What is Health, Why We Hate the Damn Doctor... and How We Change the World.

Well, that’s an ambitious first post!  Certainly this could be broken into three different doctoral dissertations .  Let us attempt to touch on all three, and see how they interconnect. 

So… begin at the beginning.  Dear reader, what is health?  The dictionary defines it as the absence of disease or injury, or simply as a person’s physical and/or emotional state.  It is the latter through which most of us, really, approach the concept.  To be healthy is, practically speaking, for most people feeling good and enjoying life.  Health can be fluid, and occur in degrees; it is not a yes or no thing.  When you have a cold or a broken an arm it doesn’t mean you are unhealthy.  You have temporarily lost a degree of fitness, but it is not the same as having diabetes, schizophrenia or cancer.  No matter the angle of your definition, health is truly a base requirement for life.  You cannot have much if you do not have your health.  So why, in this enlightened age, are we so chronically ill?

Diabetes, hypertension, chronic pain, depression and anxiety, inexplicable fatigue, or just the underlying feeling of “I don’t feel well”.  How many people do you know who complain about one or more of these issues? 

As a primary care physician the hardest part of my job is educating people to see what is happening to them, and why,  and then convincing them to pursue changes in behavior for the cure.  I have yet to find a way to convince someone to turn away from behaviors that are robbing them of health in the early stages.  We always think we have more time, or perhaps, it’s just not as bad as I, the “damn doctor” makes it out to be.  That vagueness of just not feeling well?  That’s disease creeping up on you.  The only question is – what will it be?  Stroke?  Diabetes? Cancer?  Some bizarre diagnosis you can barely comprehend? 

Sounds outrageous, severe, fatalistic… right?   But, dear reader, it is true.  I see this every day, a sad parade of muddled maladies through my clinic.  Disease starts before your lab values begin to show any abnormalities, before you see it on an x-ray or CT scan.  It is often, not always but most frequently, something you feel before you see.  The times I have successfully guided patients into big change is when they have been brought to their knees, and all other options have been spent.  All the specialists have been seen, painful and high risk tests and imaging performed, countless medications tried, financial ruin and devastation of their personal relationships happen.  It is here that I will finally have a patient look at me and say, “Okay, I’m ready”.  Simply, it is not impactful to talk to someone about how much easier it is to maintain good health than regain it once it is lost.  Most of us do not motivate by intellect alone.  We are emotional creatures. 

 If I ask you what causes disease – any disease, pick one – let’s go with the Big C, cancer, reader you could give me a quick list of what amounts to bad lifestyle choices that could lead to such a disease, right?   Cigarettes, alcohol or drugs.  Red meat, fat, lack of exercise.  Some of you, more and more these days, could say sugar!  Yup, true, that is my personal soap box (more to come on that later).  What about stress?  You think living in a neurochemical milieu of bad feelings could drive disease?  You bet.  Diet, exercise, emotional states – it is the things we do every day that build us up or break us down.  I am talking about regular use of soda, prepackaged food, watching excessive TV or excessive internet use.  Never mind cigarettes and daily alcohol (sorry, Americans, drinking two glasses of wine is not good for you, we are not European and therefore it does not provide the benefit).  The WAY we eat has a huge impact on our long term health.  You’ve heard “You are what you eat”, ever heard you are how you eat?  Choking down nutrient depleted, monocultured, prepackaged food while driving or running between meetings, or pigging out super late at night, starting our day off with a load of pancakes and bacon - this is becoming the death of us all. 

These things, when done repeatedly over time, become just as detrimental to the body as smoking cigarettes or methamphetamine.  It sounds severe, and believe me, 20 years ago I would never have believed it myself, never had believed that these tastes and habits that are so ubiquitous in society are so poisonous and that yet we willingly, happily, and thoughtlessly engage in them. 

 It is largely our daily food, drink and behavior choices are that are slowly killing us.  Yes, people are living longer.  Through the magic of modern medicine I can prescribe for you, reader, in 15-30 minutes of clinical interaction a fistful of pills that will eradicate your bacterial pneumonia.  This might also eradicate the good gut floral balance you have working for you and change your base physiology (we are just beginning to learn about this).  There are other pills that will do miraculous things like minimize the wreckage of high blood sugar, blood pressure – even the depression and anxiety that abusing your body generates (it’s not just your mother-in-law).  I can prolong your life decades, potentially, with pharmaceuticals.  And with these magic capsules and tablets that become vital to your existence, the ones we will continually fight with your insurance company to provide to you at little to no cost, I will extend to you a dismal quality of life which will only further your embitterment toward me and my profession. Get why I am the Damn Doctor now? 

But wait!  Reader, it does not have to be this way.  You, my patient, may roll your eyes when I start lecturing on how soda is killing you (if you haven’t figured it out I HATE soda, it is the worst of legal poisons, you should have to be 21 years old to drink it, it is that bad for you. There I said it).  You may feel fine, you say, six Mountain Dews a day make you feel good, they taste fabulous and besides, you couldn’t get through your stressful daily tasks without them.  You will argue with me that chewing tobacco must be better than smoking, so there’s that. 

All that said, ask yourself this: in the 15 precious minutes allotted to us by the standards set by our Federal Government, why would I exhaust myself like I was pretending to be back in high school debate club?  Patients look at me like I am nuts sometimes, trying to win their hearts and minds over why the long hard road of change is infinitely superior to simply opting for the pharmacy every 90 days.  Why?  Because I must.  Not just because it is simply true, but because you and I reader, are the same.  We are all one family, one fabric of being, one living, breathing, complex organism on planet Earth, duking it out for survival.  It may sound like hippy crap, New Age-y nonsense, I know.  But cheesy stuff is such because it is true.  We are all bound to each other through each other by a shared purpose, space and time.  The sicker we are the sicker we all become.  Hard to see how someone’s choice in St. Louis could affect me in the Alleghenies, and yet, it does.  When we lift ourselves up in health, in love and enlightenment, we lift each other.  When we socially engage in harmful choices we bring each other down.  It is the old domino effect, and in 2018, its reach is global.  Did you think a discussion on health would end in how we change the world?  Honestly, when I sat for my first lecture in medical school, nor did I.  Just like a vote, every choice you make matters, from the microcosm of your molecules to whether Big Pharma controls the price of your EpiPen.  Even war.

As we go forward I will elaborate on many of the subjects I mentioned above, and much more.  Please, reader, join me.  Discuss with me, offer your wisdom, your experiences, your emotions and your insights.  Your criticism. I want to hear from YOU.  I want to be part of your experience, your change and hence my own. 

Peace.

Shalom.

Namaste.