# 81 November 2006

"Many of the greatest pictures are enigmas; beautiful toys; others, harmful and corrupting enchantments. In the loveliest, there is something weak; in the greatest, there is something guilty."

John Ruskin
Victorian art critic

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# 81 November 2006

"Helping a Patient Feel More Comfortable with a Reasonable Risk"

TISA Description of the Problem: Some patients can be almost phobic about risk when it comes to side-effects. Such unwarranted fears can make it difficult for them to use medications that might be very useful for them. The following useful tip by Sharon Laval, M.D. effectively addresses this potential hurdle to healing.

Tip: If a patient seems inordinately worried about a particular side-effect (by the way there are many side-effects that one should be appropriately concerned about), I try to help the patient develop a more objective listing of the pros and cons by gently reminding them that we all deal with relative risk on a daily basis. To do this task I might say something like this:

"Taking medications is sometimes a bit like driving a car. We all know that there are risks to driving a car - some quite serious. Some of these risks might also be out of our own hands. But we all choose to drive a car because we believe that the relative risks to driving the car are outweighed by the convenience, fun, and benefits of driving. In short the risks are outweighed by the simple fact that we need to get from point A to point B, and we think the benefits are worth the risks. What we will do concerning potential medications is to look carefully at the pros and cons. I can't tell you that you will not have any side-effects. But you may decide that it looks like there is a good chance that the side-effects will be outweighed by the benefits. If you think that will be the case, it may be worth giving the medication a chance."

TISA Follow-up: I like this very low-key and sensible approach to helping patients who are inordinately risk aversive. Try it out and see what you think.

Tip provided by:

Sharon Laval, M.D., BSCMSC, FRCSC
Ob/Gyn Department
Timmins, Ontario, Canada