I have a back ache and am thinking of joining a gym , so I can exercise my back muscles to prevent the problem from getting worse. My wife insisted that I go see an orthopedic surgeon and get his advice as to what exercises I should do and which I shouldn't , because she's worried that exercising may strain my back and make the problem even worse.
I was very reluctant to go to an orthopedic surgeon because while they know a lot about things like arthroscopy and hip replacements , they actually know very little about mundane things like back pain, because this is a garden-variety bread-and-butter problem which doesn’t excite or interest doctors . Doctors don't understand much about exercise ; and if there's a problem , they usually refer the patient to a physiotherapist , and that's that. I was wondering what the advantage of seeing a doctor would be.
I also told her that I've read enough books on back ache , which describe what exercises can help and which will not, so I am quite well informed. I'm not sure what value going to an orthopedic surgeon would add to my life. She was quite insistent that orthopedic surgeons are experts and know a lot about all this stuff . Her point was that a book is all about theory , while a surgeon would provide practically useful advise.
I feel that a book is actually a much better source of information , because it is written by an expert who has a special interest in the problem , and is willing to take the time and trouble to share his expertise with others. This is why I would rather learn about what exercises to do and how to do them from a book , rather than going to a doctor.
This dichotomy between theory and practice is completely artificial ! All sound theory is based on practical experience – and a book is written by an expert who has a lot of real-world expertise.
We have medicalized life so much , that we seem to feel that we need permission from a medical expert before we can do any thing - even doing something as simple as exercising ! ( It’s ironic that most exercise books will also start off with a disclaimer – please take your doctor’s advise before starting a fitness regime !) I think this is a broken model and not one I'm willing to subscribe to. While doctors are great and can provide a lot of value, we need to use our commonsense so we know when to use their services - and when not to.
Dear Dr,
ReplyDeleteIf possible write a blog post about ‘Why men are reluctant to go to doctors?’ :). I would love to know the psychology behind it ;) I have seen my dad do the same thing. He is tall too and had back pain most of his life. He tried many different remedies. Read lots of books. Used pain killers and muscle relaxants. He even tried anti-depressants (I am not sure whether the pain increased his depression or vice versa). He would ask me to walk on the entire length of his back (even when I am in college!). But one thing he never did – he never ever went to a doctor! I would ask him ‘Why can’t you go to a doctor?’ His reply will be ‘What will a doctor know? They simply do not have any practical knowledge. I am the one who know my body better!’ His aversion for doctors started in 80s when he had an amoebiasis attack. Not even a single doctor at that time made a correct diagnosis. He even feared for his life because of the suffering he underwent. He later resorted to medical books. He diagnosed himself and took amoebiasis medicines. He got cured and this incident killed his trust on doctors too. Actually, he is the one who taught me the importance of information therapy, as you call it now. He never went to a doctor in his life (a 2 time visit to dentist is the only exception!). He used to advice me ‘Be careful when you go to a doctor! :).
I can say there are two things which prevented him from going to a doctor. He did not believe in doctors because of his bitter experience. He always thought he is more knowledgeable than a doctor. The next point is he is afraid. He doesn’t want doctors to dig out something which might inturn lead to another new discovery about his health. He lived with a mind set that he is healthy except for his discomfort in his back and he doesn’t want a doctor to make a novel diagnosis which will break his belief and destroy his peace of mind :)
I think an intelligent patient is more knowledgeable than a doctor. But a very wise and empathetic doctor can help an intelligent patient more than any books. The wisdom they get from years of practice cannot be compared to anything else. When a person writes a book he will be lured into writing more interesting things than pure scientific facts. I would say go with Dr. Anjali’s wise words :). Find a doctor who is caring and wise enough. Visiting a good doctor is like meeting a good friend. Just forget that you are a doctor and go as a patient and that will help a lot :D (sorry for talking too much!)
Dr, why can’t you visit Kerala and have a nice ayurvedic massage. Might be it is very, very rejuvenating for the body and mind :). Eventhough you claim that your job is a fun job; it is too emotionally demanding and stressful. Wind up everything for a month - hundred e-mails per day is way too much! I am sure your patients and this blog will be kind enough to excuse you :)
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ReplyDeleteDr. Carl Balog