You'd be surprised how many perfectly healthy patients believe they're ill

(Guardian) It was an impossible situation. A young man had come to my clinic complaining of a headache and was concerned that he had a clot in his brain. He wanted a CT scan, but there was nothing on his physical examination or history suggestive of anything more than a simple tension headache. I tried to reassure him and hoped to have him try some ibuprofen. Yet I could see that he felt almost cheated.

I thus faced a choice: I could get a scan that not only raised his exposure to radiation, but also ran the risk of uncovering incidental findings requiring further tests, raising further stress; or I could reassure him and stick to what I thought was the right course for him.

Ordering the CT scan constituted no more than a click of a button for me. But would a normal CT scan be able to relieve his fears? I tried to comfort him and convince him that it was unnecessary. The visit ended with him firing me as his primary care physician, leaving me in my room with only the whirring computer for company. Should I have just pressed the button and gotten the scan?

All physicians treat anxiety, whether it is an obstetrician squeezing a first-time mother's hand in clinic or whether it is a surgeon in the intensive care unit having a conversation about end-of-life care with a 37-year-old.

Disease breeds dread and despair – and hospitals don't help. Neither do the scalpels and catheters bundled with the experience of sickness. But there's a difference between a genuine anxiety about being sick and the people who believe they are ill even when they aren't.

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