I have a reputation at work. That of a cold blooded, rational, thinker. It’s not an “all good” kind of reputation, in a world in which health care professionals are judged to be too cold, to uncaring, as soon as they show too little empathy, I do hit my snags.

But give me a six car pileup, blood and red and blue lights, screaming patients and responders, mud, in the middle of the night, with the smell of burning rubber and fear all over the scene… and you want me there.

A patient with six stabs and three bullets, bleeding out rapidly? I am your man.

There’s something soothing, calming, about knowing what to do. My mind hyperfocuses, a steady stream of new information gets crossmatched with data I acquired over a long and storied life in medicine.

My friends call me fearless to a fault. And, yeah, I do stupid shit. Not sometimes, always.

And then, there’s the fear. Deeply seated, irrational, and paralyzing.

I have two. I suffer from an extreme form of thalassophobia (fear of bodies of water, not to be confused with aquaphobia, which is the fear of water and clinically one of the signs of, for example, rabies). Oceans are OK, most of the time, as are lakes, but give me any water bounded by steel and/or concrete, any time there’s anyting man made nearby, and I get the shivers, racing heart, inability to concentrate away.

Yes, that makes bridges a pain. Levies. Harbors.

The second one is worse and career limiting. Much as I am the cool cucumber at work, I have [test anxiety](https://www.scirp.org/(S(lz5mqp453edsnp55rrgjct55)). The fact suffers from the word, “anxiety” is generally seen as much less a problem than phobias and often caused by laziness, lack of preparation, or other personal shortcomings. Which isn’t the case.

Since 1998, the American Psychiatric Association recognizes test anxiety as a trait anxiety and phobia, often comorbid with generalized anxiety disorders and depression. And while I suffered from depression in my younger years (and, in fact, quit school over it, something I had to work hard to compensate for later), I do no more. And I do not have generalized anxiety disorder (GAD).

Medication is a very bad idea when it comes to test anxiety. All medication used to treat anxiety causes all the things you don’t want in a test: drowsiness, attention deficits, and more.

Instead, cognitive and behavioral therapies are recommended, meditation, and proper sleep, dietary, and exercise habits.

Those combined get me past most tests OK. I will never be an A student. I will never be the valedictorian. But, by Odin, I will pass (finally, it took me years to get there). In 1997, before the diagnosis made it into the DSM, I took my paramedic tests. I scored 98 on practical, 92 on oral, and 48 on written. On the same questions, essentially. I had a hard time convincing my teachers, that this was not due to anything but my test anxiety.

Later, in the early naughts, I taught in San Jose, CA. One of my students was a bright woman, a whirlwind in class and in practical exercises. I was convinced she’d pass with flying colors, and was dismayed to see her grades. Other teachers pushed her to “study better” and “study more” to combat her anxiety, which she blamed her grades on.

So I made her retake her test in an oral exam. She passed. With an A. Other professors were split, oral exams are a hell of a workload, but some did. And she passed all of them. Well.

The world would have been poorer without this woman’s knowledge and skill in the work force. And, almost, it did not happen. I am glad it did, but I feel bad for those whose learning environment does not accommodate their particular needs.

As for me? I’ll be fine. For a few hours I know fear, anxiety, the feeling of walls closing in on me, the dark tunnel. And I don’t even have to drive down to the harbor to experience them. And then? Right back to being Mikka, the guy who needs to be disciplined for being too fearless. Damned if you do, right? :)