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  • Rosalind Kaplan, M.D.

Only Flesh and Bone

Everyone says it: 'Doctors make the worst patients'.

I don't completely believe this. I think many of us have a particular way of handling our own illnesses and injuries. I think we often expect too much of our own bodies and our own minds. And yes, sometimes we have crazy ideas:

Sickness and pain is for other people! I don't have time for this! And besides, how could something like this happen to me? I know too much to get sick! And humph, now that I'm in this situation, I'm just going to take it into my own hands and fix it myself! I don't have time to get medical care, I'm too busy giving medical care! I am NOT going to take time to recover from this- I don't need that! Only patients need time to recover!

I'm sure many doctors recognize these thought patterns in themselves. They also likely recognize how foolish the thoughts sound when spelled out this way. But there we are, right?

Of course, we didn't come to these ideas on our own. It was umpteen years of medical training that instilled these thoughts in us. Years of no time to eat or to sleep or to use the bathroom. Years of long days and night call and 24-hour-a-day availability and extra hours of EMR notes at home. Years of receiving the message that we have to sacrifice ourselves for the well-being of others. With this kind of indoctrination, where would we get the audacity to believe that we should stay home if we are sick, or leave work to see a doctor or get a test? Why would we think it's okay to spend resources on our own recovery, resting, getting physical therapy or pursuing psychological help?

When we're young, if we're healthy, we can probably get away with a little bit of self-neglect. I'm not saying it's a good idea. But our bodies will likely compensate for the hunger and dehydration and at least a certain amount of sleep deprivation in our 20's and 30's. Maybe even in our 40's. And the need for routine medical care is pretty limited when we're young, too- vaccines and pap smears, but no colonoscopies or mammograms or DEXA Scans or prostate tests. If we're lucky, we won't spend much time as patients during the early years of medical practice. Pregnancies might change that, but it's temporary, of course.

It's different as we get a little older. At 59, I don't think of myself as 'old'. Not at all. Sure, colonoscopies and mammograms have been added to my health maintenance tasks. AARP keeps sending me membership cards. I had to get some knee injections for worn-down cartilage. But I could brush all that off. I was moving as fast as ever, working, exercising, traveling.. Until a few weeks ago when I had one of those humbling experience, the ones that remind us that we are just frail, crumbling flesh and bones. And that wear and tear on body parts starts WAY before we know it, WAY before we are ready.

So, yeah, 5 or 6 weeks ago, I developed a lumbar disc herniation. I didn't have any specific injury. As anyone who has studied any orthopedics or neurosurgery knows, most disc herniations in 'older' folks like me are 'degenerative'. Due to DDD- the dreaded triple D- degenerative disc disease. I didn't need an injury, or any particular occasion to have this herniated disc. It just happened. On the heels of a 12-hour shift at work, during which I was standing most of the time...surely that helped it along. But, like many people 'my age', my spine is full of hypertrophic facet joints and degenerating discs. I started having back stiffness on Saturday night, and by Monday morning I had searing, horrible radicular pain in my left leg, a decreased knee-jerk reflex, a weak quadriceps muscle, and numbness above my knee.

I have to admit that this was the worst pain I have ever experienced in my life, even more intense than labor (the thing about labor is you know you're going to get something out of it, and you know it's eventually going to end. - I had neither with this!). I was supposed to work on the third or fourth day that I had this sciatica pain, but there was NO WAY, since I couldn't stand or walk!

I was out of work on FMLA for over a month. I had epidural injections and PT and the pain has died way down, but it's not completely gone. I went back to work last week, with a new appreciation for what people mean when they say they're in severe pain, and a new sense of caution.

My thigh is still weak. My knee is still numb. I won't be tearing around without regard for what my body is telling me. I can't ignore pain unless I want to be back at square one. I have to do my PT exercises every day. I'm going to have to be a good patient, and I really don't like it!

I tell this story not to get sympathy. I got plenty of that, and honestly, what I wanted was mobility, not sympathy! I tell this story to remind us all that we are only human. We 'older' docs have to be particularly self-protective, as we've had a lifetime of wear and tear, and stuff happens. It's not heroic to push through pain and illness. I was forced to rest, but lots of times, doctors push through a lot more than is good for them. So yes, a reminder. But also a reminder to the younger folks to do everything you can to protect yourself now. Invest in your future health, both mental and physical.

Take the time to do your health screenings. Eat meals- yes, actual meals! Get the regular exercise you need to be strong and fit, because it will help you to do your work and also to survive any illnesses and injuries that come later. Take vacations to refresh yourself. Try to get adequate sleep.

Don't go to work sick, and don't return before you're better. Nobody is THAT indispensable.

We each only get one body to live in for, hopefully, a long time. Even us doctors.

#lifeworkbalance #selfcare #physiciandepression #compassion #physiciansuicide #physicianwellness #patientcare #medicine #health

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