Lost Health and Living Well
Health is not what you've been sold for the past few decades.
I chose to pursue medicine because I saw health all around me. A mother who had the stamina to run after us 2 kids. A father who had the strength to lift 50 lbs produce boxes to deliver to restaurants.
My body could jump, climb, and avoid falls on the edge of river boulders. My sister could swing a mean forehand on the tennis court.
I wanted others to enjoy the same health. Growing up in Iran and later Germany, not everyone was fortunate. From untimely infections to unfortunate autoimmune diseases, my family and friends were at the mercy of and experienced incredible transformations by doctors.
I wanted to be that doctor.
If Medical School Taught Health Care
The Krebs cycle, the renal glomeruli, and the connective tissue between fascia and muscle are what were taught. They are the building blocks of the human body doctors learn to take care of.
Health, however, is a personal definition, not defined by an elite group of physicians on a guideline panel. It’s what I needed to learn to define for myself when in training, so that I could one day tease it out from my patients.
I learned pharmaceutical names, prescription guidelines, how to interpret research studies, anatomy, physiology, psychology, and pathology. But never getting close enough to the health I recall having definitely before, certainly not during medical school.
The Medical Care Complex
The sterile clinic of today is the battle ground where the doctor attempts to sell the patient on a new diagnosis, accompanied by related drugs, treatments, and lab testing.
The patient attempts and very quickly gives up because the propaganda of clinical medicine is so powerful. From the cellular to the magnetic imaging, it’s really tough to stand up against this convincing behemoth.
The patient goes in every 3 months, stripped of their autonomy, showered with acronyms and latin words, leaving with a lighter pocket after their final visit to the pharmacy.
The are often waiting for the next symptom to show up, desperately hoping to never have to go through the same phone tree, talk to yet another new receptionist, or, much worse, see yet a new clinician whom they’ve never met before. NP, PA, or was it a DO this time?
The Diseases That Compete With Health
Now, 2 decades and 100,000 patient visits later, I know what health is. I’ve defined it for myself but need to define it over and over every time I enroll a new patient in my medical practice.
The 20 year old often coasts on the great genetics most of us have in our first two decades. There’s resilience, easy recovery, and sleep will happen even if you don’t want it to. Alcohol, weed, and fast food go down easily, rarely making you feel like you’re on fire.
It’s in the 30s and 40s when you need caffeine to avoid the headaches, the purple pill for the reflux, the yellow powder for constipation, the red bottle for aches and pains. These are the convenient OTC solutions until they become our gateway drugs to the prescription bottles.
It’s diabetes, hypertension, cancer, dementia, and autoimmune diseases that eventually take us down. The over the counter runs won’t do it anymore. It’s time to go sit on an exam table, half naked, with an middle-aged, white-coated person standing over you.
Lost Health
It was just a few years ago that you were doing bunny hops on your bike and taking dives off your surfboard into the waves. What changed? You haven’t done a thing different than your early 20s.
And, honestly, you don’t feel as bad as this wrinkled white coat is making it out to be. The last thing you want is to be on a bunch of meds. The dropped faces of those waiting in line at the pharmacy are enough to keep you from ever going back.
Not Joe Rogan, Peter Attia, Andrew Huberman, or Rhonda Patrick actually care about your health. You figured that out because the $2,900 red light therapy device didn’t do anything. Your $349 Oura ring just made you more anxious. And the creatine, magnesium, and 10,000 milligrams of vitamin D or, was it E, just made you bloated.
But there’s no lying - that LCD screen is definitely showing 148/92. The Quest lab says you’re in the prediabetes range at 5.9. And these were the good numbers you’re using to make yourself feel better.
Living Well
On Reddit people say how terrible these doctors are. Gaslighters, patronistic, condescending, rude, and dismissive long white coats. These doctors are making money on ordering MRIs but never tell you to lose weight, sleep better, or exercise.
Back when I used to work as a family medicine doctor at Kaiser Permanente, I wondered why we’re doing what we’re doing. Then again, everyone, including the president, was praising what a great example KP was as a healthcare system. All the while, I’d escalate prescription dosages, add new meds and new ICD 10 codes to their member’s charts.
The only 2 people I recall in my decade-long stint at KP who escaped my clutches were 52 year old CP and 83 year old EM. He got tired of more and more diagnoses and didn’t want to end up like his dad, a pulmonologist who had a pharmacy on his nightstand and lived at the hospital dialysis center. She had retired 2 decades prior and completely disconnected from society but wasn’t about to start her first prescription and decided to reverse her diabetes and high blood pressure with her plate and feet.
They are both still alive. Both doing well. But no longer my patient.
A Life Coach You Didn’t Want
Nor Aetna or Cigna are going to pay me to talk about exercise, diet, stress, and sleep. At least not when someone’s numbers are in the red. If I didn’t fear the insurance companies denying my claims I had to fear the lawyers coming after my medical license for not forcing a statin down my throat’s patient.
My mechanic wants to explain to me that the error code is coming from one of the 3 computers my car has. I just don’t want to hear it. I don’t speak wrench - please just fix it and tell me where to tap my phone. Just as my patients don’t want to hear about the glucose transporter on their myocites. So we all just talk at each other but don’t know what the other person is saying.
While the 3rd computer is replaceable, your coronaries aren’t. So I decided to test a hypothesis of preventing over treating. If I can keep your vessels clear, your liver lean, and your muscle cells working, maybe you wouldn’t get sick. You wouldn’t be in a doctor’s office or the long pharmacy line.
It worked. Blood pressures and cholesterol and CRPs came down because I health coached more than I doctored. People felt better because they had a life coach who wasn’t bound by clinical conflicts of interest. They got their 20s back in their 40s. And now they knew what health was. They didn’t need me much because they were empowered.
No more bamboozled by the banker turned carnivore dietician. Free from the clutches of the supplement dealer. And no more having to listen to someone who’s on an ACE-I, statin, and injectable testosterone who’s telling you how to stay healthy. The freedom!
It Starts Here
As long as we’re in these human bodies we’ll need ER, ICU, and rheumatology doctors. But it turns out that even ICU stays and aortic dissections are preventable. It starts by knowing that they are preventable.
Smart, caring, dedicated doctors don’t believe that. Because their paychecks depend on them believing their training. We are, after all, human. My biases are as colorful as yours. Except I’ve been fortunate to question my clinical biases and my health coaching clients are reaping the reward.
UCLA, the Cleveland Clinic, JAMA, nor the AHA aren’t about to turn on this dime. They certainly aren’t dying on their hill. Their disciples are building them mansions on top of them. From PBMs to vertically integrated healthcare systems, you only need to go in for acid reflux and you’ll come out with a prostate cancer diagnosis.
It starts with knowing what’s at steak. Your Health. And who actually cares about it. You. And who is on your team to help you achieve your definition of health vs. try to convince you that they have the solution to your health safely stashed behind the counter.
https://drashori.com