As I never tire of reminding people, I am the son of two doctors. My tongue-in-cheek claim is that this gives me authority to opine on all things medical. In fact, while feeling confident about routine issues of self-care, I am deeply respectful of what I don’t know, and I am quick to cede authority for real medical questions to those who have more knowledge than me.
My father was a professor of medicine at Johns Hopkins Medical School. Though an MD, he never practiced, choosing instead a career in academic research. He was fortunate in that he had three areas in which he was able to contribute: in the 1940s he was involved in experiments that helped explain the mechanisms that allow the body to exchange oxygen and carbon dioxide; in the 1950s he proved that particles the size of a mote of dust could transmit tuberculosis; from the 1960s until his death in 2001 he investigated mechanisms of air disinfection. My mother was a respiratory physiologist (despite never being able to give up smoking!) and practiced in a number of clinics in Baltimore including Johns Hopkins, where she was one of the earlier female graduates from medical school.
It was my mother, generally, who cared for my sisters and me when we got sick. My father was somewhat squeamish around sick people; he once told me that one of the reasons he never practiced medicine was that he didn’t like the sight of blood.
But for sure, I grew up in a house where there was constant talk about medicine. My family had a sit-down dinner for all of my childhood and adolescence. Talk at the dinner table was dominated by my parents, and my parents, naturally enough, talked a lot about medicine. I did a lot of listening.
Here are two maxims I remember.
1) An ounce of prevention is worth a pound of cure.
2) Stay out of doctors’ offices.
I do my parents a disservice by citing just two broad statements, but there is something of the essence of their approach to medicine in those admonishments.
Given that they both worked, in different capacities, in the field of public health, the first statement makes perfect sense. The second statement incorporates the imperative of the first – invest the greatest amount of energy in preventing rather than treating disease – but implies an additional cautionary warning: once under treatment by a doctor, there is a heightened chance for misdiagnosis and faulty treatment, so it’s best to avoid exposing oneself to those situations.
Over the last month I’ve had a chance to ruminate on my parents’ medical maxims, highlighted by a routine visit today to a new doctor for a “get acquainted” check-up. One month ago, when I was in obvious need of medical attention, I welcomed the attention and expertise of the attending doctors with open arms. I was a good patient while in the hospital, accommodating myself to the routines of the doctors and nurses without complaint. Today, having made an appointment to meet a new local doctor, and be checked out for the first time since I left the hospital 30 days ago, all in the name of “an ounce of prevention is worth a pound of cure,” I found myself wary and hyper-critical of the value of what I was doing and the care I was receiving.
For some reason today’s doctor’s inquiries into my health and habits seemed invasive. But just a month ago a surgeon’s incision into my belly was not felt to be “invasive” at all, but a necessary, deeply appreciated pain relieving, “caring” intervention.
This makes no intellectual sense, but does make sense, I think, on a “feeling” level. When one is vulnerable, one instinctively defers to those who you think have the knowledge and tools to alleviate your discomfort. When one feels healthy, any suggestion that you might not be doing all you can to prevent future illness is received as an implied criticism of your life style. (This, I hasten to say, is not a condemnation of the doctor I saw today, who was professional and respectful, but rather an admission on my part that the ego of the healthy individual is not always helpful to the medical profession.)
One can begin to understand why it has been so difficult to get those people who consider themselves healthy to sign up for health insurance through the Affordable Care Act. To admit vulnerability before it knocks you flat on your back is hard to do.
As for me, Susan tartly observes that I’m not particularly good at accepting criticism and am generally resistant to authority, so perhaps others handle this better than me. But even if you handle it better than me, I bet you struggle on some level with that fuzzy dividing line between when you are able to accept a doctor’s care and when your instinct is to resist it.