I recently listened to a close friend of mine tell me his personal story of the pain he has been enduring in his mouth for the past six months. His long, arduous journey began with seeing a dentist in his neighborhood, followed by a visit with another dentist in a different city, and ending most recently with a consultation by an oral surgeon. After the previous dentist visits and lack of any significant findings to explain his pain, I was enthusiastic to hear the outcome of his latest visit to the surgeon. In fact, I became even more eager when I heard my friend say that he learned a lot from three statements he took away from the visit:
"Sorry, but no one really knows what causes your condition -- it can just kind of happen."'
"There is no known cure."
"You'll just have to live with what you've got."
While he felt a sense of fleeting despair in the encounter, he also acknowledged that many others must have a similar experience with a whole array of clinical manifestations. Being a health care provider himself, this experience gave him renewed insight on how he approaches his own patients. After summarizing his takeaways, he thoughtfully stated that the journey of health requires lots of listening, patience, and sheer hope that there will be a breakthrough if one continues the pursuit.
In reflecting on his experience, it became clear to me that our health care system is undeniably in need of repair, or maybe an outright overhaul. We have embraced new technologies, processes, and increased administrative oversight that has left us with unfounded expectations in the delivery of efficient health care. We have believed in process over patient. Listening to accounts like my friend's remind me that we continue to live in the age of reductionistic medicine, looking at body parts in isolation, almost as though they were unrelated to the rest of the body. There seems to be a lack of piecing apart the roots of a condition, even if its formal diagnosis is unknown, into whether there are imbalances in immune function, digestion, hormones, structural issues, metabolic detoxification and elimination.
I am fortunate to travel in medical circles consisting of people who have the intellectual curiosity and heart-felt patience to explore the "story" of their patient's illness, which may reveal certain antecedents, triggers, and mediators if we just take the time to listen a bit rather than fit verbiage into a box and make it tidy.
What if, rather than three roadblock phrases, patients heard the following:
"You have an interesting condition -- an intriguing case -- and I am looking forward to exploring it with you. For every cause, there is an effect. I believe there could be multiple underlying causes for what is troubling you. I will guide you down the path to discover what might be there."
"There are many paths we can take with looking at what will help you. Your condition seems to involve inflammation, so it would be worthwhile to examine your immune function, and since most of your symptoms involve the mouth, let's take investigate parameters of your digestive function and your diet while we are at it."
"It may take us some patience to unravel what is going on at the root of your condition, but I am hopeful that you will find some relief by working with a variety of health care practitioners who have different trainings and modalities to offer you, along with expansive medical and scientific paradigms based in both modern medicine and ancient traditions to provide you with some alternate outlooks on your situation."
You might imagine that the physiology and psychology of a patient listening to these three statements vs. the ones mentioned previously might be radically different.
You might suppose that an individual would feel a sense of opening, hope, and trust with the practitioner if they heard these sentences in the 10 minutes of the visit rather than a rattling off of what seems like dead-end absolutes.
There is a group of practitioners eager to engage with patients in this way. They are practitioners of personalized lifestyle medicine using the functional medicine model. Doctors are practicing this today with exceptional results and, more importantly, in the time-honored tradition of "relationship" with the patient.
One day, I envision that we will get to the point when all health care professionals will ask their patients about what they are eating, how they are sleeping, whether they are stressed, and how often they exercise. After all, there is evidence to suggest that lifestyle modifications can be essential in an individual's quality of life and even improvements in symptoms and disease conditions. After all, how we eat, sleep, move, think, feel, and live can translate into whether we have symptoms.
The medicine of the 21st century is making its way into the unraveling emergence of personalization. If we take the elements of lifestyle medicine and apply them to the patient, we get a personalized lifestyle medicine approach to health. As a practitioner with this kind of clinical practice, it feels right to me. Rather than the despair of the three statements we may typically hear in an everyday medical practice, I am hopeful that we will get more practitioners engaged to help our patients experience this unique, empowering approach.
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