As some of you know, I am large enough to apply for my own zip code. Looking for inspiration, I reviewed some of my old articles today.  I came up with this one from  May 1, 2013

An article published on KevinMD today asks the question, “Why don’t our patients do what we tell them?”  While the author lays out a completely plausible explanation of why patients ignore the doctor’s advice, I think the “my brains a whore” scenario is much more likely to be the culprit.

When you get right down to it, doctors advise patients to do thinks they don’t want to do!  Why would I advise you to cut sweets out of your diet if you weren’t eating them in the first place?  Why would you be eating large quantities of sweets if you didn’t love them?  Life is hard enough without giving up your double chocolate, hot fudge covered delectable desert, isn’t it?  Who, in their right mind, would turn away from their lover?

The real question should be, “Why should our patients do what we tell them?”  You have to have a pretty good reason to give up that piece of “to die for” cake!  Maybe if we explain to our overweight, diabetic, hypertensive patient that the piece of hot fudge covered cake literally is “to die for” or at least represents an admission ticket to the cardiac ICU, it would make a difference.  The skeptic in me says it won’t make a difference.

That little whore of a brain will do whatever it takes to get what it wants.  “Segal doesn’t know what he’s talking about.  He’s a reactionary!  Besides, I’ll start dieting May 1st.  Well, maybe June first.”

Meanwhile, I will continue to try to find novel ways to explain to my patients why they must give up things that they love (cigarettes) and do things that they hate (exercise) in order to be healthy.  Unfortunately, most patients don’t realize how much they love health until they have lost it!

“I know smoking that cigarette makes you feel good.  I know you love (it) her.  I also know while she may look beautiful to you, she has the equivalent of AIDS.  She will steal your health from you.  The next time you pick one her up, fondle her and start to put her to your lips, recognize her for what she is, a diseased divining rod guiding you to an early grave.”  Now that’s reactionary!

HERE IS TODAY’S JOKE: Ate salad for dinner! Mostly croutons and tomatoes. Really just one big, round crouton covered with tomato sauce. And cheese. Fine, it was pizza. I ate a pizza.

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