I wish my patients could see what I see.  I see through a lens sharpened over 30 years of experience.  I see the present and often the future.  Yes, I’m a fortune teller!  Many times, the picture of the future I see is bleak.

It’s my job to predict the future and then try to change it.  A friend once told me that he believed life was a movie playing on a VCR tape.  It was his belief that each of us had a library filled with thousands of tapes and at any time, we could hit the eject button, remove the current and put in a new tape that would play to a different ending.

So, what is it that I see?  I see a 30-year old diabetic who is overweight and out of shape.  His blood pressure is high, his cholesterol is high and he is high on life with his family and work.  He has no time to take care of himself.  He does not respect diabetes.  He doesn’t fear it.  He will take care of it “one day.”  I know what’s coming.  I can see his future.  How?

When I walk into the next room, I see a 60-year old diabetic who started with me 28 years ago.  He has kidney disease and sees a kidney specialist.  He can’t feel his feet (nerve damage from uncontrolled diabetes).  He is here due to an infection in his toe.  His infection won’t heal.  He goes for wound management therapy to the local hospital and is seeing a surgeon.  He will lose his toe and maybe, his foot.

My 60-year old patient is my 30-year old’s future.  Neither have time for themselves.  One is working on building a bright future, the other built a future that should have been bright but now is bleak.

I see a 48-year old woman who has uncontrolled hypertension.  She is busy being a parent, spouse, and is soon to be a grandma.  Her Christmas shopping is done.  She ran out of her medication 2 weeks ago.  She did not have time to pick it up.  Her blood pressure is through the roof.  I know her future.  In the next room is a 71-year old female in a wheelchair.  The Medi-van brought her to the office from the nursing home.  She had a stroke.  She can’t walk, has trouble eating and communicating.  She was a CFO of a large local company.  She used to run through the airport, rushing to her next meeting.  She did not have time to be hypertensive.  She, too, did not take her medication as prescribed.

I see the future.  Sometimes, I see dead people, walking.  I wish my patients could see what I see.

Stewart Segal is a family physician who blogs at Livewellthy.org.

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