Art by Randall Nelson
Way back in 400 bc, Hippocrates said, “Let your food be your medicine, and let your medicine be your food.” Some 2,413 years later we’re still struggling with it. And it’s killing us.
Maybe the laundry list of lifestyle changes we must make in order to prevent diabetes and heart disease is too overwhelming. Maybe the stress of daily life keeps us running toward things that kill us (donuts, television, and cigarettes). Maybe processed food engineers are just too good. Maybe we personally have some kind of addiction gene or something?
Or maybe it’s shame—we know we’re hurting ourselves, which makes us feel bad about ourselves, which makes us hurt ourselves. How do we get past our own barriers?
Dr. Andrew McGinn, a North Memorial Heart and Vascular Institute cardiologist with 31 years of experience treating chronic disease, won’t greet you with a litany of questions about what you eat and how often you drink, smoke, and exercise. Instead, he says, “I make sure I understand who you are, where you come from, what your goals are, what your stresses are, and what you’re feeling.”
Dr. David Homans, a Park Nicollet cardiologist, takes a similar approach. From this place of empathic understanding, he says, springs a more engaged person-patient. And that’s where true change—the kind that will last—starts.
Take a hypothetical patient, Guy Who Smokes, Homans says: “The most important person is him and what he sees as a need to change. Does he intellectually see a need to stop smoking? We have to start with what’s most important and meaningful to him.”
Take hypothetical Lady with Hypertension: “If I tell her, ‘Don’t eat salt!’ we will turn her off and nothing will change. What we need to do is engage her in the work of exploring different flavors, and finding some way to make the food that’s good for her fun and exciting to eat.”
Take hypothetical Treadmills-Are-Boring Woman: “Ask me what the best exercise is, and I say, ‘Whatever form of exercise you’ll still be doing a year from now.’”
Both doctors agree that it sounds simple, but it’s challenging. “What we’re doing,” Homans says, “is working with our patients and the families in the somewhat mundane, unexciting, but critical issue of lifestyle and health.” At Park Nicollet that means coordination and collaboration between cardiology, primary care, and endocrinology so that patient information is shared between providers and messages to patients are clear and consistent. It means an onsite kitchen and healthy-cooking classes. It means support even—nay, especially—in the face of setbacks, guaranteed setbacks that never mean you or your doctors should give up.
“There are two ways of hurting patients: not giving them what they need and giving them too much,” McGinn says. “My job is to help people understand the risks and benefits and make sure I don’t withhold any therapy that might be appealing.”
Lifestyle changes, Homans says, are like soccer: “You just keep shooting.” The goal? “The goal is to put us out of business.”