Mother Knows Death presents External Exams with Nicole and Jimmy. Hi everyone, Welcome The Mother Knows Death. On this week's External Exam, I will be interviewing author and podcaster Caroline Crampton. Caroline just wrote a new book called A Body Made of Glass, A History of Hypochondria, which came out last week. She also has a podcast called She'd Done It, a storytelling podcast that unravels the mysteries behind classic detective stories. Hi Caroline, Welcome The Mother Knows Death.
Hi, thanks very much for having me.
When I first learned of your book, I was immediately intrigued by the title, mainly because I feel like I suffer from hypochondria a tad as well. Can you please explain to everyone what a hypochondriac is. So.
Hypochondriac is someone who has an unwarranted and persistent fear that they have a serious illness, often in the face of a lack of evidence of any organic cause of a disease. So it's someone who has been to the doctor to have a loaded symptoms checked out and the doctor's saying I can't find anything. All your tests are coming back fine, but the person is saying, well, I'm still experiencing this thing. It's more commonly today known as
health anxiety. That's the kind of modern medicine's preferred term.
In the beginning of your book, you speak a lot about a little bit about your life and how you came into this particular subject. And one of the things that you stated, which makes total sense to me as to why you're interested in this subject, is that you are diagnosed with Hodgkins lymphoma when you were a teenager, which has a pretty good success rate of survival if it's caught early, and then it tends to go down
a little bit more as the disease progress. And when you were seventeen, you were diagnosed with this and had you receive treatment, and they kind of told you, oh, you're good, everything's fine, and then you went away to college and then a lump pop popped up in your neck and then they told you, oh, it came back, and then you had to get more aggressive treatment after that.
Do you think that that's the reason that you started to become a hypochondriac yourself, because you lost trust in the system.
Yeah, it's definitely the reason I became a hypochondriac. Partly that incident that you're describing where I was given the all clear to head off to college and then dragged
straight back again to the hospital. And then also partly just the fact that as part of their recovery from that, you know, good doctors always say things like, you know, you should come and see us whenever you have any concerns, or you should always keep an eye on this, and if you feel anything that doesn't feel right, come straight in. And that habit of checking and hyper vigilance and always being on high alert that something could be wrong. That's
really the core of the anxiety for me. That's where it began. The issue of losing trust in doctors is an interesting one though, because I actually didn't really find that that was the case, partly because my doctor was very upfront about this could happen. He didn't try and pretend that this wasn't a likely outcome, but he just and I did my own research to double check that
this was true. He laid it out, as you know, this treatment I'm doing for the first round has a ninety five percent chance of affecting a total cure, so absolutely overwhelmingly on your side, but there is a five percent chance that it won't work, but the scandal seemed to show that it had worked, and so off I go. But then once I found the lump again, I was like, oh, so I'm just in the five percent. It wasn't like
I'd been promised something that was then withdrawn. It was it was presented to me as a possible outcome, just not a likely one.
That's good because I hear a lot of stories of people getting diagnosed with some nasty like nasty cancers, including my grandmom, and the oncologists kind of giving them a lot more hope than what the actual numbers show.
So it's good that you were you at least.
Had it laid out for you, that you know this was a possibility, and you just so happened to fall in that rare percent of it coming back unfortunately. It so now, just to get this out there, like you've been all clear for a while since you've gotten diagnosed with that, right.
Yeah, yeah, I think it's fifteen coming up, fifteen years now.
Oh wow, that's awesome. Congrats on that.
In the book, you talk about the history of hypochondria, which is really it's really interesting to me actually, and you start with Hippocrates and then you go to modern day, which would be like people google doctor Google, they say, googling your diagnosis. Through your research, what are some of the common themes that you've seen throughout history as it relates to being a human with health anxieties.
One of the really big ones is people seeking alternative treatments to whatever the medical authority is in their particular decade or century. So I had a lot of fun actually with this aspect of the research in the book is diving back into what was once upon a time called quackery. So you know, there's ancient Egyptian accounts of people being prescribed mixtures of dung and honey for a
whole variety of conditions. And then you get into the Middle Ages when people are carrying parts of animals around with them because they've been told it will ward off a particular type of sickness, or taking some really incredibly noxious remedies including mercury and things like that, because they've been told by some medical pseudoscientifical salesman that this will solve all of their problems. And then I really do think it connects right up to the present day with
our modern wellness industry. An awful lot of that is uh designed to tempt people who feel like conventional scientific medicine is not satisfying them, it's not giving them the answers that they want. So why don't you try these supplements and on regulated industry, why don't you try these habits, these things, all of which you conveniently have to pay for. So that was a really really big theme. Another one is just how sad and tragic this can all be.
I found accounts of people from second third centuries who have such advanced anxiety that they believe that they're made of pottery. It was called the earthenware delusion. That they're so concerned about the fragility of their bodies that they think that they're actually made of pottery. And then right
up to the present day. I think it's a really tragic and sad thing when someone isn't able to enjoy that the body that they're in, they're not able to enjoy the health that they've got, whatever state that is, because they're always so anxious about what could be about to happen. And I say that from personal experience, it's this concert did a cycle of guilt in my head that well, I seem fine. Why can't I just enjoy being fine instead of living constantly in the space of fear.
Yeah, it is a terrible I've gone through it sometimes, so it is definitely a terrible way of living. And it is interesting though that you say that about the treatments, because I just wrote about Steve Jobs last week. He was the creator of Apple and mac and stuff, and he had gotten diagnosed with a cancer that was seemingly pretty treatable, and he decided to go the alternative route as well, and then he ended up having it come back a little bit worse, and by the time he
actually decided to go with traditional medicine. So I've definitely heard about that. It's just interesting that you've been seeing that hundreds of years ago. It's really interesting in your research, did you find that health anxieties followed trends like, for example, right now, the hu to in the news the past couple of months has been that there's an increase in
cancer in younger people. So now all of a sudden, people that maybe never had calling cancer on the mind when they were thirty, or like, oh my god, I might have calling cancer. Is that something you've seen with trends throughout history.
Yeah, absolutely, very very markedly. I think I wrote a lot about actually how medicine and hypochondria to me seem to go hand in hand, that whatever the state of medical progress is, that's where hypochondria will be. So yeah, today it's people young people fearing that they've got kinds of cancer that are traditionally associated with people a bit further on or I don't know, in the mid twentieth century, people are fearing that they've got AIDS because that's just
kind of come onto the news that they've just heard about. It. Go back one hundred years before to the nineteenth century, people are afraid that they've got tuberculosis. You can do that. Whenever the condition du jour is any century, that's what the hypochondriacs will be afraid that they've got. And there's something about it that is just this hunger for new information and incorporating new information into your anxieties. And yet you see that absolutely throughout history.
Throughout the years, there has definitely been obviously you're talking about all this documentation of health anxiety, has there ever been any kind of suggestions for treatments and ones that actually work? Is it a combination of therapy and maybe just like taking some kind of SSRIs to like chill you out, or like what seems to be something that helps it.
So historically there have been some very bad treatments. So in the sort of eighteenth nineteenth century, you've got these really entrepreneurial quack medicine salesmen who are saying, oh, nothing cures hypochondria apart from my potion, which contain I don't know, mercury and phosphates and all kinds of other things you definitely don't want to ingest. In the twentieth century and into the twenty first we have a much better grasp
on it. There was some really good research done in the sixties and seventies and more recently about Yeah, the effectiveness of SSRIs and antidepressants generally have really shown to be effective for people with health anxiety. And the biggest thing there is cognitive behavial therapy, and that's I know in the UK where I live, that's what you will be referred for if you are diagnosed with health anxiety, and I think it's the same in other places as well.
Often a combination of those two things, antidepressants and CBT. I personally, also did a course of what's called EMDR therapy, which is this eye movement and desensori desensitization, which is often used for people with PTSD. I think the quite big book The Body Keeps the Score is all about this and its use on military veterans, but it can be used on other kinds of trauma too, and medical trauma is one of the kinds. So I found that really helpful personally.
Yeah, I believe that too because my older daughter, actually, she when she was younger, she had I mean, she didn't have something as terrible as you were going through, but she had asthma and she was in the hospital a lot as a child getting IVS. It's a lot for a little kid to have to go through that. And now as an adult, she wants to faint when
she has to get her blood taken. And I could directly just relate it back to her going through all that as a little kid, that just the thought of any of that stuff just makes her want to pass out, you know, it's nuts.
Yeah, I think that's a really common reaction, especially people who've had childhood medical experiences, medical trauma, and what EMDR does, which I think is really interesting, and it's still it's a difficult thing to produce evidence about, so it's a slightly contested therapy. People who've done it and find it works are very positive about it. Other people are skeptical.
What it purports to do is move memories from one part of your brain to another, So memories that are from the past, but you're still experiencing them, and you every time you say go to get an IV, you're connecting it back to that experience in the past, and
you're re experiencing your kind of retraumatizing yourself. What EMDR proposes to do is move that memory from that part of the brain that's very much in the present and move it into the part where memories are stored from the past, so you can still think about it, you still know that it happened, but it's not reaffecting you every time you find yourself in a similar situation. That's
the theory, at least. I think we'll have to wait for some clever neuroscientists to finally produce the proof or whether that's possible.
Well, I mean, you had it done and you said that you feel like it worked for you, right.
I did, I really did, But even while I was doing it, I had my doubts about whether itlt a bit like hypnotism in a way because the eye movement part of the acronym. What it refers to is the moving of those memories. The way they do it is you have to do what they call bilateral stimulations, either by moving your eyes from side to side in a rhythm, or some therapists I think, like to do sort of tapping on alternate sides of your body, either you doing
it or someone doing it to you. And you combine that bilateral stimulation with talking therapy about the incident and ideas that are connected to it for you. So you start with that incident and then you talk about, well, then it happened this time, then it happened that time, and you keep connecting back and they keep checking in with you the whole time you're doing this and saying like, how upsetting are you finding this memory? On a scale of one to ten, they keep doing it until you
basically till you get down to one. So even as I was doing it, I was like, is this hypnotism. I'm kind of moving my eyes in a rhythm. I'm being It's very after a while, you really get into the rhythm of it and feels very mesmeric. So I did have my doubts even while it was going on, but I experienced very positive results from it, and you know, I'm very grateful for that. Whatever happened.
Yeah, Like it's almost like who cares? It worked, right, And you really, having health anxiety is so disabling because it's only going to get worse as you get older, because the more you're you get older, the more your body starts falling apart, and then you need blood work every couple months for certain medication you're on, and all this kind of stuff. Like you just got to get over it somehow.
Absolutely, And people with health anxiety as well, they with the diagnostic manual categorizes them into two different types. They're either care seeking or care avoiding. That doesn't seem to be any in between. Care Seeking are the people who are, you know, at the doctors every other day, always wanting
more tests, always wanting reassurance in that way. Care avoidant, I think, are the people who struggle even harder as they age because they're the people who would rather never go near a doctor in case they get bad news. And I think you're right as you age, there's more good reasons why you should be getting stuff checked out. You should be receiving regular care, and if you're not willing to cross the threshold of the doctor's surgery, you could end up in some serious trouble because of it.
We had this story once in one of the hospitals that I worked at. One of the doctors told us that there was this doctor that she used to work with that had this chronic cough and just stop didn't want to go get it checked out because this doctor swore that he had lung cancer and he never got it checked out, and then he ended up dying. And when they checked him and it did his autopsy, he ended up having TB, which was something that could have totally been treated for the amount of time he let
it go on. And just working in surgical pathology and autopsy, I've seen lots of cases like that that you're just like, Man, if this person just got this checked out when it presented the they wouldn't be dead or have this massive surgery right now.
Yeah, I think it can feel a bit like you're in a catch twenty two though, because absolutely you feel like all the good advices. You should always get something checked. Like I was saying my cancer doctors being like, if you have any concerns, always come back and get checked. And then if you go too much, then they start to go. You're always hear what's really going on, what's really lying behind this? So in your mind, as the anxious person, you're like, well, where's what's the perfect number
of visits? What's the perfect number of times I should go to the doctor. And of course that all feeds into the overthinking.
That's what's so scary though, because you always read these news stories that are titled like she had a headache, it turned out to be so much worse and it was like stage four brain cancer or something like.
And then you say, well.
I have a headache, could that be why I'm having headaches? And it's hard to just because you hear a lot of times of these stories where people had these super mild symptoms and it ended up being something really bad.
Absolutely, and even in real life, I feel like when you've had a health condition or you're known to have had it, people love to share their stories with you, and mostly they do that from very positive motives and they're trying to be kind, but they will say something like, oh, so you've got a blood cancer. My cousin had a blood cancer and she's dead now, or you're like thanks, or went she went through five years of treatment and she's mostly okay now. But you know, everyone's always got
a treatment, they've always got a story to tell. So yes, absolutely, I think what the CBT around health anxiety tries to do is just try and persuade you hard as it is, to only trust yourself in that regard. If you feel like something's wrong, take the appropriate action, but don't allow yourself to be kind of externally persuaded that as you say, you've got a headache, so you've got a brain tumor. If you've a headache felt normal and fine before, it's probably still normal and fine.
Exactly.
It's just like I feel like that's the key to life though, right, is to just like think for yourself and not listen to the outside noise, like if we can.
It's just like a lot easier said than done, you know.
It really really is. And I also think that some of the tools that we have available to us today make that even harder. I think I included this in the book about how if you do a Google search, because the search results or the suggested search is tailored to what you've searched before and what it thinks you
might want to see. If you type in does headache mean, it'll say things like brain cancer, miscarriage, death, rather than like dehydration, needs fresh air, should take a nap exactly, all of which I'm much more likely outcomes, but the scarier ones or what will get you to click what you keep you online longer. And that's what the company providing the search engine wants for you.
I know that it really is.
And that's I was going to ask you that, like, just through your research, have you found that health anxiety is worse now because we do have so much information than we had before.
I mean, anecdotally, I feel like worse and also more prevalent, more people have it, and the people who have it have it worse. It's really hard to get hard data on the number of people out there with health anxiety.
It's something that I really struggled with in the research actually, because a lot of it is reported differently in different countries and over different times, and it's all done on self reporting as well, on these different questionnaires and they change the questionnaires, so it's quite hard to compare and look at percentages, but it does seem very reasonable that there would be more people with health anxiety now, and also that just the constant availability of information about medical
conditions would cause those same people to have it worse. It was interesting researching and looking back, though, I found some quite interesting references to similar anxieties as we might have now about the relationship this has with the Internet, with the wide availability of books and them being cheap
and easy to consult in libraries and so on. And there's even a really funny satire of this in a comic novel from the late nineteenth century called Three Men in a Boat, in which one of the men, who is a hypochondriac, writes about how he went into a
library worried about some symptoms. He had to look in a medical dictionary, and he left with an alphabetical list of ailments because the book convinced him that he had all of the things that it listed, which is not dissimilar to how you might feel after a long googling session or falling down a few Internet rabbits.
It's a It's really interesting because we just went through this having lived whatever forty years of my life before the pandemic happened and then going through that, and you know, in my personal life as well as my professional life, I just know people that from all spectrums of like being a germaphobe, so to speak, like I'm absolutely not. I just like really don't care if I get blood
on my hand, I just wash it off whatever. Whereas other people that are doing like a little biopsy in the lab put on like a biohazard level three suit just to.
Like touch it.
Or people that just work in pathology, I've seen they use tissues to open the door knobs and things like that. And I feel like those people already kind of had their thing, and I think that the pandemic like threw
them over the edge big time. And I was wondering if you think that it's at this like all time time high because of things like the twenty four hour news cycle and there was like a ticker that was telling you every time a dead body showed up, and then social media talking people back and forth and stuff like that, Like is that impacting our mental health.
As far as health anxiety anyway?
Yeah, I think the fact that for months and months governments were encouraging or in some cases requiring, behavior that had previously only been the realm of you, as you say, extreme germophobes, so obviously mask wearing. But then people were doing things like cleaning all of their groceries when they got them back from the store, or I did that one myself, or cleaning obsessively cleaning surfaces. And there was a lot of very sensible chat about this is just
hygiene theater. This doesn't actually have anything to do with COVID. This is just done to make you feel like something is being done. It doesn't actually have any on your chance of getting the condition, all this kind of stuff, and yet I think it did make people feel better in some ways. It gave them a sense of control, which, you know, who's to argue with that if it helps
you in a difficult time. But yes, I do think the fact that all of these behaviors, previously fringe niche things suddenly became widespread, even required in some areas, and therefore people kind of incorporated it into their previous beliefs in a way that I don't think is necessarily going to be helpful in the long term.
Yeah, I mean, I definitely felt victim to it at first, like the first week, you know, just oh, you should really wipe down your phone with alcohol after you go into the store and just this. And then I did it one day and I was like, why am I
doing this right now? Like I just worked in a lab with blood and a hepatitis C in HIV like all the time all around me, and I would pick up a pen that had blood on it and not even like and just like carry on right, So I'm like, what this Hell's us any different kind of But I think just when you hear it all the time, it starts you start thinking like, well, is this just like totally different than anything else I've ever experienced kind of thing.
And so don't beat yourself up for cleaning your groceries, because we've all been we were told to do it, like it's just that's that's how it was.
We were told to do it. And I also think that there's this element of the CBT that they do for hypochondria where it's about doing something that you're afraid of and then waiting to see what the consequences are so as to prove to yourself essentially that actually it's not that bad. That the fear was much worse than
the actual thing. And one of the CBT therapists that I interviewed for the book described this protocol that she does for people with OCD or extreme gemaphobia connected to their health anxiety, where if they're of say public transport, she'll have them take the bus, touch the handle, and then lick their hand, which is for someone with that
problem just unthinkable, could not possibly do it. And then they do it, and then they wait a week like, actually, I didn't get sick, nothing happened, And then it's easier the next time to get on the bus and touch
the handle because they know that that time. So I did feel a bit like that myself with COVID, that you can't possibly be the perfect kind of surgical, sweet scrub down of every single thing that's touched the outside world, and every time you don't die of that, it becomes a bit easier to maybe not clean the groceries every single time.
Yeah, And it's I always would vision like if you've ever seen these videos sometimes they show with like ultraviolet light on surfaces to show you where all the germs are and stuff. You're just like, no matter how much I wear gloves. How perfect I am at this? How may ask what I There's no way to avoid it. There's just not it's it's just it's just them. It's
just not possible. So I think, even though you think like, Okay, I wipe this stuff down and I did this, and you live like it's it's just like it's because you were exposed to it. That's how life works, right, you really have not. No.
I also thought a lot about My great uncle was a doctor. He was one of the first gps in the NHS. So he started practicing in nineteen forty five in a very rural area, and I remember going to visit him with my little sister when he was retired, and my sister had impetigo on her hand and it was getting worse and worse, and my mum asked him if he could recommend anything, and he said, yeah, you know, this is what you should go to the chemists and ask for. But also in the longer term, you need
to just she needs to be eating dirt more. She needs to like sit under the table and just eat dirt. Because this is a condition that is helped, this propensity is by greater exposure to more bacteria, more viruses, more things, And I just I still remember all the time him just saying that she needs to eat dirt and talking about how that was a positive thing. So I tried to keep that in mind when the sort of worst of the gemophobia hygiene stuff was really getting to me during the pandemic.
Yeah, I'm kind of the same way.
Like I have friends that they make their kids like wash their hands before they eat and stuff, and I'm like, no, don't wash your hands, just get it all in, like whatever you've been touching all day, wash them when they're soiled kind of thing.
Like I'm not.
I'm like a really big proponent of that, just because of everything I've learned in school. That just completely makes sense. Do you think that people are who have health anxiety, Like, is there is the reason for all different things? They're just scared they're going to get sick, or is it they're scared they're going to die or the two just kind of go hand in hand.
I think the two go hand in hand. I do think hypochondria is a form of fearing mortality. I think ultimately that's what it's about. But I think it's a bit of a variant on that because you're afraid that you're going to die, and then you're afraid that before you're going to die, you're going to go through a really horrible, prolonged period of illness, hospitalization, all this other stuff. I think for people like me who have a serious pre existing condition in their past, that's part of it.
You're quite specific about your fear, like I don't want to go back into a hospital and be in an isolation room for a month and have you know, noxious chemotherapy given to me. I'm very very specific about the things that I'm afraid of, really because I've experienced them and I don't want to have to experience them again. And so I do think that it's kind of fear of illness and then fear of death in that order.
But something that writing the book I feel like allowed me to see a bit more clearly that I had really understood before, is that the fear of death part is not without cause, because we will all die. So actually being able to separate that and sort of see it from a different perspective and just say, well, I will die one day. Is this all this anxiety, all this fear, all this concern and preparation about illness. Is this how I want to have spent that time? It
could happen anytime. So I did find that writing about health anxiety gave me a renewed appreciation for my mortality as it were, and it did help to lessen the anxiety some.
Yeah, I feel like that too.
Like I used to have a lot of anxiety about death when I was younger, and once I went to school for it and started writing about it and just really just trying to figure out why things happen and learn about it, it makes it a little bit easier to figure out that this is just going to happen to lots of people just because your anatomy and your physiology is not going to work perfectly all the time.
And even with one of.
My kids had a little bit of death anxiety a few years ago, and I guess my approach worked because it kind of went away. I just was like she would just be like, I'm just scared I'm going to die, And I was like, you are going to die. You're going to die one day, like and so am I, and so is everybody around you. Every single person you know right now is going to die. And this is when she was like six or seven years old, you know.
And but I said, but it won't be if you just live healthy and stuff, it won't be for a very long time. So you don't need to worry about that right now. And I think a lot of people, and I even saw this during the pandemic especially, It's just like there was like this weird thing that like nobody should die ever, and everybody just needs to know that, like that's going to happen for people all the time.
And really, when you think back to like back in the day where the average life span was like thirty seven years old, people living to eighty and stuff is remarkable, you know, and certainly things are going to take them out just because they're basically pumped alive with drugs as it is.
Yeah, definitely, I had my own experience like you and your daughter, where my grandmother died when I was five, and my mother and I flew out. She lived in South Africa. We flew out for her funeral, and my mom had done a really good way, she'd done a really good job of like preparing me for everything that was going to happen. But the one thing she'd forgotten about was that my grandmother was going to be cremated
after her funeral, which was her wish. And so after the funeral of them family go with to the crematorium, and you know, everyone knows what that's like. I was five, and I was like, what are they doing? What are they doing to grandma? No one had explained the concept of cremation to me, and that was the particular part of it that I was absolutely horrified by. But then afterwards she gave me the same talk that you did. She was like, you know, this was her choice, this
is what she wanted. She knew she was going to die, and she chose this option, and we're just carrying out her wishes and so on, and so I really went through the whole sort of cycle with that thinking it was awful, thinking how could you do that to someone? How could that possibly happen to me? Could that happen to other people? And then coming out the other side of oh, I see how actually this is. We're just
we're fulfilling her wishes. And she had a finite number of options at this stage and she chose this one. So yeah, I do think that being upfront with people, even children and quite young children, they can handle it, and it's actually better than lying to them. It's better
than pretending. I saw some stuff when I was in hospital because I was seventeen when I was diagnosed, I was classified as a child, even though because I was under eighteen, even though I was two months away from being eighteen, and you know, to all extents and purposes, had the same cognitive abilities I would have after my birthday. But so I was kind of on some children's wards and stuff, and I I saw the different approaches people took.
You know, some parents visiting their children in the wood were very like, it's all sunshine and rainbows, and others were very like, you're going to have surgery tomorrow. Here are the risks. We hope they won't happen, but these are the risks. And those are the parents that had chosen to be fully transparent with their children. And those kids didn't cry, they didn't feel like they'd been lied to, they didn't feel like they'd been let into something that
they weren't prepared for. So it's a difficult choice to have to make, but I don't think you can never go wrong by being completely honest.
Yeah, and especially because I mean the chances of your kid.
I don't know.
In my life, it was really weird that I only had a couple of family members die before I was twenty years old. But sometimes kids have to deal with like you did, like a grandparent dying very young or something like that, and you don't wanted to kind catch them off guard because I feel like they can go down a rabbit hole like real fast if they're not preparing for that, and then all of a sudden someone that's really close with them is gone one day.
Yeah, definitely. I think the kind of healthier attitude you can cultivate towards mortality the younger you are, I think the easier you will find those hard things, and probably the more you'll get out of life, because you'll understand very early on that you only are going to get so much of it, and therefore you need to choose what you're going to do, don't put things off, and so on. So yeah, I do think it's best if people know the deal.
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Join the grossroom dot com today. Have you found hypercontraction more common in certain demographics like certain age groups, male, female, certain races, or certain geographic locations like I'm sure that it's probably higher in people that work in the medical field. That would just be That would be my theory, But do you have you seen trends in other areas.
So the only objective data that I've seen about this is from the World Health Organization, and it's to do with access to healthcare, and they're saying that there's a there seems to be a strong association between people who don't have access to healthcare have a higher level of health anxiety, which makes total logical sense to me that if you're not able to get things checked out by a medical professional, if you're not able to be sure
that you're getting good advice and get that advice whenever you want it, your level of anxiety would be higher.
Then anecdotally, I think, yeah, there's this thing called medical student syndrome, which is this idea that everyone, or a high proportion of people, at some point during medical studies will develop anxiety that they have one of the things that they've been studying that just seems to be a product of the extreme and rapid exposure to so many different possibilities in the way that the human body can malfunction that your brain just starts to take them on
in that way. Then there's also some stuff which is a bit harder to define, but groups where there has been historically medical bias or a lack of seriousness given to their reporting of symptoms and pain, So women, non white people, indigenous folks, basically anyone from a traditionally marginalized group, it seems to be that there are higher levels of
health anxiety there. But it's really hard to untangle from what is health anxiety, what is hypochondria, and what is people just not taking their illnesses seriously when they present with them. So you get in the gender area, you get into all this stuff about women just being quote hysterical about their health or having hysterics or having the vapors rather than maybe having a serious health condition that just isn't being tested for or treated or considered seriously.
I found that the condition endometriosis is a really interesting case study for this. It's a condition that only affects women, and it's been historically very under researched. It just hasn't been something that a lot of money has been poured into understanding. And so people who do successfully get a diagnosis of endometriosis, I think the average is something like
five years it takes people to get a diagnosis. So that's a lot of going to the doctor and saying I'm having these problems, I'm having these symptoms, what do you think it can be? And being told to just go away and come back if it's still a problem in six months, and that kind of thing. So again, it feels reasonable to me that in that situation you would experience anxiety about your health.
Yeah. I mean, I've had one of my best friends had this happen, that she was having all of this like pelvic pain and crazy bloating and everything, and you know, she was going to her regular gynecologists who just kept blowing her off and basically telling her to take motrin. And she finally went to because I was telling her, like, it sounds like you might have endometriosis.
I don't know.
I would say that it is kind of hard to diagnose because you can't really see it great on imaging and you have to go in and do a laparoscopy basically to go in and look around to see if a person has it. But she went to a specialist doctor who did that for her, and she had it all over the place and got surgery to remove certain patches, which isn't always the great the greatest, but it did.
It worked for her for years. And I hear this all the time, especially with that particular condition, and it's almost upsetting to think that a person goes into the field of gynecology to specialize in female genital health and then like just tells you to take tile and all or something, right, It's kind of messed up.
Yeah, absolutely, And I think there are lots of examples. I mean, I heard one recently from a friend. We were just talking about something else and she brought this up with when she was a teenager, she was having serious pelvic pain around her period. Mother took her to the doctor. Doctor was like, oh, that's just period, Paine, She's just having pelvic pain. She's having period. Pain, and I was like, I don't think she should be passing out and throwing up, you know, every time this happens,
just doesn't feel normal. A lot of persistence and seeing a different doctor later, it turns out she had a really big cyst, benign cyst that was pressing on things and that was what was causing the really extreme pain, and she had it for months longer than she needed to have. If only when they'd first gone to report this, it had not been dismissed as oh, that's just what
periods involve. So yes, I think there is a very difficult area of health anxiety that is not really hypochondria in the sense that a person does actually have a genuine, identifiable illness, but for a variety of reasons, including bias and incompetence, it's not being investigated and discovered, and they're being told that there's nothing there when actually there is. And I can imagine that being so distressing and cognitively difficult to just rationalize for yourself.
In my book, I have over one hundred cases, and if you read, the genuine theme for all of these cases is this, it's the same kind of thing like they had this, they got blown off. It's really kind of amazing, honestly.
Yeah, absolutely, And I think that's something else I took away from this project was that you just you have in the same way that you have to try and cut yourself off from external anxiety, from catching conditions from hearing about them on the news, you also have to really believe your own feelings and sensations. And you know, if you go to the doctor and they say, oh, that sounds like that, that's nothing, and you don't agree, you have to say, I disagree, Please look again, or
is there someone else I can speak to? And of course that's much easier to do if you're able to pay for her second opinion and all these other things, but you have to have the confidence in yourself to do it.
So you were saying earlier that there definitely seems to be an association with people that don't have access to healthcare having higher health anxiety.
Do you I think things like modern day.
Things that have been happening, like screening tests for like colonoscopies and now even like Kardashians paid to get full body MRIs just to kind of see if anything's wrong. That's definitely not like a normal screening test. That's something you'd have to pay for at this point. But do you think things like that ease people's anxiety?
I screamed when I saw that on the Kardashians, when I saw Chris Jenna paying to have like a full body MRI scan just because and then being so happy when it didn't find anything. I think there's Yeah, there's
two different things here. The first is what you might call public health programs, where healthcare providers mandate that you all strongly recommend that you have things like colonoscopies and perhaps smears and prostate exams at certain ages and at certain intervals because that's what the research suggests will help catch possible instances of disease early. And then there's elective extra scanning like the full body scans and so on.
What was interesting to me when I looked into the public health angle of it is that there's really been a change in consensus about that that when it first became possible to really test for these things at scale without it costing vast amounts of money, governments and healthcare authorities were like, this is amazing. You know, we can just test everybody all the time for everything. And then no one will ever have to have a serious illness.
And so they really went strongly for it, and more recently there's been a bit of a pullback from that, some recognition that actually you need to be sure that you're testing people kind of at the right times and at the right frequency, because testing too much can result in a lot of just stress and potentially mental health problems from people who get serious anxiety about contact with
medical tests. Also, unnecessary biopsies of things that you know look a bit strange on imaging then actually are totally fine, and if you'd never seen them on the image, they would have just resolved themselves without anyone ever knowing. And just the general kind of looking at the population level outcome, like how much colon cancer are we preventing versus how
much trauma are we causing with unnecessary colonoscopies. So there has been I think a bit of fine tuning of that kind of thing to try and make sure that the balance of that is always right. With the elective full body scans and stuff. I think that obviously, if you've got the money, you can do what you want. But I think from a purely from a health anxiety perspective, I don't think they do anybody any good because I don't think that in a very rare incidence, maybe it'll
come back saying you're perfect, you're brilliant. Nothing. We didn't see anything at all like you are like the title of my book, you're a body made of glass. We saw perfectly through you. We didn't see anything that's caused for concern. But I think in reality, in most cases they will see something. It won't necessarily be something you
were even aware of. It might not be something that was causing you any trouble or is ever going to cause you any trouble, but it did show up on it, you might end up getting further tests, you might end up spending more money, you might end up going through unnecessary procedures, all because you elected to do that that scan. So I'd say my personal view is not really something
we have access to in the UK. And anyway, I think my personal view is that unless a doctor I trust is telling me it's a good idea, I don't think I would go anywhere near it.
You're right, actually, because like for example, right now, I don't have any concerns about my KARATEID arteries in my opinion, they're fine. Right. If I go get one of this scan and it's like, oh, you're starting to get karateid stenosis and like you're at risk for a stroke in a few years, then I would be like, oh, great, now I learned about this, and you know, I would be like worried about it all the time, even though it's not something that maybe has to be addressed right away.
Just knowing that that could be a problem in like five years from now or something would just give me anxiety.
So I get that, Yeah, yeah, I think that is the overwhelming product of them, is extra anxiety. And I've also heard of people getting results from them and then making connections that aren't necessarily sound. So you know, they get told that, oh, we see some like something with the blood vessels in your brain, and then the person's like, oh, well,
I do have terrible migraines. Could this be related? And they start building this whole story that isn't necessarily true and isn't easily verifiable without serious surgery of the kind that no one's going to want to do, and it all becomes further material for the health anxiety to feed on, which had they never gone and got the scan would they never would have known about.
Have you heard about these apps that they're coming out with that are diagnosing people Like I just read about one a couple weeks ago that someone is making one for sexually transmitted infections in men, so they could take a picture of their penis and they could It just gives them like a thumbs up or a thumbs down, like thumbs up, you're safe to have sex. Thumbs down is like you better go get that checked out. They don't really specify what it is, but they're like, something
doesn't look right. I feel like they're trying to make these kinds of things. I heard Google was making one for skin lesions, so people that find a bump and it's a Saturday night, they don't want to have to wait until Monday to go to the doctor and find out, like they could learn right away if they take a picture and upload it to this AI technology. Do you think that that's gonna again? I just feel like it's like the same thing. There's like nothing that's going to make it get better.
Right, Yeah, I feel the same about it. I hadn't heard of the STI one, but it doesn't surprise me. I think There's been a few different attempts with this over the last few years. The most recent is the kind of machine learning AI aspect of it, where they claim that, oh, you know, we can train a product to recognize the difference between a cancerous lesion and a
benign one or whatever. But if you think back to something like Elizabeth Holmes and Theronos, that's kind of what she always claiming she could do, is you know, a pinprick of blood, she could diagnose a vast array of different conditions that you've never been able to diagnose with that little material before. And then now you can also get these home vitamin and hormone tests that again with like a relatively small blood sample, they claim to be
able to find all these underlying problems for you. And I don't think it's ever it's ever gonna do anything apart from you know, it's either going to say you're you're fine, you're great, in which case what was the point in the first place, Or it's gonna say you should go to the doctor. The app is never going to actually give you, give you a prescription, or make you a surgery appointment or anything. So maybe you should have just gone to the doctor in the first place.
I know, right, and imagine, like like my family, doctors closed on Fridays. So it's like, imagine something happens on Thursday night and then you have to wait four days. And on top of that, this app has now told you like something's not right. It would just make it even worse.
I think, do you absolutely? I do? I do feel that thing about the doctor's office being closed. I mean I once had a very ridiculous situation where it was a long holiday weekend in the UK and on the on Friday night, I'd started noticing my hair was falling out at what felt like a much higher rate than was normal, Like you shouldn't be able to just like pull handfuls of it out by the Sunday night, and everything's closed on Monday as well because it's a holiday.
By Sunday night, I'm like, I've got to talk to someone about this. So I called the sort of official non emergency helpline for the NHS in the UK, and I end up with this call operator, this guy, and he's just reading out responses that the computer is feed him and it doesn't have an option for one if pulling out handfuls of hair. So it just keeps taking us round and round in a circle until he eventually
asks me the question are you currently bleeding? And I think this was meant to be a triarge question, because if someone calls that number with an actual, you know, blood spilling emergency, they're going to dispatch an ambulance. I was on my period, so I was like, yes, I
am currently bleeding. Oh my god. The co operator went completely mad, started trying to call paramedics, and it actually took me quite It was quite difficult to like talk him down and persuade him, by which time by the time I'd calmed him down and called off the paramedics and stuff, I was like, I think this can wait till Tuesday morning. To be honest, I think the hair thing, I'm good. Never mind the whole chaos that doing that tried to cause really gave me some perspective on it.
And I was like, I know, this felt unbearable and like I couldn't wait till Tuesday. I think it can now.
Yeah, exactly, Like and what I mean, what are they really going to do anyway for that? It's not I mean, it is an emergency when you're losing your hair just because cosmetically it bothers you, right, but like you'll survive.
Exactly. Yeah.
Have you come across cases where people are the opposite of hypochondriacs, so they just they just completely don't get treatment ever, I mean usually in the hospital. It would either be like people that don't have insurance, which you could understand because they like, at least in the US, it could cost you a lot of money if you can go to the hospital and get treatment, but it'll cost you if you don't have coverage. But then there's just like this whole other subset of people that came
in with completely like this. I'll never forget this one messtectomy that we got one time double mestectomy and the tumor of.
On the one.
Breast was so large it was like bigger than her bob, Like I can't I don't even know how she could have worn a bra.
It wouldn't even a fit.
Like it just was like having two boobs on one boob and just thinking like, how how did this get to this point? How did you finally decide to come in here right now when this thing is like growing through your skin and smells and so have you seen stuff like.
That, I'm not aware of a sort of official condition that is the opposite of hypochondria in that sense. I don't know what you might call it, kind of medical blindness or just a total refusal to experience what's going on in your body. It might you might think of it perhaps as a subset of body dysmorphia. You know, someone's so completely dissociated from their body that they just
don't experience what's happening in it. I did have an incident personally that is a bit similar to what you're describing with that misectomy patient, where the initial consultations that led to my diagnosis with Hudkin's nymphoma. I had this one with the oncologist after he'd sort of given the
diagnosis of the original biopsy. He was trying to get more information so he could start creating a treatment plant, and he said something like, apart from that mass in your neck, have you noticed anything else like that around your body? And I went completely horrified because I'd not noticed the mass in my neck that he was talking about, and with hindsight, I should have done. It was nearly as big as a tennis ball. It was like by my collar bone and like him. You can see it
in photographs of me. In the months preceding this diagnosis, I'd not noticed it at all. It had grown so slowly and so gradually that I guess my mind had just accepted the changes in my body as being that's just my body, that's just what it does. It It didn't register as an intruder or something out of the ordinary. So bizarre as it might seem, I can kind of maybe understand how that could happen, although that doesn't sound like a much more extreme version of it, but.
The same exact thing just happened to my father in law, Like he had throw cancer, and when I went to visit him right after he got diagnosed, I was like palpating his neck and it was I could feel it. Like as soon as I went like that, I was like, whoa, And I'm like, you didn't feel he's like he's like, I mean, were solid there.
But I didn't really think anything of it.
And I was like, you didn't think a giant mass growing in your neck? Was that?
It was just like funny, like messing with them.
But I could see especially in your case though, because you're saying when you had the recurrence of the Hodgkins.
This is when you didn't see it.
No, the first time, it originally okay, so with the original diagnosis, and I think if I was trying to find an explanation for it, i'd say it's because the idea of having cancer was like just so far from my mind it didn't even register as a possibility. So I guess therefore the lump just didn't register. And I was like, oh, I guess this is just like the thing bodies do sometimes they become a bit squishy in places where they weren't squishy. I don't know. Of course.
Then the second time, when I was sent off to college, and then I was obsessively checking because it was very distressing to realize that you kind of had visible cancer for weeks, if not months, and just not noticed. So after that, I was like, well, that's never happening again. I'm going to be very sure that I know exactly what's going on. And that's how I found the recurrence of it quite early, because I was checking.
Basically, Yeah, I mean, that's good that you were like that, because that's why you have such a good prognosis.
I think, because you found that right away, and.
I wouldn't beat yourself up over that though, maybe because I feel like you were seventeen, like who thinks about You're just like thinking about like having a good time in high school and this and that, Like you're not really checked into your body that much at that point, I.
Think, definitely not. I think I was also especially not in tune with my body because I was not someone who was athletic. I didn't do like dance or anything else where you are like training your awareness of your body or anything like that. So I say, in contrast with my younger sister, who was like a gymnast and stuff, she definitely would have noticed just because she worked so much with her body. She would have noticed any difference immediately.
That was just not how I lived. What was very interesting in the diagnostic process was that when my mum first took me to the doctor was not because she'd noticed a lump or anything. It was because I had really bad fatigue and some other stuff that she just thought it would be a good idea to talk to
a doctor about. The doctor was initially, and I think this is totally reasonable given the age I was, he was pretty sure I had glandula fever, which I think is quite common in girls that age and the most likely explanation for the set of symptoms we'd given him. So he did the blood test for that sent it off.
When that came back negative, you should have seen how fast that man moved like he was like, oh, this is not and suddenly I was the same day getting x rays all this other stuff, and there was a real even though I didn't know it was like cancer yet, I was like, oh, this is all stepped up like five years, which that was. That was very interesting, actually, how how fast the tone of the whole thing changed.
It is interesting.
My my little one, who's now nine, has a an autoimmune disease of her bones. And when we first got diagnosed, because you know here too in America, wherever you're at, it's like it takes weeks to get doctor's appointments and it's always I couldn't believe what happened when like she went for knee pain and then it was like she got I brought her to the local place to get the X ray. Within twenty four hours, I got a
phone call for them. They said, come back, we want to do our other leg And then I got a phone call from my pediatrician and they were like, we made an appointment for you at eight o'clock in the morning to see the children's hospital specialist. Like, and it's kind of funny when there's like really emergencies, how fast it can move.
I've never experienced that.
Besides that, no, it sounds very similar, absolutely. And what was funny as well is that after the diagnosis is all complete and I'd started treatment, and I was copied in on all of the letters that the different doctors were exchanging, and I got this c seed version of a letter that the cancer specialist had sent to the GP, and it was congratulating him on how quickly he'd like escalated everything because he'd done it like way ahead of the sort of NHS benchmark for this and all this
kind of thing, and you're saying like this is all like testament to your good judgment and like well done, everyone involved work really well. And I remember reading this At the time, I was very like teenage and zelkey about the whole cancer thing, and I was like, why is he getting like special praise for ruining my life? But obviously that's not quite how it was. And now I'm very grateful that that doctor did that, But at the time that was my reaction.
Oh man, I totally get that.
So but aside from this book that you have that, it's just it's awesome by the way I think it's it's I think it could like so many people could relate to it, and I think that a lot of people don't talk about it as much. But everybody you know is always freaking out about something, and the Google thing is real, right, But aside from that, you have this podcast that's called She Done It?
How did you? What made you decide to start that?
So? She Done It is about what's called Golden Age detective fiction, which is detective fiction published roughly between the end of the First World War and the start of the second, where there was this golden age, this incredible proliferation and popularity for what we now call like the classic crime novel, the traditional Who Done It? The Agatha Christie, that kind of thing. And I just always loved those books.
But the more I sort of learned about them, and the more I read beyond the famous popular Agatha Christie ones, the more I realized that there were dozens, if not hundreds of authors writing this stuff at this time, and they were doing things like incorporating real life cases from the nineteen twenties and a few decades earlier into their fiction.
And then this fiction was being read by hundreds of thousands of people, the majority of them women, and it started to seem to me like this was a really interesting piece of social history, This was really interesting force of popular culture that ended up in a lot of people's lives. And of course we still read a lot of those books today, they still get made into films and TV shows. So I really just wanted an excuse to find out more about this and learn, I suppose,
And so yeah, that's why I started it. And I've been going five years in counting now, and people say to me, like, isn't this just incredible niche? You talk about these books mostly from Britain, although there are some writers from other countries as well. Write you talk about these writers that wrote in this very specific niche and this very specific little piece of time, And it's true.
But I've been doing an episode every other week for five years and I still feel like I have only just scratched the surface of all it has to tell me. And also one of those writers is one of the best selling novelists of all time, who's ever lived, Agatha Christie. So I don't feel like it's that limited as a scope of a project, really.
Yeah, And that's the whole point of podcast because otherwise you could just listen. I mean, before a podcast, it was like there's radio shows or TV shows and they're more general usually, And that's what's cool because really, if you're interested in anything in the world and you just go on the podcast app and search for it, like some podcasts is going to pop up that you would whether it's taking care of plants or looking at.
True crime or whatever.
Like there's there's something for everyone, and I think that's cool that you have your own thing, you know, and there's stuff an interest.
Well, that's what's been really interesting about it is that I didn't start it with any prospect of it being like a work project. Really, it was very much just a hobby thing. I was making podcasts professionally for other companies, mostly about current affairs and politics because that was my
journalistic background. So this was like my fun side project, and thousands of people started turning up and listening to it, to the point where I was like, oh, maybe this is actually something that people other than me just care about. And now the podcast is distributed by the BBC, Like it's it's really kind of found an audience in a way that I did not predict.
See, I would predict that because I think my mom actually just wrote an article on my website about this fascination with like the true crime mystery thing with women. It's like very strong and the true Crime podcast and all.
There's like a certain age group of women that are into it, and my mom is in her she's in her mid sixties, and she was talking about like reading all those types of books when she was younger and how it kind of transformed into, you know, being obsessed with murders today and stuff like that, because it's just like a thing women like whether it's like maybe they're
just it's the same. It's it's almost kind of same as health anxiety in a way that there's this there's this anxiety of like something really bad happening and you hear it happen to other people and that gives you some kind of interest and also just like maybe not having just like a more normal life and it being a little boring and like wanting to read stuff that's a little bit more dramatic and exciting. So I think it's I think it's awesome what you're doing.
Oh thank you. Yeah, I really enjoy it, and it's it's really it's really interesting and endlessly fascinating to be how many other people enjoy it as well.
Besides your book and your podcast and you have another book to what's your other book called.
My first book was called The Way to the Sea that came out in twenty nineteen, and that is the subtitle of it is The Forgotten Histories of the Thames Estuary. So it's a very different kind of book, same nonfiction type genre, but it's a memoir about sailing and growing up in this particular part of the UK around the Thames, because I had this somewhat unusual situation where my parents are from South Africa and they came to the UK in the early eighties on a boat that they built themselves.
They sailed from South from Cape Town to England and that's kind of how our family exists in the way that it does.
So that's so cool.
It's like such a unique experience to grow up and having done that and your parents do and that stuff was really or.
And it's very strange. I mean, my sister and I've talked about this a lot that when we were growing up, we just thought that everybody's parents had a boat and just like went places in it whenever they felt like it, and in the way that you do when you're a child, whatever you're used to is what's normal. And it was quite a lot later and we're like, oh, this is not normal. This is not normal that. I mean, my retired parents are still like scooting about the world in
their boat. They've you know, recently just come back from Canada. All this kind of stuff, you know, crossing the Atlantic is not something they're afraid of.
That's that's so cool. It's like really cool.
It's just so much different than how I grew up with, like in my suburbs of New Jersey.
It's just it's it's really cool.
I love that everything, like your two different books are completely opposite subjects, and then your podcast too. I just love that you're into all these different things. It's really neat.
Yeah, I mean I try and see it as a as a virtue rather than a limitation. But yes, it is true that I tend to have these very discreet and obsessive interests in something, and then once I've produced the thing that I want to produce about it, whether it's a book or whatever, then I'm done with it. That's everything I have to say on that subject. Move on to a new thing. I don't understand people who like keep revisiting the same thing.
And so what is next for you? Like, are you working on anything new?
I am working on a possible idea for a new book, which, in a great departure from me, is actually hopefully going to be related to the same kind of stuff I discuss on my podcast, So rather than being a completely new subject, hopefully it's going to draw on some of the research I've done for that, so it'll be about women and crime and the detective fiction from the early twentieth century.
I love it.
Is there anywhere you want to say that people could reach you?
Or obviously they.
Could find your podcast just on wherever you can get podcasts, right.
Yeah, or if you go to my website is Caroline Crampton dot com and that has links out to the various different things.
All right, awesome, Well.
Thank you so much for being here. It was really great.
It was great to talk to you. Thank you so much for having me.
Thank you for listening to Mother Nos Death. As a reminder, my training is as a pathologist's assistant. I have a master's level education and specialize in anatomy and pathology education. I am not a doctor and I have not diagnosed or treated anyone dead or alive without the assistance of a licensed medical doctor. This show, my website, and social media accounts are designed to educate and inform people based on my experience working in pathology, so they can make
healthier decisions regarding their life and well being. Always remember that science is changing every day and the opinions expressed in this episode are based on my knowledge of those subjects at the time of public. If you are having a medical problem, have a medical question, or having a medical emergency, please contact your physician or visit an urgent care center, emergency room or hospital. Please rate, review, and subscribe to Mother Knows Death on Apple, Spotify, YouTube, or
anywhere you get podcasts. Thanks