Thomas P. “Tip” O’Neill, the former Speaker of the United States House of Representatives, was famous for having said that “all politics is local.” By this he meant, I believe, that you grow to understand much more significantly any issue that touches you directly and personally.
I can study asthma all I want, and I can even come to feel that I am proficient at diagnosing and caring for asthmatic patients. But it’s a whole different ball game if I, too, carry a diagnosis of asthma. Or if my young child develops it and needs his family’s schedule to accommodate nebulizer treatments twice a day, effective immediately. Or if I grew up in a home with a sibling whose childhood years included several trips to the emergency room and a few missed days of school each and every winter. A whole different ball game.
This post is a call to my colleagues and to you, the patients who are cared for by them.
To paraphrase Tip O’Neill, I say that all health is personal. I can learn about diabetes and blood sugar control. I can control hypertension with the best of ‘em. I know how to identify risk factors for coronary artery disease, and to calculate Framingham risk scores. I put people on statins for cholesterol lowering, and I switch them to different ones when necessary. I can do all these things.
I can encourage patients, perhaps half-heartedly, skeptically even, to “lose weight, get some exercise, and try and get some rest.” But I can do all of this a whole lot better if I first have learned how to do it on my own behalf, for myself.
Learning to take care of patients and to guide their lifestyle-based decisions starts with learning to take care of oneself. Smokers will, rightly, find it tough to accept advice to quit from a doctor who smells like tobacco. Doctors whose pants fit better because they figured out how to enjoy more fruits and vegetables, legumes and whole grains will understand better how to inspire first steps in their patients. It’s called walking the walk, being the change.
How am I supposed to show a patient what steps-in-the-right-direction look like when I look like I don’t get any?