Fear of Hospitals

Why the fear and the infection share a word

Nosocomephobia comes from the Greek nosokomeion, a hospital, and phobos. The adjective medicine uses for an infection contracted in one is nosocomial, from the same noun. The 2008 encyclopedia of phobias describes the fear as the worry that a person will enter healthy for an examination and later need treatment for an infection acquired during the stay, and files it beside the fears of illness, of contamination and of germs.

That is an unusual position for a specific phobia to be in. The feared event is a recognised category of medical harm with its own surveillance vocabulary. What the diagnosis turns on is not whether hospital-acquired infection happens but whether an individual's estimate of their own risk, and the avoidance it produces, has come loose from it.

Why the Nixon case proves little

Richard Nixon is named in almost every account of the term. Wikipedia records that he allegedly had an irrational fear of hospitals and purportedly refused treatment for a blood clot in 1974, saying that if he went into hospital he would never come out alive. Both hedges are Wikipedia's own. Merriam-Webster's entry for the word quotes a writer using Nixon as the illustration, which is how a single anecdote becomes the standard example of a term.

He did enter hospital and he did not die there. What the story records is a refusal, a sentence, and a decision reversed, which is more than most phobia words have attached to a named person and less than a case report.

What is actually feared is the handover

Marc Siegel, a physician and clinical professor at the New York University Medical Center, gives the plainest account of why the reaction is widespread. It is perfectly understandable, he says, that people feel as they do about a hospital stay: a person has control of their life up until the moment they are admitted.

That locates the object somewhere other than illness. Admission is the point at which decisions about a body pass to other people, and the fear attaches to the transfer rather than to any procedure. It explains why the reaction can be as strong in a visitor as in a patient, which the clinical descriptions report and which a fear of treatment would not predict.

Which fears the hospital assembles

The Cleveland Clinic's page, last reviewed in 2022, treats nosocomephobia as a specific phobia and lists eleven neighbouring ones that can build it:

• pain and needles
• cancer and disease
• enclosed spaces
• blood and surgery
• doctors and germs
• medicines
• death

A hospital is the one building that contains all eleven at once.

On causes the page names four possibilities and commits to none: a family history of anxiety, a traumatic experience in a hospital such as serious childhood illness or watching a relative die there, other fears spreading, and the portrayal of hospitals in films and news reports. It also states that the fear is more common than many specific phobias, putting it in company with the fears of heights and of flying, and gives no figure for any of the three.

What avoiding hospitals costs

Every source on the term says the same thing about consequences and none quantifies it. A person with this fear may avoid hospitals when they need medical attention, and may not visit someone who is dying in one. The second is described as leaving lasting emotional effects.

That is the shape of the harm, and it is the reason the entry treats the fear as worth separating from a reasonable wariness of hospital-acquired infection. A cautious person washes their hands and asks about the catheter. A phobic one does not arrive.