The vicious cycle of health, outlook and happiness…

Health impacts mood, mood impacts outlook and outlook impacts health.

Have you ever noticed that when you are not feeling well your friends and relatives seem to talk to you with caution .If they were laughing about something, suddenly they lower their voices. I don’t know if that’s supposed to make the patient feel better in any way, but I can’t help but realise when it comes to health issues, people are not as happy.

The good physician treats the disease; the great physician treats the patient who has the disease.”

Sir William Osler

If you come to the hospital, most of the times we want to make sure we relieve you of the symptoms of the condition you are presenting with. We ask you if the symptoms are getting better or worse, we ask any other associated symptoms-you know the usual doctor stuff. We do all this so that we know how to manage you appropriately so that you feel better. It was taught to me very clearly in medical school that I should have a holistic approach when treating patients and in my mind its exactly what I should be doing for every patient.

But in contrast, as a doctor in practice, I will be more focused on the physical aspects of the disease, to the extent that if a patient reports that their symptoms are better than the previous day I feel happy that I would have done a good job. It is on very few occasions that I inquire about the emotional status of the patient. Not because I’m a very bad Doctor (or maybe I am), but in most cases I will be having a long queue of patients waiting to be assisted and typically patients will rather freely report their physical ailments- having been programmed accordingly or perhaps and even sadly not wanting to burden us with the emotional qualities of their illnesses.

Being on the other side of the table when a patient is sick had subconsciously made me someone who sees a patient with the eyes of the doctor. Forgetting that if a patient is being followed up for conditions like hypertension, Diabetes, HIV or even an acute condition like typhoid, they still have to tolerate their medication every day, they still have to deal with the effects of the disease and medication in their daily lives. Their feelings are the stories and impact behind their conditions.

Their pain might be improving, they maybe tolerating their medication but perhaps they are afraid, frustrated, nervous, angry, hopeless, depressed or upset. And if so, does it matter? Does it impact their disease state? Should we care? If time is a limiting factor for healthcare professionals , whose responsibility is it to make sure that being a patient doesn’t mean misery? I truly believe that someone can actually be a happy patient. I don’t presume that these challenges are facile to solve, but I know that a patient’s happiness matters as much as their cholesterol.