, andmake mistakes and may gather imperfect information, both fuel fear.

And fear is part of illness. It is scary to have your bodyand/or mind not behave in familiar ways. It is scary to have a body you knowwell fail you. I think of family members and friends who have come to termswith new diagnoses, aging, and mental health challenges. No one asks for these.No one welcomes such changes with open arms. Usually we make peace with thechanges after much kicking and screaming, either externally and witnessed byothers, or internally creating inner turmoil and likely restless sleep andexhausting dreams.

Lately I have been reading Kathleen Norris’s Amazing Grace: A Vocabulary of Faith. I became familiar with her when a friend handed me Dakota, published in 1993, a collection of poems and stories about returning to the farm in South Dakota that she inherited from her grandmother. Like me she has visited Benedictine monasteries and found herself intrigued with the monastic life and the poetry in the psalms. Kathleen discusses fear, and reminds us that fear is about our shadow, in Carl Jung speak, the unclaimed parts of ourselves that can wreak havoc when not brought into the light.  

As a physician, I try to help patients come to terms with theirfears about their health and their lives. Often that is done by listening,doing exams and tests to name what is happening, prescribing medications thatmight cure or minimize the discomfort that illness brings, and working throughthe uncertainty.

As a human, I try to recognize my own fear, name and be accepting of the shadow parts of my personality, the places where I fight for control or perfection that is impossible. As I have said before, walking alongside the struggle of patients and those I love gives me insight into my own healing. Hopefully, like the wise men I will pay attention to spirt speaking in dreams or the myriad other ways spirit works in our lives so I don’t report to the Herods in my life or in myself. In other words, better decisions are made when we step beyond the fear. Often that involves naming the fear in order to move beyond it.