March 31, 2011
Everyone is interested in the “whats” and “whens”. What do I have? What are you going to do about it? What is going to happen to me? When will I feel better? When can I go back to work? While the “whats” and the whens” are certainly important questions to ask, the “whys” are the most helpful.
I have not been particularly satisfied with my last two articles. I have an important point to make and am afraid I haven’t done it justice. Today, I had a lengthy conversation with one of the brightest individuals I have ever met. Conversing with him is intellectually stimulating. During our conversation, he mentioned that most people skip the “why” and race to fix a problem before truly analyzing the issues involved. It dawned on me that the “why” in medicine is often more important than the “what, when and where” questions.
While I can’t always answer the “Why?” of illness, the true path to health lies in finding the “Why?” and preventing it. Over the last few days, I have been trying to focus on the known “whys” of illness. “Why aren’t I getting well?” Answer, “You keep smoking and the smoke is destroying you airway.” “Why do I need all of these medications for my cholesterol and blood pressure?” Answer, “You are not on a DASH diet; you are eating fatty red meats and not even trying to change your sedentary lifestyle.” “Why am I having problems getting an erection?” Answer, “You are massively overweight and out of shape. Sex might actually kill you!”
The answers sound harsh. Reality is sometimes harsh. The only way to stop the cascade into illness is to find the answers to the “whys” and then do something to change. Am I frustrated? Yes! I often refer to myself as a fireman, pouring water (medication) onto a fire, trying to put it out. My patients are often arsonists, pouring fuel on the fire and yelling at me to put the fire out. As I increase my fire extinguishers (medicines), I get yelled at, “I’m on too many expensive medications. I’m spending $500 a month. You have to do something.”
I have witnessed the success of those patients who have found their “whys” and then done something about them. On 11/23 and 11/30/10, I wrote about remarkable patients who found their “whys” and accepted the responsibility of doing their parts in healing themselves. I have lots of success stories! I also have lots of failures. The failures frustrate me. How do I motivate people to find their “whys”? How do I convince my patients to tackle their problems head on, to take personal responsibility for their wellbeing?
The first step is to make sure they don’t forget to ask why!