Do as I say, not as I do

By Norman Clothier, M.D.

One of the distinct joys of being a physician is that I always have a fool for a patient. No, not the person in exam room 2, but the classic that we all have quoted frequently — and appropriately, I’m sure: “The doctor who treats himself has a fool for a patient.” Quite possibly, considering all the wisdom of Galen, Hippocrates, and Osler on down to each subsequent attending physician, no deeper medical truth has ever been stated. Perhaps it’s the sadist in me, but I do so enjoy the stories of my colleagues when we review our approach to care, such as “I had a little bit of a sore throat, so I grabbed a couple of handfuls of the nearest antibiotic sample — more is better, right?” I feel I can almost always take a readily treatable, standard-of-care disease state, where the treatment algorithm has not the slightest of deviation known to any physician trained in any known school on the planet, apply it to me, and declare that I just simply know better than all the rest of you.

Some cases in point:

1.) Three and a half years ago, I had my appendix out. One simple surgical procedure later, and five days of a post-operative hemovac drain, I went skiing for four days. At least I had an excuse to let my friend and my kids carry the luggage. It’s not that I intended to ski, but while getting the rental skis for my three oldest sons, it seems I just got put into skis also.

2.) Last spring, I was playing ball in my backyard with my 5-year-old son when a wasp stung me as I innocently reached into a bush to retrieve the ball. It was like a spring-loaded shot to my forearm and one day later, I barely could fit through a doorway due to the swelling. I broke in a new nurse, who patiently watched when my own personal family physician opted to locally anesthetize the site, incise and drain it to relieve the pressure. Of course, this also happened to be me. I did, though, to be careful and diligent, do a culture, and I never did succumb to the temptation of antibiotics for this inflammatory reaction. What a bit of wisdom!

3.) Last summer, I had a noon surgery to release an entrapped tendon in my finger, leading to a trigger finger. I decided I had to have this done after I noted that, while repairing a laceration on a patient in my office, I was having to reach over with my other hand to release the trigger on my dominant hand just to pry the needle drivers out of it in order to proceed with the next stitch. Naturally, since my children and I take weekly tennis lessons together in the summer and I didn’t want to let them down on this day, I played tennis three hours after surgery. I quickly learned that my left hand has some role in life, if only to be used exclusively when my right hand was in a club-head style post-operative dressing. Amazingly, after 38 tries, I did get a serve in. Thankfully, my 3-year-old didn’t count a single fault against me.

Now, which of you physicians wouldn’t have done exactly the same things? I believe that if we gave patients the advice to treat themselves as we would treat ourselves, we’d have a lot of messed up patients!

It reminds me of a phrase I learned from my then 5-year-old son, Jeffrey, as we played chess one day. I made a move that was less than excellent. Jeffrey jumped on this, noting “You shouldn’t didn’t have done that!” It turns out he was right.

As family physicians, let us take a careful look in the mirror to see whether we do have the self-fool for a patient, or whether we are fair to ourselves and our own health. While there, why don’t you look really carefully in that mirror and just take care of that annual physical while you are at it. I’ll do the same, while continuing to hope that the self-colonoscope kit will be out of clinical trials by the time I am due.

Norm Clothier, M.D., is a family physician in Richardson, Texas, and resides in Parker with his wife, Jeanette, and eight children.