By ROB LAMBERTS, MD

I did a little “self care” earlier this week.  I did it by not caring for myself.

I went to the doctor.

I was sitting in the waiting area for my appointment and saw the mother of one of my patients.  ”Why are you here?” she asked.

“I have a doctor’s appointment.”

She got a curious look on her face, asking, “Don’t you doctors just take care of yourselves?  I thought that was what doctors did.”

We do take care of ourselves, in fact we do it far more often than we should.  Being your own doctor allows for a lot of denial.  When you spend your day advocating healthy lifestyles after you had trouble finding pants would fit in the morning, denial is necessary.  Do as I say, not as I do.

I realize that this is hypocrisy; that is why I was at the doctor on Monday.  My patients have noticed my expanding waistline, commenting on it more than I would wish.  Certainly my pants get in the way of denial as well, not forgiving the fact that I have been under a whole lot of stress.  Pants don’t accept excuses.

So I found myself in the unfamiliar experience of being the patient.  Instead of closing my mind and emotions to my own body, I had to frankly assess what I was doing to it.  Standing on the scale was as frank of an assessment as I would ever want.

“So why are you here today?” asked my doctor, a man 5-10 years my junior.

“For a physical.  I just need to start taking better care of myself.  I’m getting fat.” I said, feeling a bit ashamed at being “outed” to a colleague (as if he didn’t notice my pants).

“Yes, you are up 10 pounds from last visit,” he said without judgement.  ”I think you know what comes next.”

“Yes I do; I have given the same talk numerous times each day.  I need to be eating better.”

“What about exercise?”

I smiled.  ”To be honest, I don’t really like exercise all that much.  I won’t say that I don’t have time for it, because I know I do.”

He seemed to appreciate my honesty, and we launched into a discussion of how to find an exercise routine that would be easier for me to do.  Going to the gym takes too much preparation, and it requires that other people (some of whom are my patients) see me in my non-exercised body.  I suppose this may be a good thing in some ways, as they would see me as practicing what I preach, but that doesn’t salve the ego enough.  Going to the gym gives me too many excuses to put it off for a day.

Then we talked about exercising at home.  I have some weights around the house, but they presently serve only as things to kick accidentally and test my resolve to avoid cursing.  I’ve gotten exercise equipment in the past, and it has done really well at holding laundry.  I am afraid to invest too much money in something that will serve as a guilt-trip.

Still, I know I have to take the plunge.  Reasons are reasons, but eventually they become excuses.  My pants don’t listen to excuses.

In some ways it is harder to be a patient as a doctor.  Despite the fact that I know what symptoms to look for, know what food to eat, and what the latest information is on exercise, it is hard to listen to my own voice.  When sitting in the exam room, doctors are trained to shut off part of their emotions.  This is necessary because we have to face a whole lot of pain, doling out some of that pain ourselves.  I have to be brutally honest with people who I want to like me.  I have to order painful procedures and even perform them at times.  When looking for pain, I have to inflict some of it (as in “does this hurt?” while grabbing, poking, or pushing on a spot of declared pain).

Beyond that, my job necessitates that I watch people get sick, suffer pain, and die.  I am holding back an irresistible force.  Everyone eventually gets sick and dies, and I have been tapped with the task of helping them through it, and often shepherding them through to the end of their lives.  I have to do so with compassion and kindness, but I also have to emotionally survive, because there are thousands of people depending on me to do this job.

So when I am tasked to become the patient, I have to put down defenses that have been constructed over decades.  It’s not easy, but I have to do this.

I can’t make excuses.

My pants won’t accept any.

Rob Lamberts, MD, is a primary care physician practicing somewhere in the southeastern United States. He blogs regularly at Musings of a Distractible Mind, where this post first appeared. For some strange reason, he is often stopped by strangers on the street who mistake him for former Atlanta Braves star John Smoltz and ask “Hey, are you John Smoltz?” He is not John Smoltz. He is not a former major league baseball player.  He is a primary care physician.