Day in, day out, it’s like a broken record. Patient comes in with uncontrolled diabetes. Patient gets sick. Patient gets patched up. Patient could care less about their health. Patient goes home to live another day, before coming back in a month. Everyday you just accept the reality of reckless self destruction, do your best to help them while they pretend to care and then send them on their way.
Except when a patient actually shows some interest in their health. Let me give you an example. I was asked to consult on a woman with shortness of breath, unbearable heartburn, aches and pains, low energy and sleep apnea. This woman weighed close to 400 pounds. Her husband was close to that as well. Together I sat them down and talked to them for darn near an hour. We talked about all the complications that come with folks in their age group. I asked them if they had a plan for success. What their motivations were. What their goals and expectations were.
They talked about how their exercise regimen. When I tried to pin down exactly what they were doing and how much and how often, it turns out that the twice a week walk around the lake was their idea of trying. They swore up and down about the their appropriate food choices, until they admitted that their biggest problem was not what they eat, but how much they eat. For an hour I heard about how hard it was. About how frustrating it was not to see any success. About how life wasn’t fair.
And then I met their polar opposites. A man and his wife both pushing 300 pounds. He was admitted with cellulitis of the leg. But both had lost a combined 220 pounds in just seven months. I was floored. 220 pounds? That put the biggest smile in the world on my face that day. I congratulated them probably 20 times.
I asked them, “I have so many patients who just can’t find a way to lose weight. How and why did you do it?” The answer was exactly what I expected.
“We had to. We were always tired. I was always hurting. I could barely walk. My wife could barely move. We considered gastric bypass but they wouldn’t do it without first doing six months of diet and exercise. Now I’m not even considering surgery. We went through our cupboards and we got rid of all processed foods. We eat healthy. We control our portions.”
Their motivation was their own. They realized they didn’t want to live their current reality. They took the initiative to make positive change in their lives and were basking in the glory of their success. What was the difference between these two couples? It was their attitude. One couple chose to make excuses for their plight. The other was doing something about it.
*This blog post was originally published at A Happy Hospitalist*