On the occasion of this annual health and fitness issue, a word or two about doctors:
1.) First off let’s note that doctors are vastly underpaid. Contrary to all the resentful doctor stories out there (“the procedure wasn’t really needed — the doctor just had to make another payment on his Volvo”), and contrary to the money you or your company spends each year on health insurance, doctors don’t make all that much money.
I like to study the fine print of the statements sent out by the insurance company following one or another of the “procedures” I have endured in recent years. There are the astronomical numbers for the procedure itself, followed by similarly high numbers for anesthesia, the hospital, the lab work, and so on. But then the health insurance company rewrites the bill, stating what percentage of it the insurance will pay.
Starting with those numbers, and considering the overhead of the doctor’s office and the facility where the procedure takes place, the education it took to get into this business, and the amount of insurance it takes to stay in business, you begin to reach a sobering realty. Then turn the tables around: How much money would you have to be paid to stick your hand or some blunt instrument into the body cavity of a complete stranger, and then smile and offer encouraging thoughts when the procedure is completed? I’d sure as hell want to drive home in more than a Volvo after a day like that.
2.) When we were all kids and the rest of us were being told “an apple a day keeps the doctor away,” future doctors were watching some television show with the DuPont commercial proclaiming “better living through chemistry.” Name a problem and today’s physician can name a drug to tackle it.
A doctor’s drug of choice might be something like Plavix, which I — a veteran of coronary heart disease — take to minimize the risk of harmful blood clots. The warning label for this drug states that side effects may include “stomach upset/pain, diarrhea, constipation [it can get you one way or the other!], headache, dizziness, rash, flu-like symptoms, or back/joint pain.” In addition Plavix might lead to serious bleeding: Users are told to watch for “unusual or easy bruising/bleeding, black stools,” or — get this — “vomit that looks like coffee grounds.”
That’s their drug. Your drug might be a tonic such as relaxing bottle of beer or glass of wine. Compare the Plavix warning to alcohol’s: “Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery, and may cause health problems.” But don’t expect any doctor to endorse your use of alcohol.
3.) When doctors ask you how much you drink, they automatically double whatever answer you give them. You might as well lie and tell them one drink a day even if it’s actually two. But whatever you do, don’t tell them “an occasional glass of white wine.” That’s a Hollywood euphemism for serious drug and alcohol abuse, as in the comment made to me when I was reporting on John Belushi’s death in 1982. “John was on a health kick,” one of his friends told me. “The most he ever did was an occasional glass of white wine.”
4.) Doctors are not great communicators. The other day I was waiting in the doctor’s office to discuss the results of an endoscopy intended to determine the true cause of the minor heartburn I have. A salesman dropped by with samples of Prevacid, the medicine I take for heartburn. We joked about the potential health consequences of the donuts he presented to the doctor’s staff, and he responded that if I had heartburn the only thing I had to really worry about were tomatoes.
Tomatoes! On my own health kick of the last two years, I have gone out of my way to include tomatoes — a red vegetable to complement all the green and yellow and white and orange ones I had been eating. Of course, as the salesman quickly added, I shouldn’t have to stop eating tomatoes altogether — that’s what Prevacid is for.
5.) There are three kinds of doctors in this world. There are those who know everything but can do nothing about it. Some internal medicine practitioners fall into this category, and give you wise and well-balanced counsel. But when it comes to actually yanking out a gruesome tumor or tying up a herniated stomach lining, their hands are tied.
Other doctors can do everything, but know very little. The surgeons who operated on my mother fell into this category. While my mother was wheeled into the “recovery” room, the young and eager one regaled my family with the technical success of the operation: X numbers of tumors were removed, cancerous cells by the millions were plucked with (literally) surgical precision from various cracks and crevices. Then the other surgeon came in, more grim-faced. The patient, he informed the family, had been struck by a massive infection, and had lapsed into a coma.
But amazingly there are some doctors who know everything and can also do everything. They are pathologists. Unfortunately, by then it’s too late.