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Oct 31 2002

Take time to live healthily

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Dear W:

I'm sorry to hear that you got mycoplasma, and I hope you are starting to feel better now. I had mycoplasma once during residency and remember that uncontrollable cough. The doctor at the employee health center paged me and asked me how much I smoked because the chest X-ray showed a large tumor with several lytic bone lesions. This was not an optimal way to hear such scary news, and your mom was very supportive. Since I'm still here to tell the story, you know the ending was happy (for me). I never smoked, and the names on the chest Xrays had just gotten mixed up! On the positive side, that experience helped me focus on how to live fully and provided me with a great example of how not to convey bad news to a patient!

As you start feeling better, W, don't forget to finish all your doses! You know doctors are not known for being very good patients! Surely between B and your folks, you will be coerced into taking your meds and also resting properly!

This month is the anniversary of the vicious 9/11/01 attacks, and we are all still bruised. I can't tell you how many kids I have seen this year with increased headaches, sleep problems, and other signs of stress. Many doctors have spent a lot of time since last September trying to comfort our patients, and I thought perhaps it was time to write about how we must take care of ourselves as well. To be a good physician, W, you will need to "Take Time to Live Healthily."

JA, a local obstetrician, says that five things are required for a healthy and happy life: trust in a higher power, a calling, a loving relationship with another adult, an avocation, and exercise. In order to live healthily, a physician must look after his/her mind, body, and spirit. W, you seem to me to be faring well in all three spheres, but it is easy to get "out of shape" in any of them. It is a healthy exercise to take an inventory of each area occasionally, recognizing your strengths and acknowledging your weaknesses. Both were conferred on us by a higher power, and together they make us the special but quirky individuals we are.

Physicians tend to have fairly healthy minds, learning easily and often delighting in mental challenges. Nevertheless, we often have ADHD, learning disabilities, or other imperfections that cause frustrations in our daily lives and inconsistencies in our performance patterns. Contrary to popular belief, these conditions can occur in bright, accomplished adults (see www.chadd.org and www.ldanatl.org). People with an undiagnosed neuropsychiatric condition sometimes resort to self-medicating with alcohol or other substances, often leading to more serious problems. Substance abuse causes huge problems in our world, and physicians and our families are certainly not immune. In fact, we may be more vulnerable than average in this area, perhaps due to our pressured schedules, independence, and reluctance to seek help, especially for problems of the mind or spirit. There is a lot of good help available though, especially through Alcoholics Anonymous (www.aa.org), the North Carolina Medical Board (NC PHP Program), and Al-Anon (www.al-anon.alateen.org). W, if you ever experience problems like this, get help! Don't self-medicate!

W, I have never been quite sure how to divide mind and spirit since the fields that study them seem to overlap and since it is all about the brain! OK, OK, I might be a little biased! Somehow spiritual health is more abstract, though, and is the source of happiness, love, serenity, and everything else for which I cannot describe a neural circuit! Just as problems with attention or learning can affect your mental health, difficulties with anxiety, depression, anger, and lack of trust in a higher power can damage your relationships, self-esteem, and overall spiritual health. While preparing to write you this letter, I asked several friends for advice on ideas that could guide one's life. Try asking your friends this; the answers are beautiful. The answers I received included: "The Lord's Prayer"; "Frost's The Road Not Taken"; "Might as well do it right"; "Slow down, Doc, tomorrow ain’t promised to none of us" (an employee); "The Serenity Prayer" (www.openmind.org/serenity); and my o'n favorite, "Desiderata" (Max Ehrmann, 1927; try desiderata as a search word). W, I hope you will always remain humble enough to accept advice from your family and friends and to seek help if you need it!

The importance of physical health seems apparent to physicians, and yet ironically we often neglect our own bodily health. Many of us delay checkups and push ourselves through long workdays, leaving little time for relaxation, conversation, careful nutrition, sleep, and exercise. Although we sleep less (averaging about 6.5 hours) than our predecessors (8.2 hours) a few decades ago, at least we also smoke less, too! In an unpretentious Italian restaurant in Charlotte, there is a framed magazine advertisement picturing a Rockwellian physician and his patient and proclaiming "More Doctors Smoke Camels!" Let’s hope not! We have certainly made progress in understanding risk factors and publicizing healthy standards (www.health.discovery.com and www.time.com/time/health), but we still need to remember to eat right, sleep enough, and exercise. Live like your grandmother is watching and "Go outside and get some fresh air!" Although Epicurus' name has been mistakenly associated with pleasure and privilege (see Epicurean magazine,www.epicurean.com), he actually espoused a philosophy of life very similar to JA's recommendations for health and happiness. Epicurus recommended basic foods, shelter, and simple clothing, but most importantly, friends and freedom of thought. More recently, Mary Chapin Carpenter's song "Passionate Kisses" provides a similar wish list for achieving health and happiness (see www.geocities.com/islandlyrics).

W, I hope you feel better soon! I have to go now and call for an appointment for my checkup!

Fondly,
Carolyn

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