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.