Medice, Cure te Ipsum!

I could tell at a glance that my patient had lost weight. He was heavy to begin with which made the difference in his appearance more dramatic, plus his pants displayed that the general theory of relativity was not an idle daydream cooked up by a bored patent officer. The sagging trousers had succumbed to the alluring pull of gravity as he hopped up on the exam table. I examined him and saw that his feeding tube was in proper position.

"Your pants are too big for you! Are you using your jejunostomy?" I asked. He replied that he wasn't, which seemed to explain the lighter version of him that sidled into the office that day.

"You need to keep up your good nutrition," I said. "If you feed yourself regularly you'll help the cause. I need you to take care of yourself just as much I take care of you."

He pledged to restart his liquid meals and joked with me as he gathered his newspaper. I followed him out into the hallway where he turned to me with a grin and said, "So I take care of me and you take care of me, but who takes care of you?"

I laughed at the remark but then stopped in mid-chuckle as if I was a cartoon character who had walked off a cliff and just realized it. I stared at the wall like a mounted fish, and began to consider his question.

Yes, who does take of doctors? Do we just assume that doctors are infallible, that they are immune from illness, stress, pain or depression? Of course not - so where do physicians go to refuel themselves, to rekindle the fire that drives them to serve those who struggle against misery and infirmity?

Much has been written about the impaired physician, the definition of which centers around aging, illness and alcohol or substance abuse. Many resources are available to care for them, but what of the vast majority of doctors who are not sidelined by such problems? Who looks after the "normal" doctors, who toil year after year with little recognition of their work? How do they keep themselves fresh and interested in their career, let alone life? Who is their caregiver? The traditional sources of support for workers - family, friends, colleagues, faith - are certainly important in fulfilling the lives of doctors, but is that it? Is there anyone else (short of a visit from God) who is willing to help protect, nurture and defend us? Where is the fons et origo of our strength, wisdom and fortitude?

Perhaps this is a subject for debate. If so, let me fire off the first affirmation: Who takes care of doctors? Doctors take care of themselves.

The happiest doctors, in my opinion, are those who work side by side with a wonderful partner - a partner who listens to their concerns, provides them with wise counsel, helps them relax in times of stress, flashes a bright sense of humor, and always makes sure that they find the way back home. That partner is themselves.

Doctors are proud people to begin with and if they also are smart they will form a bond of respect with this noble healer who works so hard, so that there will always be someone around to monitor for stress, discouragement and laziness, someone who will whisper in their ear:

"Eat healthy...go work out...do a crossword puzzle...buy a book and read it...talk to your children...call your parents...get some sleep..."

As my patient left the office I thought once more of his query and smiled. The prime objective of patients when they hire physicians is to make sure they are doing everything possible to bring about healing. The best doctors are those who not only strive to heal patients, but who also take the same advice they dispense daily. They work in pairs with their better halves - their values.