Being a physician is a lot different than what I thought it would be.
When I was in medical school, I thought being a physician meant that I would be a healer. I thought the medicine, procedures, and surgeries would be a one-time miraculous fix for my patients' diseases. I thought I would use all the medicine I learned about to erase disease and improve the quality of life for my patients.
After being in practice for three years, I've learned something different.
Although I do believe in evidenced-based medicine (medication/drug/pharmaceutical therapy), I now think this should be our last resort as opposed to our initial treatment of choice.
Lifestyle medicine is evidence based medicine - highly evidence based - as much as practicing medicine with drug therapy is.
Although the medicine can work, it so often has serious side-effects that are sometimes so significant, it is easy to forget the reason for starting the medicine in the first place.
Sure, we can lower bad cholesterol from triple to double digits with medicine, but what good is that when the patient is having such debilitating muscle pain that they barely feel like getting out of bed in the morning?
Why then is it more socially acceptable to start on chemotherapy which can cost hundreds of thousands of dollars, often accompanied by such incapacitating side-effects (just for starters: severe, diffuse, pain which makes it feel like your bones are breaking, continuous nausea and vomiting with even trying to swallow a drop of water, the predisposition to infections that are so nasty and so difficult to treat, they typically kill a patient before their cancer does) than it is to just make a simple lifestyle and dietary change to potentially prevent the cancer in the first place?
Would people rather go through all of this suffering from medication than to just say no to the hot dog and fries?
A huge part of me thinks this is the fault of the way we teach our patients in medicine. Shouldn't it be our responsibility as physicians to teach patients to prevent or reverse their disease with lifestyle modifications first before having to go through the anguish of medicine? Why do we only focus on teaching patients about the medications, procedures and surgeries while completely ignoring dietary and lifestyle changes which would treat the disease more effectively, inexpensively and without side-effects? It's like being told to replace the car instead of change the flat tire.
If there's a better solution, then why aren't we pursuing that?
I believe we should change the entire culture of medicine and help patients to first work on their lifestyle - through diet, exercise, sleep, and mindfulness before having to resort to medications.
Our bodies want to heal themselves, we just need to give them the environment in which to do so. Once people see how much better they feel after changing their lifestyle, we really believe they will understand the importance of lifestyle change and choose that as their number one treatment for disease. The unfortunate truth is that in general, the best case scenario of starting on a medicine or having a surgery is for someone to go from feeling poorly to feeling okay. Or decent. Or satisfactory.
But as a physician, this is not good enough for me. I'm tired of watching medicine bring patients down (sometimes making a patient feel worse than they felt initially) or just making them feel mediocre. I want patients to feel amazing and despite all of our innovations, I think that is not going to happen with standard medicine.
The only way to accomplish this is through lifestyle changes.
Not only do lifestyle changes reverse disease, but they push the patient from feeling "average" to feeling amazing.
I thought I would heal people with medication, but looking back at the last few years, I've realized the best things I've done for my patients has nothing to do with medication.
One patient had such debilitating depression, she could barely function. No medications worked for her and she couldn't afford to see a psychiatrist or counselor. She had no family and no friends to support her. Fully believing this would be a pointless attempt, I was desperate and convinced her to start a gratefulness journal and make some healthy dietary changes.
When it was time for her 6 month follow-up, I was expecting to walk into a a somber, hopeless encounter, and the second I opened the door, without her saying one word, I just felt a wave of happiness and actual joy. She smiled at me and I instantly knew her depression was GONE. I was certain it was because she was able to get together the money to see a psychiatrist who started her on a miraculous antidepressant. But this was not the case. She told me she had been writing in her gratitude journal twice daily, just as I instructed, and she said she started to make some healthier dietary changes. She said she didn't miss one day of journaling. She told me felt better at that moment than she had ever felt in her life. As a result of these changes, her blood pressure was lower, her diabetes and cholesterol were better controlled, and medication took no credit for this. Even writing about this now brings tears to my eyes because it was one of the first times I truly felt I was able to heal a patient.
This is why I became a physician. This is what medicine should be. This is why I am a part of Beyond Medicine - to bring healing back to the practice of medicine.
Nina Hourmouzis, M.D.