New posts are available every Monday and can be read in under 5 minutes.
|
Posted by Alex Lickerman  Print  Email to a friend  Photo: mikebaird My patient, Mrs. Withers (not her real name), was forty-five and morbidly obese. “I swear I’ve cut my calories down to almost nothing,” she told me, “but I haven’t lost a pound! I eat the exact same thing every day: a banana for breakfast, a turkey sandwich on wheat bread for lunch, and a piece of fish or steak for dinner. And no snacks in between! I used to eat twice as much, easily. I just don’t know what I’m doing wrong!”
She was literally on the verge of tears. I fully understood her frustration, as well as why her attempts at dieting hadn’t worked. Most of my patients who try to lose weight long-term ultimately fail, though not for lack of trying. Both physiologic and psychological mechanisms are in place that make sustained weight loss incredibly difficult. But, as I told Mrs. Withers, if you understand some of the mechanisms you’re up against in trying to lose weight, you’ll be able to leverage that understanding into weight loss strategies that work. Continue reading…
Posted by Alex Lickerman Print Email to a friend  Photo: The U.S. Army From quitting smoking to eating healthier to exercising regularly to getting more organized, most of us have a list of behaviors we’d like to begin (or end) that resist our attempts to do so. As a physician, I find myself giving advice about changing habits on a daily basis. Even though many of my patients are able to succeed in making desired changes in the short term, most of them revert to their original behaviors in the long term. What, then, are effective ways to alter behavior on a permanent basis?
The psychology that underlies the changing of behaviors is complex. Two researchers named Prochaska and DiClemente developed a way of describing it they called the Stages of Change Model. Though originally developed in the context of smoking cessation, it’s five stages actually describe the process by which all behaviors change. Continue reading…
Posted by Alex Lickerman Print Email to a friend  Photo: Fiona MacGinty In January of 2007, I developed a mild stomach ache and general feeling of being unwell while at a Sunday brunch. Initially, the pain sat in the center of my abdomen just above my belly button, but gradually over the course of the day inched its way down into my right lower quadrant, causing me to wonder briefly if I’d developed acute appendicitis. However, by evening the pain had actually begun to improve so I dismissed the possibility; I’d never heard of a case of appendicitis resolving on its own without surgery. But mindful of the adage that the physician who treats himself has a fool for a patient, the next day I asked one of my physician friends to examine me. When he did, he found a fullness he didn’t like in my right lower quadrant and ordered a CT scan. To our mutual surprise, it showed that I had, in fact, developed acute appendicitis. Continue reading…
Posted by Alex Lickerman Print Email to a friend 
About two years ago a patient of mine, Mr. Burndt (not his real name), committed suicide. When his wife, who was also my patient, told me the news at one of her visits, I was shocked. Fully aware that 40% of older patients who are suicidal visit their primary care doctors within one week of killing themselves, I found myself wondering over and over how I’d missed recognizing the severity of his distress. I’d known he’d been suffering from depression but had thought it mild.
But even more shocking than the news of his suicide was the reason his wife gave for it: six months earlier, he’d been involved in a car accident and had inadvertently killed a pedestrian. In the end, he simply couldn’t live with the guilt. Continue reading…
Posted by Alex Lickerman Print Email to a friend  Photo: vanGalenMarco A young violin prodigy was walking down the street one day trying to decide whether or not to pursue a life in music when he came upon the most famous violin teacher in the world. Scarcely believing his luck, he stopped the great teacher and asked if he could play for him, thinking he would abandon his dream of a career in music if the great teacher told him he was wasting his time.
The greater teacher nodded silently for him to begin. So he played, beads of sweat soon appearing on his forehead, and when he finished, he was certain he’d given his finest performance.
But the great maestro only shook his head sadly and said, “You lack the fire.” Continue reading…
|
|
