The cure!

He came in every year for his physical right after tax season (he was an accountant), an event I learned to dread. 

He was significantly overweight and reliably gained 15 pounds every year, a result of a preference for fast food and an affinity for beer. He considered putting out the garbage and carrying groceries from the car to the kitchen more than adequate exercise. His blood pressure and cholesterol were poorly controlled, in part because of his high salt and fat intake, but largely because he hated taking medicines. He got short of breath quite easily and resented the fact that he had to pause halfway up the stairs to his bedroom. He had recurrent episodes of respiratory infections for which he invariably demanded antibiotics. He couldn’t get to sleep without several beers, but then had to get up twice during the night and had diarrhea in the morning. He would not discuss dietary changes, exercise or reducing his alcohol intake, let alone smoking cessation.

Our annual visits became a ritualized exercise in futility. He listed his complaints of dyspnea, fatigue, sexual dysfunction (too short of breath), heartburn, insomnia, lack of energy, and chronic cough, pointing out emphatically that I had failed to fix them last year and that they were worse. Discussion of the role his lifestyle played in his ill health was met with denial and a request for antibiotics, sleeping medication and something for energy. We were both frustrated by the visits. In retrospect, I am sure he dreaded the dance as much as I.

One April he called the day before his scheduled physical and canceled without rescheduling. Several weeks later, I called him after hours, asked about his cough and dyspnea, and suggested he reschedule his visit. He said he was not interested and hung up.

Several months later he called saying he was transferring to a new physician and asked that we make copies of his records. When he stopped by to pick them up, he asked Judy if I were available for a moment. It was during lunch and I was not with patients, so she buzzed me and I popped down to the waiting room to see him.

I was amazed. He had lost at least 40 pounds, and looked tan and almost trim. “You’re looking great,” I told him. “No thanks to you,” was his reply. In an obviously well rehearsed speech, he told me I was a lousy physician who had loaded him up with medicines that cost lots of money, ruined his sex life, and never helped. Now he that he was off his medicines he was feeling great. “What’s the secret? I asked. “What made the difference?” 

He told me he had signed up for a $2000/week six-week stay at a health spa in Arizona, during which time he had become a vegetarian and a Buddhist, quit smoking, and had learned to meditate. He no longer drank any alcohol, and was following an exercise program that included a 40 minute run every other morning before breakfast and 2 days a week at the gym doing strength and plyometrics. He was sleeping well, had lots of energy, was enjoying an active sex life with his new partner, and no longer took any of those damn medications that had made him feel so lousy.

I still wonder what triggered his conversion. And I’d love to know if it was a sustained success.



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