The human memory is a fascinating entity. I am told that the brain is able to store 2.5 million gigabytes of information, which equates to three million hours of TV programme storage. As amazing as the brain is, I cannot comprehend such. I am also fascinated by the fact that we have the ability to recall information in impressive detail stored from our youth.
I astounded myself the other day by remembering my induction ceremony to the medical fraternity with such clarity that I believed I was smelling the perfume I wore that important night. I was bedecked in a black frock that was long enough to defy gravity and connect me to the floor in a most appropriately embarrassing way. In addition I recall the electricity in the air as we recited the Hippocratic Oath.
Named after Hippocrates (460-370 BC), the father of modern medicine, the statement outlines the promises made by physicians throughout the world about how to conduct their medical duties according to a code of ethics.Vows are recited by medical novices that state their intentions to not attempt procedures beyond their capabilities but refer as necessary; to keep what has been divulged to them by patients in the strictest of confidence; and, one of my favourites, to abstain from intentional wrongdoing and harm.
Having recited those words a few years ago I have discovered that I have ‘harmed’ my patients by not leading by example. I am in fact a hypocrite and if ever there was an oxymoron I qualify the foregoing by saying I am an ‘honest hypocrite’!
As physicians we know only too well the benefits of regular exercise and this information to our patients rolls off our tongues like water off the well-oiled feathers of a duck’s back. Yet, so many physicians bonded by the constraints of busy practices or just life in general do not get the required exercise. And, in the spirit of true hypocrisy, we have medical personnel who themselves are either overweight or obese trying to convince patients to, ‘Do as we say and not as we do’. We advise on the benefits of fruit and fibre, yet the staples in our diets include fried chicken and chips, with enough greenery to appease the conscience.
Each profession has its intricacies and medicine is no different. A wealth of knowledge is necessary to come up with not only a diagnosis, but other possible diagnoses due to the unique complexity of a given individual. Long periods of arduous study are synonymous with this profession which, if the truth is told, is at its core a rewarding vocation. However, many doctors live under a thundercloud of stress which is left unchecked for long periods, so that the patient is taken care of. After all, we promised not to harm those in our care, and therefore getting fewer than three hours of sleep on-call, if any at all, is not an uncommon occurrence to ensure that the patients’ needs are met.
By virtue of the profession, a physician might find himself or herself in a predicament. We either sit on the side of the fence where we know too much and worry about the slightest symptoms, or choose to ignore said symptoms for a variety of inexplicable reasons and not seek the counsel of colleagues. Contrastingly, we advise our patients to seek medical attention should they be alarmed about any aspect of their health however the slight the ailment.
When medicine ‘woke up’ and realized that the most important person in the health care relationship was the patient and not the doctor there was an accompanying change in the jargon. Instead of paternalistic relationships patient-centred models became the buzz words, and patients were no longer to be compliant with medication but to be adherent with treatment regimes.
Whether it is more empowering for the patient to be adherent than to be forced to comply, or it is merely semantics, taking one or several medications on a daily basis is not a task for the faint of heart. I tip my hat to those patients who come rain or shine take their medications. Truth be told, as I am writing this article my magnificent memory reminded me that I am yet to take my medication. Yes, we as physicians are not perfect. Far from it, as many have declared that we make terrible patients!
I am proud to report, however, although I have not quite gotten everything right with respect to living a healthy lifestyle, there are several in our fraternity who have. Despite challenging hours they MAKE the time for exercise; they PLAN their meals or make wise choices on the spot if needed; they put in their diaries (be they electronic or stone and chisel) adequate non-negotiable periods of relaxation and respite.
Confession is only good for the soul if it is followed by repentance. Therefore, it is not enough for me to boldly stand on Mount Hillaby and declare that I am an ‘honest hypocrite’. No! There must be a change in thinking followed by appropriate actions.
Try not to make the same mistake made by most persons embarking on a lifestyle change and promise to make 20 laps around the Garrison. That is a sure way to become unmotivated and set oneself up for failure. Making small consistent changes on a daily basis is the proven way to go. Lifestyle change is about progress and not perfection.
I have decided that as a mother and physician ‘honest hypocrisy’ should not be one of my character traits and have put measures in place to change. To all those who have made up in their minds that a new path is necessary, I wish you success on your journey as I embark on mine. I will start by taking the medication that I just remembered again I forgot to take!
(Renee Boyce is a medical doctor, a wife, a mother and a Christian, who is committed to Barbados’ development. Email:reneestboyce@gmail)