Hard-Wired Brain

While going through the thick pile of paper that contained patients’ test results almost with an automated motion of reviewing the results and initialing the documents, the rhythm came to halt when I saw this particular breast imaging report. The report read that the patient, who had breast cancer more than 10 years ago, had a new breast nodule, and biopsy was warranted. The patient was notified at the time of the imaging.

I picked up the phone and called the patient right away. Let’s call her Amy. Amy expressed that she knew about the results, and was scheduled to have the breast biopsy in 10 days. Even without seeing her in person, I sensed her anxiety. I did my best to comfort her, and advised her to keep her appointment with me the following week (few days before the biopsy).

Amy sat on the exam table, unlike her usual pleasant self. She reported feeling alright physically without any complaints. She did not feel the breast nodule that was detected on breast ultrasound. She opened up and told me that she was thinking of the worst case scenario, that the nodule would be malignant. She reported that, when she was thinking the worst would happen, she kept thinking about all bad things possible, felt anxious and uneasy. As a result, she had a hard time focusing on other things.

I sat down and discussed with Amy. I told her that there are many ways to think about one thing. The reason we tend to think of the worst thing possible is that we are wired that way. The primitive brain wants to protect us from harm. By doing so, it causes us to focus on the all the bad things possible and ignore other possibilities. What if it’s not cancerous? I asked Amy. We don’t have the definitive answer until after the biopsy is done, and by thinking what it could be will not change the outcome of the results. Are there other options to think about the breast nodule? Maybe it’s not cancerous. When the results are available, we will tackle it together. We will figure it out together. There is always a solution.

Too many times I catch myself to be similar to Amy, thinking of the worst case scenario. I quickly remind myself: is the worst possibility really that bad? What are the other ways to think about that particular situation? By opting to focus on other ways, other ideas, I don’t get stuck on feeling depressed or defeated; I get to move on. The final outcome may in fact be better than what I imagined – because it was meant to be, not because I was thinking a certain way.