As with all psychopathologies, it is best to place the blame on one's parents. My father had significant cardiac disease with a heart attack at 38 and 40 and sudden cardiac death at 57. Since I became a physician, I retrospectively diagnosed him with obstructive sleep apnea, peripheral vascular disease, and metabolic syndrome. He wasn't on a statin or an aspirin, and he was on an anti-arrythmic that causes sudden death. In other words, there are six things off the top of my head that could have been done. (I could have done? Guilt is our most constant companion.) Moreover, he ate like shit, smoked, drank too much, and barely got off the couch. (As an aside, this isn't to berate my dad. He was a remarkeable man. He was the most insightful and intelligent person I have ever met and treated me with the utmost love and respect. He just didn't treat himself with love and respect.) His disease, although mixed with genetics and bad luck, was mainly due to a lack of action: not taking the proper meds; not exercising; not eating well; not receiving the proper diagnosis; not getting surgery; etc.
So I take action. I eat (sorta) well; I exercise; and I take a statin and aspirin. The problem I have is my near obsession with action. My hypochondria clusters (and they do come in clusters depending on what is occurring in other aspects of my life) are less about the disease process and more about what I have to do about it. Go to the doctor; make sure s/he does the correct tests; wait it out; not wait it out. The possibilities are endless. I start to malfunction because I am convinced there is something that I am not doing. I often think that it would be easier to live during a time when there was very little we could do with illness (assuming that there was minimal diagnosing; it's worse to have a disease with a name but no treatment).
The problem is, when you look closely at it, there is no "correct" thing to do. It's all probability. I am not trying to imply that there is no such thing as preventative medicine. My grandma lived to 88 as a lifetime smoker, but for everyone like her, I can find 100 smokers that died of a heart attack, emphysema, stroke, or cancer. Taking control of my eating and exercise simply gives me the illusion that I have control over the possibility of future heart disease. It certainly puts the odds in my favor, but it is not control. I have no control over any future disease state. This is truly an existential dilemma: I have control over what I do now (i.e. not smoke or eat like shit) but have no control over the future (i.e. heart disease or lack of it) despite the fact that I put an enormous amount of thought and meaning into it.
When faced with our mortality, it again comes down to the ability to surrender to the present. I (we?) need to reposition the meaning and magnitude of our existence within that existence and not in what may be.
