The spring allergies are in full swing, complete with sneezing, congestion, and eyes that resemble cherry tomatoes. I have the usual risk/benefit choice of whether or not to take an allergy pill. I would feel better but there will be side effects, sometimes called adverse drug reactions. I will walk around in a daze if I am walking around at all.

I think a lot about risk/benefits. Recently our financial advisor who assured us our choice of a ‘low/moderate risk’ investment approach combined with ‘staying the course’ hasn’t made mega-bucks but it has succeeded that in 2020 we actually made money. I continually advise my patients about the risk/benefits of this or that treatment, especially medications their risks and benefits.

I like to think I good at risk/benefit analysis and I make rationale decisions, but I am not so sure. Human beings are horrible at weighing the risks of things, preferring to make decisions based on worst-case spectacular what-ifs over the mundane and the likely. I have a patient who refuses a covid19 vaccine as she heard seven people out of several million had a bad reaction (true) but she smokes, daily rides a motorcycle without a helmet, and she regularly plays the lottery. I have patients who refuse medication for bipolar depression as they read online they could get a life-threatening rash from it (true) yet they don’t bat an eye when I point out their daily long time use of Xanax is associated with falls/hip fractures and early-onset dementia.  Statistics about the (very slim) chance of dying in a plane crash or an intruder breaking into your home vs. the statistics of dying from cardiovascular disease (common and quite preventable) persuade nobody.  I suppose we are wired to zero-in on worse case scenarios. A tiger in the jungle only has to jump once for us to cash in our chips. Our ancestors didn’t have to worry about avoiding a diet of drive-through and a lack of moving and wearing seatbelts as they didn’t live long enough to see the consequences or these endeavors.  

So much of our economy seems based on appealing to emotional response to snowball-chance-in-Phoenix emotions. Security systems, handguns, government policies – even news shows all take advantage of our wiring for the worst case scenario. Paradoxically lotteries and casinos do the same. I have never bought a lottery ticket as I prefer to put that money into mutual funds. While both are a sort of ‘fingers crossed/hopes the works” the latter is more likely to pay off.

I take my cholesterol and blood pressure medications and I wear my mask and seatbelt too. I try to eat sensible and I opt out on extended warranties. I don’t worry about being struck by lighting unless it is raining, nor do I worry people of color want to break into my house.*  I might live a longer less anxious life this way. Sometimes being sensible saves your life. 

*Stats indicate the ones to be wary of are white males 15-40yo.