"It's probably nothing"

Of all the reasons for not going, this is the one that's most often true. I'll start by agreeing with it.

It probably is nothing. Most moles are harmless. The NHS page on moles says most people have them and they're usually nothing to worry about, unless they change size, shape or colour. Its page on breast lumps says most breast lumps are harmless. It also says that when a GP refers someone to a breast clinic for tests, those tests usually show that the lump is not cancer. The same is true of most coughs, most aches and most changes that send people to a search engine at midnight. Bodies produce odd sensations and small changes all the time, and the great majority mean nothing.

So when the voice in your head says "it's probably nothing", the voice is right. Where it goes wrong is the conclusion it draws, which is "so I needn't go".

Think about what follows if it's probably nothing. It means that the most likely outcome of the appointment is good news. You'd walk in carrying a worry and walk out without it. The doctor looks at the mole for a minute, perhaps through a small magnifying instrument, and says it's the harmless sort. Six months of background unease would be gone in ten minutes. At present you're turning that down. You're carrying the worry when you could hand it to someone who can dispose of it.

I'd compare the two kinds of relief, because the habit runs on one and ignores the other. This is my own reasoning. When you think "it's probably nothing" and pull your shirt on, you get a small relief. It lasts until the next headline or the next ten past three. It has to be renewed every week or two, and each renewal is a little less convincing, because a part of you notices that you keep needing to say it. When a doctor tells you it's nothing, that relief is of a different grade. It comes from someone who knows and has looked, and it lasts.

There's a second branch, the unlikely one. Suppose it's something. Then "probably nothing" was wrong in your case, and every week you spent repeating it was a week lost. I'll deal with that in the next chapter.

Put the two branches side by side. If it's nothing, going gets you lasting relief, and not going gets you an occasional cheap relief and a continuing low dread. If it's something, going gets you an earlier start, and not going gets you a later one. I've tried to find the branch in which putting it off comes out ahead, and I can't.

One objection is worth answering. "If most things are nothing, then doctors' surgeries must be full of people with nothing wrong, and I don't want to add to that." Chapter 6 takes this up. The short answer is that the system is built on that basis. A GP can't find the few somethings without seeing the many nothings, because from outside they look the same. That's the reason you can't tell either. The NHS's own wording on breast lumps is direct about it. It says to always get a lump checked, and in the same breath that most are harmless.

So the NHS also thinks it's probably nothing, and its advice is still to get it checked.