Physician’s Puzzle

Now let me tell you about the “good ol’ days,” back when I was convinced that people would change their habits if they only knew a better way. While this happened to be true for most of my pregnant clients, it was seldom the case for those struggling with hypertension, diabetes, and obesity.

On patient was approximately 50 years old, and the most pleasant grandmotherly lady you could imagine. This was the first patient I had cared for that weighed over 300 pounds. Baking and decorating specialty cakes was her hobby. It was also her business. When my twin boys had their second birthday, she baked the most incredible train cake I had ever seen. The engine, caboose, and all the train cars were exquisite.

She came to see me monthly for her weight control and hypertension.

On one of those visits I discovered what games we were playing. She was so upset that she just blurted out the truth. The previous night she had taken her usual, large, pre-appointment dose of laxative, anticipating its effect before her office visit. It hadn’t worked yet. Now, she felt like a failure twice over—once for not really losing weight, and once for failing to cover it up!

Revealing her “secret” was bad enough, but she also had diarrhea to look forward to after our office visit. Not only did I find out her actual weight, more importantly I now realized the real level of her motivation! For two years I had mistakenly thought that education would be enough to help change her lifestyle.

Here are some facts about health education:

Dozens of well-designed studies confirm that knowledge alone does not motivate most of us to change our behavior. As a physician, I wondered, “Should I give up in despair or continue in the false hope that the studies are all wrong?" Repeating the very same experiment expecting different results is insanity! The studies couldn’t ALL be wrong.

Puzzled, I pondered the question, “Was there anything powerful enough to motivate my patients to choose what was best for their health and happiness? Could the One who made us possibly have anything to offer?”