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What's Yours?

What's Yours?

When I am seeing patients, there are times during the day that I want to just leave the office and walk over to the next building where my studio is located, pick up a paint brush or a welder and go at it.

I have come to the conclusion that when I do what I enjoy, I feel so free and the world of the infirm has no heaviness on my Soul. I love to help the sick. The difference between creating in the literary and visual arts and practicing the art of medicine is that while doing the work I execute in the former, there is no opinion or worldview other than my own to deal with. When I work steel, paint or plaster it follows my thoughts and ideas. In the later, I have to try to heal people who have established worldviews and many times they are inflexible in their lifestyle habits, they continue to eat two bowls of cereal in the morning or have three beers at night before bed. Many times an entire family is desperately trying to get one individual that they deeply love to make some changes. Sorry to say, that very important person just sits and stares at the candelabra in the corner of the room their entire session. Sometimes they sit in denial, other times in rebellion.

I have learned over time that regardless of the number of times that friends and loved ones have sat someone down and counseled them about their health disturbances, seldom will any of their concern cause their loved one to even consider a change. Considering a change is exactly what is needed in order to start healing. Someone has to really decide to change, not just decide to tell everyone they are going to change just so they can get their loved ones off their back for awhile. A period of time that comes to an end when everyone around them notices that they really had not changed at all. These are patients I label Illusionists.

Patients who really do not want to change say the right affirmations but do the wrong stuff constantly. Actions speak louder than words. They wonder why their problems have not melted away to the point of blaming errors in the therapeutic process as they deny drinking two bottles of Hershey's chocolate sauce every time they have some sort of psychosocial stress. They make me want to paint, sculpt and escape the confines of our patient care rooms. More important they continue to seek the advice of many local physicians to help show others they are trying their hardest to get well. Too many cooks in the kitchen makes the Paleo chili taste terrible. To their husbands, wives, daughters, sons and friends they are trying very hard to get well. In reality, they are desperately hanging on the what is unhealthy but familiar. In doing so, the Illusionists make everyone in their lives including me crazy.

One of the most common aspects of an Illusionist's personality is that they are crazed about their psychosocial stress and they want to hold off doing something until the perfect time arrived. Everything has to be in order for the change to be made. On a certain level, it may not matter what health management tool or therapeutic exercise is employed, other than an intervention that makes their or someone else's life worse. If the Illusionist is finally willing to say no to all those things that cannot be said no to, in order to hang upside down for ten minutes while reciting a soliloquy from Shakespeare's A Mid Summer's Night's Dream, there is a sliver of hope that they will begin a journey of change which may ultimately lead to recovery. Then again, maybe not.

Last week, one of our Illusionists sent us an email about her deplorable situation. The email was almost two pages long and single spaced ten font size. It was overwhelming to read. The bottom line of the email was that she had been evaluated by a personal trainer and her exercise guru told her that she could exercise as a way back to health.

I for one, am an advocate for exercise. However its only stress reducing and healthy as long as it is something a person wants to do. Forcing someone to exercise who has never found it to be enjoyable will merely worsen their health. I have been running and exercising since I was nine years-old. It is a big factor in my life as a stress reduction technique. I enjoy different forms of exercise and physical labor. Not everybody does. I doubt this particular patient enjoys exercise since she exercised for the purpose of being skinny all the while dreading her time on the treadmill in her remote past.

Exercise enhances mood and blunts the stress-response only for a few hours to a day after the exercise session is over. Studies show that aerobic exercise is better than anaerobic exercise. With the new technology available, it is simple to keep heart rates down while exercising, keeping the body in a more relaxed zone while running, bicycling or jumping rope which are traditionally anaerobic exercises. Exercise needs to occur on a regular basis and for sustained periods of time. I believe 40 to 45 minute sessions are the best, four to five times weekly. Researchers have spent their entire careers devising the best exercise schedule for a particular sport or for maximizing health benefits. There is no perfect approach, there are many effective ones. And one should not overdo it. Just as the old saying goes, too much of anything can be as harmful as not enough.

Her exercise guru was clearly trying to help a woman who is on the surface desperate to get better from many chronic ailments and unhealthy habits. However the exercise guru is a bit too zealous about the innate power of healing that exercise has. Our patient stays in the bed for days and cannot function, but there are times when she emerges from the pillows and comforters and functions at a pretty high level, only to alienate everyone who cares deeply for her. Then she is back to her bed room cave. As long as this woman has a gain for being ill, she will remain so. And all I can do is keep trying to get her back on track somehow, knowing that she really does not want to get better, she merely states she does. And to be fair to her, the only way she may know how to cope with the psychosocial stress in her life is to be ill in order to escape as much as possible. Who knows the truth? I think there is no truth.


Life is an illusion most of the time anyway. What's yours?

Doc
Posted by Amanda Sanders at 9:58 AM
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