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with Rod Moser, PA, PhD

Stories from behind the examining room door, as told by Rod Moser, PA, a primary care physician assistant with more than 35 years of clinical experience.

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Monday, November 23, 2009

The Power of Acceptance

Not all things in medicine can be cured, or even adequately treated. There are definite limitations of medical science. While medicine has made leaps and bounds over the last few centuries in the on-going battle with microorganisms and disease, there are still conditions that just defy all the powers of science and technology.

If you happen to be the person who gets the bad news that there is “nothing more that can be done”, this can be a tough pill to swallow. People leave the medical offices feeling frustrated, often angry. Many cannot believe that all diagnostic and treatment avenues have been explored. Many will seek “second opinions” – an important step that I encourage often. Two medical heads are always better than one in these more difficult cases. Not all doctors are the same, and two different people viewing the same test results, hearing the same medical history, or even examining the same person, can often come up with entirely different perspectives. Patients often see this as ambiguity. Many will tend to believe the second doctor, over the first. There is really no evidence that the second doctor will be correct, although I once heard that the “Early bird gets the worm, but it is the second mouse that gets the cheese.”

I have a good friend that was diagnosed with brain cancer – The Big Kahuna, as he calls it. It is a stage IV glioblastoma; perhaps the worst of all brain cancers, and the one that recently took the life of Senator Ted Kennedy. Although he remains optimistic that his aggressive radiation and chemotherapy will extend his life beyond the dismal estimates, he is also an intelligent realist. He knows his changes of a cure are dismal. We all hope for miracles, but do not really expect them. Statistically, if statistics are really the answer, he may have another year. He accepts this. His acceptance of his fate has really brought him peace. Having a terminal brain cancer is like falling off a high cliff and going down real slow. At some point, you give up the idea that you can flap your arms real fast and land safely. You have little choice but to accept your fate.

I look at our brave soldiers coming back from Iraq or Afghanistan missing an arm or leg, or both, from a roadside bomb. An optimist would stay that a life was spared, but a realist would tend to focus on the missing parts. During their long rehabilitation, healing must take place in the mind and soul, as well as the body. Missing limbs will not come back, and it takes time to accept and appreciate the parts you do have left. Technology has given us artificial limbs – the best the Uncle Sam can buy – but, of course, they are never the same as the ones God gave you originally.

I saw a little ten year old in the clinic last night. She is a type I diabetic, wearing a high-tech insulin pump. It was a surprise to the family when she was diagnosed, but now it is second nature to adjust and regulate her insulin, monitor her blood sugars / ketones, and carefully watching her diet. Diabetes is currently incurable, but very, very treatable. The insulin pump cost the parents – out of pocket – about $4000, and looks like a iPod. Because she wears it all of the time, she also wore it to soccer practice. Her over-zealous coach, thinking she was listening to music, snatched it from her belt and threw it in the weeds. I would have loved to seen his face when ther mother informed him that he just threw a very expensive piece of essential medical equipment away. Fortunately, it did not break.

One of the more common complaints on the Ear, Nose, and Throat message board would have to be tinnitus – ringing in the ears. There can be hundreds of causes for tinnitus, and in many cases, it will resolved spontaneously. However, tinnitus can also be permanent. About nine years ago, while working on WebMD, I suddenly felt a wave of nausea, dizziness, and tinnitus. The vertigo went away in a few weeks, along with the nausea, but like many people, my tinnitus remained. I now hear a high-pitched whine 24/7. In the last few weeks, it has become louder, so I am off to see my own ENT. As a clinician, I know how difficult tinnitus is to treat, so I am not expecting a miracle, but it would be nice to know why I am experiencing this recent exacerbation. I think I have accepted the fact that my tinnitus will not just “go away” some day.

Smokers have to accept a lot of risks. At over six dollars a pack now, smokers have to accept that their habit is very expensive; perhaps not as expensive as a cocaine addiction, but a pack a day is going to eat into those dwindling profits. Smokers have to accept that they will most likely experience some significant health problems – cancer, emphysema, etc. Smoking is so risky in fact, that many smokers feel that putting on seat belts may be a moot point.

Humans have no choice but to accept their mortality. Like it or not, we will all eventually die. We may die of old age in our 100′s, die prematurely of some unexpected disease, or be killed in an automobile accident. Many people who are deaf (not all of them) would like to be able to hear. People who have limited mobility, would love to be able to run and climb again. People who have diabetes and must check their blood sugars regularly and adjust their insulin, would rather not do this. To accept life, we have to accept that life is rarely perfect. At some point in our lifespan – no matter how long that ends up being – we will have to accept a some challenges; challenges caused by disease, aging, or accidents.

Once we accept that things may not always turn out the way we planned, or accept the fact that medical science has definite limitations and not all illness or life challenges can be cured, or effective treated, then we can be at peace. We will never know what is around the next corner until we get there. We can live a lifestyle as healthy as we can, but at some point, even healthy people will die.

I once read that “Good Health is the slowest
form of dying.” So true. It is much more comforting to accept life as it is, rather than what we wish it might be. We need to celebrate each day. We need to make the best out of the limited time that we have. We need to honor those that have died prematurely by doing those things that they did not have a chance to do. We need to hug more and complain less. We need to compliment people that do good things, and ignore those people who do not enhance our existence.

Life, even an imperfect one, is truly a gift.

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Posted by: Rod Moser, PA, PhD at 11:15 am

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