Don’t give up on your patients, some will absolutely amaze you

Do you, or people you care about, have a chronic medical condition? There are all kinds of chronic diseases, but the ones that are most aggressively killing us—and the health care system—are heart disease, diabetes, and metabolic syndrome (a deadly combination of excess weight, high blood pressure, increased cholesterol and elevated blood sugar). These are all primarily lifestyle diseases and cancer should probably be on the list, too.

I felt sad after a recent gathering of physicians I attended. I was really disappointed by the negativity with which they talked about patients with conditions like diabetes and heart disease. They didn’t believe that lifestyle interventions worked beyond a few months of initial effort, and talked about these patients as lost causes.

I know I’m a bit (a lot?) of a Polyanna, but this really upset me. I got a degree in Dietetics before my M.D., and have been obsessed with preventative and whole-life medicine for over two decades now. Yet at this meeting, since the specialists who were present agreed with the general opinion that these patients were a lost cause (and I’m always open to the possibility that I might be wrong or excessively optimistic), I wondered if my beliefs about disease reversal had recently been proven to be incorrect or naive.

I did some research when I got home, and sure enough, found numerous sources that cited lifestyle change programs that had been successful in reversing diabetes and heart disease.

The next week, in a cosmic coincidence that wasn’t a coincidence, I found myself in New York City at Social Media Week, listening to Dr. Michael Roizen, Chief Wellness Officer of the Cleveland Clinic and one of America’s top docs. He spoke of the epidemic of chronic disease, and the disastrous impact it has had on the American economy, even to the point of forcing the loss of manufacturing jobs to other countries.

He also talked about how to reverse, or dramatically alter, the course of aging and chronic illness. He discussed incredibly encouraging data which supports the idea that the bodies of people who are considered medical “lost causes” are stunningly capable of reversing the course with the right kinds of nutrition and lifestyle changes.

As a medical doctor, wellness expert and life coach, I constantly talk to people about how to create previously elusive (yet often desperately needed) change. My strategy is subtly different for each individual, because each has a unique multitude of different reasons why they continue to make choices that harm their bodies or their lives.

As Roizen pointed out, “our behaviors aren’t changed by data, they’re changed by emotion.” Giving people information is a start, but it isn’t enough. That’s largely why hordes of people with diabetes and heart disease have changed so little about their lifestyles (or tried and failed), even after going through well-intentioned public education programs. Roizen described a complex wellness program that they’ve created at the Cleveland Clinic which has proven to be powerfully effective in improving the health of thousands of people.

That’s beyond the scope of this post, though. What I’d like to convey more than anything is the need to give hope back to the sufferers of chronic disease. They are not a lost cause. There is a very big difference between telling someone the reality of where their lifestyle choices are currently taking them, and telling them that there’s no hope and to prepare for the inevitable worst.

I work in a clinic where patients are seen by multiple physicians. The other day, I made a man cry. He’d recently been diagnosed with diabetes, and when I saw him he’d come in for a renewal of his new prescription.

I started talking to him about lifestyle change, and he interrupted me and asked: “What’s the point? The other doctor told me I have diabetes and that I have it for life, there’s not anything I can do about it and it’s just going to get worse. I may as well keep eating what I want to.”

It was all I could do not to shout my response.

“This is an opportunity!” I told him. “You just got diagnosed and yes, if you continue eating and living the way you have, it’s not going to be pretty—you might go blind, your kidneys might fail, all that is true. But Diabetes is potentially reversible, and you can take your health back.”

He swiped at his eyes as he started to cry. Tears of relief. We talked about his diet: he was drinking an insane amount of soda, ate hardly any vegetables, and ate a ton of fast food.

When I saw him a month later, he had kicked the soda and fast food, had frozen vegetables in his freezer, and told me “I feel so great, I can’t believe how much energy I have. I can think clearly, it’s amazing.” Some of that may be from the medication having normalized his sugars, but I have no doubt that it was also because of the key dietary changes he’d made. He thought so, too. He thanked me again for having given him hope, and told me, his eyes gleaming, that he was determined not to let this disease win.

The cynics might counter by saying that in six months he’ll have given up and will be back to his old ways, but I don’t care. I believe there’s a good chance he might prove to be the exception. Regardless, there’s still no excuse for not giving people hope.

You never know who has that kernel of greatness inside, who is going to be the 68-year-old woman with severe heart disease, on 26 medications, near-dead in the ICU, who goes on to be a Guinness Record Holder for fitness (another story I heard, from Dr. Pam Peeke, at Social Media Week).

The wonderful thing about some people – and you never know who it will be—is that just when you’re ready to give up on them, they will absolutely amaze you. So don’t give up on people. Whether you’re a doctor, or a friend or family member, believe in them and speak hope into their lives, whenever you can.

Susan Biali is a physician and author of Live a Life You Love: 7 Steps to a Healthier, Happier, More Passionate You. She blogs at her self-titled site, Dr. Susan Biali, MD.

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