"Either this will happen or that will happen"

"Doc, I just saw the cardiologist last week, and, I have to tell you, he wasn't very reassuring."

"No?  What did he say?"

"He looked at my EKG and basically put out his hands and said-- it could go either way.  Either you'll have a  heart attack-- or you won't."

"Did you give you any medication?"

"I don't know."

"No, it's a real question.  Did he put you on any medication?"

"He gave me some prescriptions, but I don't know what I did with them."

"I can check in the system and call them into the pharmacy if that would make it easier."

"I don't know-- is there even a point?  If I'm either going to have a heart attack or I won't, what's the point?"

"Well, everyone's either going to have a heart attack or they won't.  The point is to decrease the odds that you do, and increase the odds that you don't."

"Whatever, my life is over anyway."

"I'm wondering if it might benefit you to talk to someone about your health and your anxieties about it."

"I'm talking to you."

"I mean someone who might be able to prescribe you something to make you feel more relaxed.  Do you sleep well?"

"No."

"So maybe this would be useful."

"You mean a shrink?"

"A psychiatrist, or maybe a psychologist would be useful, just to have someone to talk to, even if you don't need medication."

"I'm not crazy."

"I'm not saying you're crazy."

"I wasn't worried until I went to the cardiologist.  He was just so matter of fact about it.  Either I will or I won't.  Either I'll live or I'll die.  No difference to him."

"I'm sure it mattered to him.  But even if it didn't, it matters to you and your family.  Not important if it matters to your doctors as long as we're giving you the best treatment."

"I'd rather see a cardiologist who didn't have such bad news to give me."

"I'm not sure I can change the news, but maybe it would be helpful if I referred you to a cardiologist who would be better at delivering it."

"Will I need to pay another co-payment?"

"Yes."

"Then I don't know.  I'm tired of sitting in doctor's offices."

"I understand.  Why don't I call in your prescriptions to the pharmacy, and set you up with a social worker, who can see if we can get you an appointment with a psychologist, just to see if that would be helpful."

"The psychologist is going to take another EKG?"

"Nope."

"Oh, okay."