'Scare Yourself Silly, but the Real Terrors Are at Your Feet'

essay by ABIGAIL ZUGER, M.D. here.

Just in time for Halloween, the usual yearly ritual of terror by headline is now playing itself out in medical offices everywhere. Last year it revolved around flu shots; a few years ago it was anthrax and smallpox; a few years before that it was the "flesh-eating bacteria"; and before that it was Ebola virus, and Lyme disease and so on back into the distant past. This year it's the avian flu.

"I was crossing Third Avenue yesterday and I was coughing so hard I had to stop and barely made it across," a patient told me last week. "I'm really scared I'm getting the avian flu."

I just looked at him. What could I say? He has smoked two packs of cigarettes a day for the last 50 years. He has coughed and wheezed and gasped his way across Third Avenue now for the last 10 years. His emphysema is not going to get any better, but it might stop getting worse if he were to stop smoking.