Tag Archives: NaBloPoMo

On Walking the Talk

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NaBloPoMo 2016, Letters to Patients, Day 4

To My Patients Who Wonder, “How Healthy Is Your Diet, Doc?”

I cannot tell a lie, it kinda sucks sometimes!  I’m not a foodie, really.  In fact, I have maybe the least discriminating palate of anyone I know—everything tastes good!  I particularly love sugar, starch, salt, and oil—especially in combination.

So when I talk to you about the picnic plate method of eating—half stems/stalks/leaves/fruit, a quarter high quality lean protein, and a quarter whole grain—believe me, I understand the challenge!  In fact, every time I counsel you, I review my own food log in my head, and I resolve to visit the raw salad bar more often.  When I give advice or make suggestions, it’s not that I necessarily know better than you, or that I think I’m better than you.  We’re all here doing our best every day.  It’s my job to look out for your health, which research tells us is only 20% related to what I do in the clinic or hospital, and 30% related to your own habits (incidentally, it’s 40% related to your environment).  So if I can help you make even the smallest change for the better, then I feel useful.

When I ask you about exercise, sleep, stress management, and relationships, I am also taking stock of my own habits in those realms.  To me, these are the central domains of health.  And nobody has a perfect balance all the time.  Maybe you’re great at exercise, but your diet is the pits.  Maybe you eat really well, but you stay up too late at night.  Everybody’s patterns are different, and they shift over time.  Sometimes I might share my own fluctuating experiences with you, if it feels relevant and helpful.  But our time together is about you, not me.

I want you to feel free to ask me how I manage my own health.  It’s important to me that I Walk the Talk.  I will answer honestly, if sheepishly.  I will share my struggles with you.  I risk judgment by you when I do this, and I accept that.  One of you actually said, “Shame on you,” to me one time.  Maybe you feel judged by me, also?  I think that is inevitable.  We all judge ourselves, and then subconsciously project our judgments onto others.  I’m working on self-compassion—ask me about that, too!

It’s about strategy and execution, trial and error, and repetition.  No matter what the behavior change, the more times we try, the more likely we will finally succeed.  So the next time you come in and we talk about health habits, think of it as comparing notes, rather than reporting progress or regress.  If you found something that works, please share!  I might just steal the idea for myself.

On Plumbing and Other Disciplines

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Cartoon courtesy of Pixabay

NaBloPoMo 2016, Letters to Patients, Day 3

To My Patients With Diverse Occupations:

What a pleasure and an education to know you!

I think none of you are plumbers, though.  But I remember the first time I met a plumber—it was in college, a friend of a friend.  To this day I wonder if he thought I was a little crazy—I grilled him mercilessly about his work.  Was it like “Moonstruck,” is copper really always better?  What’s the grossest thing you’ve ever seen?  What do you need to know, is there plumbing school?  How do you know when you can’t do a job?  What equipment do you carry around?

I have only ever known medicine, you see.  I resisted at first—so typical, the Chinese kid who wants to be a doctor.  But then I volunteered to be a health aide in college—I got to move into the dorm a week early that way.  And it was inevitable, I was hooked!  So I went ‘straight through,’ as they say—biology/pre-med, no gap years, no real life working experience before medical school.

Traders, dog trainers, book editors, retail managers, accountants, nurses, call center agents, firefighters, small business owners, truck drivers, professors, musicians, actuaries—you all have such interesting lives!  One of my favorite parts of the history is when I get to hear what you do for a living, because it’s so different from my own.  So please be patient when I interrogate you about your work, I’m just so curious!  How do you spend your days?  What makes a great day for you?  What makes it hard?  What are the greatest sources of stress and meaning in your work/career/vocation?  What do you love about it?  Would you choose it again?

This curiosity stems from my deep desire to relate.  In your work, people probably present you with problems.  You apply specific expertise to diagnose the underlying condition.  You determine the most appropriate or attainable solution, and map out a path to achieve it.  You take some responsibility for the result, while recognizing that your coworkers must also participate fully for the team to succeed.  On your best days, the collaborative effort yields not only the desired outcome, but also a deepened connection between people.  It’s not so different for me.

It’s easy to perceive a distance between you and me, between patients and physicians.  Medicine can seem elitist sometimes, what with the onerous entrance exams, the stiff competition for school admission, and the prolonged and grueling training.  But in the end I bet we share more experiences than we realize.  I’m just here to use my little heap of knowledge and skills to help others, and I know that’s what you do, too.

 

On Primary Care

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NaBloPoMo 2016, Letters to Pateints, Day 2

To Those Who Disdain Primary Care:

Maybe you don’t know what you’re missing.

“I don’t need a doctor, I never get sick.”  And yet, optimum health means so much more than the absence of illness.  I am called to steward your health as a whole person.  I value the chance to know you as such.  I seek to understand your temperament, your history, your past experiences, and how they influence your current perceptions and choices.  That is how I help you optimize your health—by reflecting your own patterns back to you, so you may determine how they serve you, and when they need updating.

So often our daily routines take the path of least resistance, like spring runoff tumbling inevitably downhill between the rocks and shrub roots of a mountainside.  Without attention and navigation, topsoil erodes and the landscape can get disorganized, unstable.  But with some intention and guidance, we can channel your energy and activities toward the mighty river of health.  There your strengths and motivation preserve the ecosystem that is your best you, for the long journey of life.

As a general internist, I have the privilege of getting the first call when something takes you down.  I get to hear the story first, to initiate the investigation.  If I know you already, I can apply history and context in the most personalized way.  Together we can examine and understand the mudslide triggers (there’s almost always at least one).  We can make an appropriate plan to slow the erosion, and then rebuild.  With each episode, our tools sharpen.  We become a team.

I relish the chance to help you dig deeper into your own capacities for self-care.  Each encounter is an opportunity to share and connect, in service of your long term health.  I want you to live not just to be an old man or woman, but a STRONG old man or woman.

But to do that, I need to know you starting now.  I need to connect with you early and often, in good times and bad.  It’s a relationship like any other.  I can’t help unless I see, hear, and understand.  There is no substitute for time and contact.  So think about it.  I’m here to help.