Sunday, April 02, 2006

The Bigger Picture

I am on vacation and enjoying the final chapter of the story known as March Madness, and my alma mater is once again reaching for that National Championship in basketball. It has been a wild but exciting ride, with the Championship game to be played tomorrow night against the Florida Gators. As remarkable as this basketball season has been for UCLA, some things stand out a little more, such as when UCLA overcame a 17 point deficit to defeat Gonzaga. While the comeback was one for the ages, what happened after the game was just as memorable. Adam Morrison, Gonzaga's star player and future NBA draft pick, had crumpled to the floor in disappointment and tears after his team's defeat.
UCLA's Arron Afflalo and Ryan Hollins, in the middle of celebrating their come-from-behind win, went over to Morrison to help up the player who had caused them fits for the previous two hours. The gesture wasn't lost on Morrison.

"At first I didn't realize who it was," Morrison said. "That's just a sign of a great program and great people, as far as they're concerned.

"They had enough guts as a man in their moment of victory to pick someone up off the floor. If I could thank them I would. That's a sign of great people and great players. That's more than basketball."

As the legendary former UCLA basketball coach, John Wooden, used to say, "What you are as a person is far more important that what you are as a basketball player."

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When I used to work at Kaiser I had medical students shadow me, and one day one of them asked me why I was always so persistent in trying to get patients to stop smoking. Did I have a relative who died because of smoking, he asked. No, I didn't. In fact, few of my friends or relatives smoked. But I have known many smokers and ex-smokers through my medical career and have seen what smoking can do to them. I explained to the student that the patient's cold or back pain would be gone within a week no matter what we did. Oftentimes what we did as doctors, the prescriptions we wrote, the tests we ran, wouldn't change a patient's life at all. But if we could get someone to quit smoking, then that could save their life someday. That was the bigger picture.

That is why I was happy to receive this e-mail from a patient recently:
I wanted to send you an email to follow-up with you. I'd like to sincerely thank you for your advice regarding the diagnosis of my shingles and it being caused by stress factors in my life. Immediately following my appointment with you, my husband and I sat down and had a long discussion about our priorities and causes of stress. We decided that the majority of the stress in our lives was from the pressures of owning our home in our current financial position. We decided it was unwise and unhealthy to continue on that path...the health costs were simply not worth it!

After prioritizing our lives, we decided to put the home on the market and live in subsidized graduate student family housing at my husband's university. He also accepted a new position there which had him doing an extensive commute which meant he was rarely home...also adding to the stress factors.

Anyway, I just wanted to follow up with you and sincerely thank you for the time you spent talking with me about the causes of my shingles and how to takes steps to get myself healthy, including minimizing stress factors in my life. I sincerely appreciate your care. You will be glad to know that the symptoms are healing, though I still have numbness. I do feel these are slowly getting better, though.

This person's shingles probably would have resolved with or without my intervention. But her stress was affecting her health and eventually might have led to worse things, such as headaches, depression, obesity (due to stress-induced overeating), cancer (due to a depressed immune system). I'd like to think that I helped her see the bigger picture, and helped her get to where she wants to be. Hopefully, I can do that for others, too.

As a physician, having the time to be able to talk with people about their lives makes all the difference, and I am grateful that I have the kind of practice where I can do that. My wish is that all physicians will someday be able to have the time to do that, too, although I think we still have a long way to go before that happens.

To paraphrase Coach Wooden, "How you treat someone as a person is far more important that how you treat them as a patient."

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Whether or not UCLA wins their Championship game tomorrow, as Coach Wooden used to say, as long as they did their best, they are a success. This team has already demonstrated to me with their class and character that they are winners.

Go Bruins!