As years of patient practice progresses, I get better and better at the art of patient care.  My scientific knowledge has always been on point, but there is a certain art to working with people.  Having the ability to identify their strengths, weaknesses, building a communication strategy, and developing a good B.S. meter are all part of the ART of practicing.  When I was green, fresh out of school, I held a very purist point of view.  The perfectionist in me wanted to know the best way to do things and that was my recommendation.  Period.  I knew there lived a grey area, but the grey area simply appeared a slippery slope to me, and I wanted nothing to do with someone enjoying the slip and slide.  This SERIOUSLY bothered me for a long time when I started out.  I wanted my patients to get better, I wanted them to be healthy, and I wanted success for them!  If I was going to help them achieve these things, how could I ever recommend a packaged food and feel good about it?!  How could I ever give them a sugary dessert recipe and tell them it’s ok?  How could I give them any “best of the worst” options and sleep well at night?!?!?

I was thinking about this the other day when I was talking to a patient about doing her best with the options she had at the moment.  Do I ever recommend a McDonald’s hamburger as healthy?  NO!  But what if that’s the ONLY place to get food for 100 miles?  Then we need to entertain the slip and slide and be honest about how to avoid it in the future.  Then we need to move on and not beat ourselves up about it.

It kind of reminded me of the debate in sex education: abstinence vs. condoms.  What do you do?  You don’t want young people having sex all over the place, getting STD’s and having babies before they are ready!  However, you know they are teenagers and arming them with tools to ensure their safety is necessary.  Do you give a teen a condom and say “I’m giving you this condom, but you shouldn’t have sex, ya know?”  That’s a big problem!  Do you stand by the purist argument saying we aren’t even going to address it because it shouldn’t be happening?  We all know those techniques don’t work very well, and we certainly have learned this the hard way in some cases.  So, how do you talk about RESPONSIBLE risk taking.

Working with patients is no different.  We live in a world full of temptation that is bound to get into people’s lives on occasion.  We can’t ignore the temptations or they will likely be abused in a risky fashion.  This is part of why I created a blog full of desserts.  Desserts are often a huge culprit in the world of health issues because they are full of processed sugars, refined grains, GMOs, and chemicals.  So, I’d rather provide a tool for responsible indulging than to allow you to kill yourself when you see a cupcake.  This is also the reason that I don’t have people worry about meat sources in the very beginning.  WHAT?!  I know, I personally care a lot whether my meat was grassfed, pastured, humanely raised, etc.  However, if finding that is impossible for a patient at the moment (on top of all the other changes), I’d rather talk about what cuts of meat are better if they aren’t perfect specimens.  I’d rather give them convenient or affordable options to make good choices regardless of if those choices aren’t perfect.

You will see this tug of war in my head if you ever ask me a question about food in passing.  It doesn’t give me enough time to preface my answer, but I don’t want to leave you without information.  Therefore, in a split second, I assess what the best answer is for taking RESPONSIBLE RISK.  Then, I hope you become my patient so we can talk about all the aspects of health, what fits into the bad, better, best categories, and why your individual health status may put more pressing need into a certain category of compliance.   Just like mom wants to have an open dialogue of communication about sex BEFORE it happens, I like to talk to patients about the facts, their situation, and how to make the best decision for them and their unique circumstance.  This empowers them and creates sustainability for continued improvement without me watching over their shoulder.  After all, that’s what our goal is in both instances: arm with information so the best decisions can be made when the authorities ARE NOT AROUND.   In that sense, my job is not much different than that of a sex ed teacher.  Food for Thought.

As I work with patients to correct disease, restore health, and give a foundation for their growth moving forward, I often contemplate what the world will be like in 10 years, 100 years, or 200 years.  As a species, we are doing a great job of creating a perfect storm for extinction.  With statistics of diseases growing exponentially, it’s only a matter of time before we will not be able to come up with enough drugs or surgeries to outsmart the diseases that will kill us.  We are looking at a population that will have 1 out of every 2 children born having autism.  Cancer is no longer confined to the elderly.  Diabetes has no mercy.  Anxiety and depression are literally causing our species to be sad, mad, feel as though we have no purpose, and unfortunately creating the tools by which we use to act badly toward one another.  All of these things rising without a real change in genetics.  If this were genetic, we would see MASSIVE shifts in our genome, but guess what, we haven’t seen more than 2% change since hunter gather times.  That means this is all directly linked to our environment.

If we left it at that, it may not seem like it could get any more depressing!!  However, we keep having children, we set our alarms every night in anticipation for tomorrow, we seek out healthcare professionals for answers to our problems.  These things tell me there is hope in the human race; if there was no hope, why would you ever consider bringing a life into such doom and gloom?  Why would you bother to even get up tomorrow?  Why would you give a damn whether or not you could change your health?  The fact that this hope for a better future exists, means that we all have a responsibility to be a part of it.

“Each generation borrows the world from the one that came before it and holds it in trust for those yet to arrive.  Each generation is a steward of this great gift while it is ours.”-John Izzo

On a very simple level, we have a responsibility to treat this Earth with respect, to take what we need and nothing more.  Part of our purpose, the purpose greater than yourself, is to leave this Earth better than when you arrived.  Do we do this by poisoning the crops, which in turn kills our soil?  Do we do this by over-prescribing antibiotics to the point of creating super-microbes that are resistant to any drug we could ever come up with?  Do we do this by feeding animals inappropriately in order to mass produce cheap meat?  Do we create such a shitty environment in our body that we hope our children can overcome all the epigenetic timebombs?  Please tell me we do this by single-handedly creating the sickest population ever to exist while turning a blind eye that we are the ones creating it.  If these are NOT what we should do to create a better future, then what are we doing?!?!

The beauty afforded in all this is that no matter what we do, the Earth and its microbes will still exist even when we have managed to destroy ourselves.  The world began with single cell organisms, and it can certainly maintain its livelihood without us.  If I consider purpose in life, happiness, and the greater good, I can’t help but continually ask: “What have you contributed today to leave this Earth better than when you arrived?”  If we did nothing else but ask that simple question daily, we may have a fighting chance to be happy, healthy, and leave a world worth living in for future generations.  After all, they will inherit the world we have borrowed from those before us.  Would you want to live in the world you are creating?

I have always had Tuesday’s off from seeing patients, so that tends to be the day I schedule all of my own body maintenance, appointments, errands, etc. On this past Tuesday’s agenda was to get a massage and an oil change. As I was sitting at the shop, waiting for my car to be done (in my greasy hotmess-ness), I started to think about how the two appointments I had that day weren’t too different from one another. I knew I needed an oil change because it was around 3,000 miles since my last one. Was there a noise that sent me running to the shop? Nope. Was there a sensor telling me my oil was sludge? Nope. Then really, how did I know? Because we know that oil has a lifespan and that lifespan (depending on the oil) is around 3k miles or 3 months. What would happen if I waited until my car was throwing symptom after symptom at me that something was up? I may have actually waited TOO LONG to JUST need an oil change!
My massage wasn’t really much different. Did I have an ache, a pain, a problem? Nope. Did I have a “reason” to see the massage therapist? Nope. What I did have was a consistent timeline in my body that knows every month is good maintenance. There are so many benefits to massage that I won’t go into, but what I can tell you is that many times people go in for a massage and during the session, they realize how tight a certain muscle is, or notice a random spot of soreness. These things weren’t screaming in need, they simply had adhesions or stagnant blood flow. You never would’ve been aware they existed unless the massage therapist ran across them. Oh wait, you likely may have known a few months later when something started nagging at you. At that point, you are not getting maintenance, you are in need of acute care that requires multiple appointments within a short time frame.

Let’s look at it from another point of view because my mind does this; therefore, I am bringing you inside of my mind for that 10 minute break I had during the oil change. What happens when you have a check engine light come on on the dashboard? Do you take it to the shop for diagnostics? I would like to hope so. Would you be satisfied if they just put some electrical tape over the light or went in to the computer system and just turned it off without truly diagnosing the problem? What if they came back after that and said “All better! No more check engine light!” I sure as heck wouldn’t want that type of mechanic! Then why do you let the doctor give you a medication for your symptoms? It’s essentially the same thing. You have a joint pain? Take this anti-inflammatory. It will “cover up your check engine light.” What if the problem is actually an overuse pathology, a bone tumor, or a side effect to the cholesterol meds you’ve been taking? Have you fixed the problem? Nope. What if you have heartburn because your stomach isn’t producing enough stomach acid for your sphincter to get the message to close? You reach for a pill that is alkaline (like tums) to neutralize the hydrochloric acid coming up into the esophagus which dampens the symptom of burning; however, it did NOTHING for the underlying reason why the “check engine light” came on. The reason you had the symptom of heartburn is likely because there isn’t ENOUGH stomach acid.

You see, doctors are just like mechanics. However, you hold your mechanic to a higher standard in many situations. You would never put up with a mechanic just covering up a light or telling you to turn up your music so you can’t hear the clunk! Those solutions would be nothing more than covering up the symptom that brought you in. However, you often let the doctor give you a pill for a symptom that comes right back if you don’t take it. You want your body to last your lifetime? Then you must put a standard for it’s care at the same level as your car. At least you can replace a car; you only get one body.

*Thank you to my favorite mechanic, Patrick, at SAS Auto for always DIAGNOSING the problem, giving me all of my options, and doing what’s right for my good ‘ole car that gives me the ability to travel to all my patients near and far!