I enjoyed this article...good writing and very funny.

I've dealt with some of these same issues over the last few years. What many people will not understand is that the only difference between a hypochondriac and someone who actually has a condition is the dreaded confirmation from a doctor. In fact, until the diagnosis is confirmed the hypo and the real patient have similar mental and physical experiences. The hypo lives out in their mind, over and over, that terrible conversation with their doctor. They agonize over the final details of how to say goodbye to their loved ones, and mourn the life they wished they could have lived.

It's a terrible place to spend your days--walking in the shadow of the terminally ill. It's a mental illness that does not kill you, but does completely steal your life away. You have to combat it actively, both mentally and physically--get plenty of exercise, eat a healthy diet, and seek out the support of a knowledgable mental health expert.

If you don't mind.

Somoataform disorder, a far more respectable sort of self image dysfunction than the older term hypochondria (but really the same) is also known among med students as "intern disorder" since they seem to come down with every condition they've been exposed to withing a few days, even when said disorder is not "catchable."

The same is not true for panic disorer, and there is a fine distinction between the two which is very important to note: the somtatically disordered patient ("hypochondriac" is easier to type what with my ulnar neuropathy, sorry), actually accrues some secondary gain, which is why some of the more famous hypchondriacs (take Oscar LeVant, for instance) tend to treat their "illnesses" almost like their children ("My arhtritis", or "My lymphogranuloma") and are very resistant usually to reassurance, preferring to "keep" the disease if possible. Which is why doctors hate to see them coming. Les petit du papier used to be muttered in polite medical offices when one would show up.

Unfortunately, far too often, patients suffering from panic disorder got the same reception. Back as far as the Spanish-American war there was coined a cruel term, "Soldier's Heart", for people suffering from acute anxiety and/or panic disorder, the latter being utterly unknown back then, and the former being considered a "woman's disease." Way to castrate a perfectly reasonable man with a fear of premature death by bullet or cannonball, especially when the fear often was unnamable and came uncontrollably out of nowhere like, well, a cannonball. Between that war and the next (The "Great War"), the term became "neurasthenia." It was even more a "woman's disease" then, and men with it were, at best, called "sensitive men", which was code for "probably a homo." Of course back then being gay was catastrophic anyway, so the name change did little good.

Meanwhile the hypchondriacal male was seen as merely "eccentric."

People with either somataform disorder or panic disorder can also, of course, suffer from actual disease processes, sometimes quite serious. While the hypochondriac is somewhat easier to diagnose (most often), this doesn't preclude other quite real ailments and can, sometimes, cloud the clinical picture.

People with Panic Disorder almost always present (at least the first time and often many times over a period of years) as a possible heart attack or severe asthma. Considering the involvement of the cardiovascular system (rapid, often irregular pulse), dizziness and numbness due to hyperventilation, and a unique sense of depersonalization which by itself can set off an episode, the panicky patient can often be worked up for heart problems numerous times before the true problem is diagnosed. In fact, with hyperventilation often comes non-speficic abnormalities on the electrocardiogram (EKG) as well, so it can really be a challenge in the ER, whereas somataform disorder usually betrays itself right off.

Even with these differences now well understood, there is a tendency on the part of some medical staffers to berate the panicky patient and call them "hypochondriac." While this should not be considered a pejorative term, it is, and it is worse when the patient is not one, but is suffering from the physically mediated panic disorder. While PD can be triggered by stress, imaginings, etc., the event takes place in the temporal lobe, almost like a seizure, and is not somataform disorder and does not call for the same forms of urgent care and long term management.

I speak from experience, and then one day after decades of dealing with PD I had a heart attack (ultimately winding up with clean arteries but a dissecting right coronary artery and consequent emergency bypass surgery). That experience cured panic disorder for me. I'll never mistake a real heart attack for a panic attack now. And if anyone ever calls me a hypochondriac, as much as I empathize with sufferers from that curse, I will punch that somebody in the face. Really hard. You can't argue with a broken nose.

OK, I'm probably kidding about that last part. Probably.

It's the rod of Asclepius. The caduceus (two serpents around a winged staff) represents Hermes and commerce, while the rod of Asclepius (on serpent wrapped around a normal staff) represents healing and medicine.

for the extra info about PD. Since I have been an asthmatic since my teens, and have had some issues with PD since my early 30's, I found your letter very interesting. I have had real asthma emergencies that fell just short of requiring intubation, and other panic-fueled trips to the ER, in which I was afraid I was having one of those attacks. (Note to self: If you can drive yourself 15 miles to the ER on the interstate.....).

But as for the article. I found it very interesting,a little sad (I can't imagine wanting exploratory surgery), and actually understandable. I mean,who hasn't seen all the Datelines and 20/20s and magazine articles in which "the doctor told me it was nothing, but it was really [insert horrible disease here]? Although I am an anxious person, I don't worry much about my own health, but every little rash, or cough, or ache my kids tell me about has me wondering if I should take them to the doctor "just to be sure."

As for those who think that thed author should "get a life:" we all have ways, conscious or not, of dealing with the stress of daily life. For some people, by nature, nurture, or both, it takes the form of hypochondria. In the end, I think that Ms. Traig is dealing with her condition very well--with understanding and humor.