by Stewart B. Segal, MD
GAMBLING WITH YOUR LIFE
Today was a stressful day. When “high rollers” come into the office to be seen, my day is more stressful than usual. Today, I saw an unusually large number of “high rollers”.
“High rollers are those patients who bet their lives on the premise that they “know their bodies” or they are “healthy”. Their bet is a real one; and, when they lose, they either lose their lives or suffer major losses to health and dignity. No matter what I say or do, “high rollers” insist they understand the risks involved and will live with the consequences of their decisions if they are wrong. The problem is that they really can’t imagine what the consequences of having a stroke or heart attack are until it is too late. They really can’t understand what the consequences of an untimely death are and never will. They will not be here to witness the aftermath.
To make my point, let’s examine two typical, but fictitious, all too real patients. Patient number one is a male in his mid fifties. He comes into the office complaining of chest discomfort. He has had some “discomfort” in his chest off and on for a few months. “Doc, it’s not bad. Doc, I think it’s my meds or something I ate.” He has significant risk factors for heart problems and I explained that he may well have angina pectoris, a condition stemming from a serious vascular problem with his heart. I advise him to see a cardiologist in the very near future and start him on medication. He states he that is too busy and won’t seek further help or diagnostic tests until after New Years. I warn him that he is gambling with his health and may not see the New Year. “Doc, I know my body! It’s just my medication. It’s not bad! It’s no big deal.” I hope he is right but I fear he is wrong. I tell him about Tuesday’s article and the cartoon my mother sent me. Would you rather spend two hours of your busy life assuring your heart is ok or 24 hours a day being dead?
Patient number two is a sixty year old female who feels perfectly healthy. She just wants her refill and to go home. Because she feels well, she does not have her annual health exam, pap and mammogram. After all, she is healthy! The problem lies in the fact that most people are healthy until they are not. Preventative healthcare’s goals are to find problems and fix them before they find you! Every year I diagnose the earliest stages of cervical, colon, breast, and prostate cancer and eradicate the cancer prior to its devastating course. I find subtle signs of heart disease and stop it in its tracts. Those patients blessed with the knowledge that they have a curable disease, treat that disease and live long lives. During the same year, I have to diagnose cancers in their late stages and then witness the devastation caused by metastatic disease. I meet patients in the cardiac intensive care unit after a major heart attack and talk about rehabilitation and limitations. The healthy “high rollers” bet that they will always be healthy. Some win, many lose. The loss is often catastrophic. Many are afraid of what I will find if they come in for an annual physical. To those patients I say, “Be more afraid of what finds you than of what I find”.
May you be so blessed as to never know what disease you prevented! Have a happy and healthy New Year.