M-ing My Own B – Or Not

Sometimes I suck at minding my own business. Usually I’m pretty good at it, but it’s harder for me when I really care about someone. And unfortunately (or fortunately, which is how I generally look at it), I really care about a lot of people.

So sometimes I open my big mouth.

When I do it in a way that I know risks crossing a line, it’s because 1- I know what I’m talking about, 2- I genuinely believe that disseminating the information has the potential to make an impact on someone’s life/health, and 3- I care about the person enough that the risk of pissing them off is outweighed by the potential that the information/suggestion will do good in that person’s life.

And it’s hard to take the doctor out of a doctor. When a patient is sitting in front of me in an exam room, or when a medical advocacy client is talking to me about a health/medical/weight-loss issue, I have carte blanche to give my opinion. I mean, that’s why the patient is there, and that’s why my clients pay me. They asked for my opinion.

But sometimes, when something is revealed in a personal, not professional interaction, and my opinion wasn’t asked for, the doctor in me comes out anyway.

It actually comes out all the time – like most docs, I’m always analyzing, synthesizing information, asking ridiculous numbers of questions, and trying to find answers. That questioning is probably inborn and leads a lot of people to become physicians, and through the process of becoming a doctor it is honed into a sharp weapon of third-degree-interrogation.

And then information comes out that puts me in a spot of feeling compelled to offer unsolicited advice. So of course it’s my own fault.

Anyway, I was with a (relatively new) friend today, and what started out as normal small talk conversation about candy bars and fast food got Abi-ified into a little more questioning and resultant disclosure that this friend and his wife “really aren’t doctor people,” and therefore he had no idea about his blood pressure because he hadn’t seen a doctor in almost 40 years.

Which of course then shot my blood pressure up about 20 points as I swallowed and thought about 1- how doctors in general have done a horrific PR job and how a doc with a less-than-ideal bedside manner can turn people off from all doctors and how the corporatization of medicine is making that even worse and driving wedges into whatever tenuous doctor-patient relationship had been there in the past, and 2- what, as an internist, are my biggest worries when a middle-aged patient walks into my exam room who hasn’t seen a doctor in decades and what are the things most likely to kill him if we don’t check now and what is a person who’s not-a-doctor-person possibly going to listen to and would have the biggest potential impact of overall health, function, and longevity and if I say something to this person in front of me who’s not my patient or client am I going to annoy him or piss him or his family off and cause problems or if I say something could I maybe get him to consider getting just a few basic things checked and save himself and his family potential heartache or if I don’t say something will something awful happen that I could have prevented by not being chicken-shit and just saying something.

Yes, I always have that many thoughts at once. I should really learn to meditate.

But yeah, I said something.

In the few-second brain arc between his disclosure and my opening my mouth, I figured the things with the biggest bang for the buck would be checking blood pressure, screening for diabetes, and colon cancer screening. There’s more, but if I had to pick three, those would be the big primary-care-doc-office-visit items I’d hit first (at least without knowing any other specific medical history, and even with my incessant questions I do have an understanding of basic boundaries and don’t do complete medical interviews with my social contacts), so I suggested he consider seeing a doc to discuss these things and explained (minimally) why they were so important. If he were a woman, I’d have thrown in suggesting a PAP smear and a mammogram. And if I had thought fast enough, I’d have also recommended a flu shot and a tetanus booster and a few other immunizations (which, if he actually goes to a doctor’s office, the doc will suggest).

I assume he won’t listen to me. But maybe he will. I’ll zip him the name and office number of a doctor I know and trust who works near where this friend lives.

If someone with professional knowledge of building structures were in my house and noticed a crack indicating a loss of structural integrity, I’d want him/her to tell me so I could do what was needed to prevent my house from collapsing. If someone with a knowledge of cars heard that I changed the oil in my car myself so never took it in to the mechanic but I’d never checked any fluid levels or spark plugs or tire treads or break wear, I’d want them to share their expertise and tell me what I didn’t know so that I didn’t end up broken down on the side of the road in the middle of nowhere or in an accident because of something that could have been prevented or caught early and fixed.

I really don’t want to be a pain in the ass. But I do show my colors pretty openly, so if someone chooses to spend time with me then they are well aware of my pain-in-the-assness.  

Somewhat recently, I didn’t like the description of a complaint by another friend of mine when we were exercising. I pushed her to see her doctor immediately. I was a pain in the ass. And it turned out she needed cardiac bypass surgery.

So yeah, I’ll keep on being me – a pain in the posterior who asks a lot of questions. At least you know that if you’re getting unsolicited advice from me, I’ve spent some brainwaves agonizing over whether I should have said anything.

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