WHY? Over the 40 years I practiced medicine, the most difficult questions to answer were always the “why” questions. Why me? Why her? Why him? The what, when, and how questions were straight forward, all you had to do was follow the science. The “why” questions were the ones that haunt you. They were also the ones that needed answering the most.
We started asking “why” during our childhood. Mommy, why is there a moon? Why do you have to go to work? Why can’t we have a dog? If you have raised children, you know what I’m talking about. In early childhood, whys grow in intensity and while the answers are relatively easy, they are rarely satisfying to the inquisitive mind. Why? Why? Why? It seems every answer provokes another question.
As we age, most of us become less interested in the why and more interested in the practical solutions to the why. Confused? I am. As a physician/scientist, the “why” is just as important as the who, what, when and where questions. As a physician, being able to answer the “why” is often critical. The “why” I referred to above, the most difficult one is the one that starts with “why do I/she/him/they have to have Parkinson’s/cancer/diabetes/stroke/etc?”
Sooner or later, shit happens to most people. For this article’s sake, shit is synonymous with whatever disease ails you. Why me/you/etc. appears to be a universal question and almost never has an answer. The question, “Doc, why does he have cancer?” is almost always followed by a statement that I can only define as a defense attorney’s summation. The preamble is, “He is a loving husband, father and the best friend you could ever have.” This statement is followed by the story of a saint who doesn’t deserve whatever illness is destroying him. Does there have to be a reason we are stricken? Did I do something to deserve Parkinson’s?”
As a physician, how do you answer this universal question? Do you stand silent? Do you turn to God? Do you apportion blame? “I told him if he kept smoking it would be the end of him!” Or do you simply tell the truth? The truth is that no one knows why! In reality, each choice is right for someone and figuring out how to console your patient and their family and friends takes a great deal of care.
Personally, I like the concept I learned while studying in Mexico. In Spanish, the word for why is “Por que?” The word for because is “porque.” They are pronounced the same. When I asked my teacher “por que”, the answer as almost always was, “porque”.
Why do I have Parkinson’s? Because! Why does he have cancer? Because! I’ve got to believe that getting sick is not punishment for prior acts. Unfortunately, the real answers await us on the other side, if that exists.
The next few articles will further explore the “why’s” having to do with health.
No jokes today! Here’s something to listen to.