Friday, 4 July 2008

Am I a hypocrite?

I used to go running quite regularly, it was something that I really enjoyed doing. But, between studying and working and having a girlfriend, I hadn’t been for ages.

I went for a run last night and it was great. The sun was shining, but it wasn’t too hot and there was a slight breeze to cool me down as I ran. This country looks beautifully green at the moment and the people I passed seemed happy as they enjoyed the summer evening.

If I’m being honest with you though, I’d say that the real reason I went running was because I stepped on a set of scales the other day and discovered that I’m almost a stone and a half (9.5kg) heavier now than I was this time last year. On the BMI charts, I’ve slipped across the line from the Healthy Green to the Overweight Yellow. More tellingly, trousers that I bought because they were baggy are now looking distinctly “fitted.”

I’m not overly concerned though, nobody who knows me would describe me as “fat” and I’m sure the extra pounds will come off again, but it got me thinking about things I’ve said to patients about losing weight.

On many occasions, I’ve advised people that they need to lose some weight, that their size is damaging their health and on many occasions I’ve been exasperated when they “refuse” to do so.

“How hard can it be?” I’d whinge to my colleagues. “All they have to do is eat less and do a bit of exercise and then they would be in the hospital in the first place?”

But now, I’m officially overweight myself. So, do I have any right to tell another overweight person to lose some weight?

The question I’m asking is “Am I a hypocrite?”

And the honest answer has to be, “Yes, I am.”

I’m far from being alone in this though. In fact, I believe that the vast majority of doctors across the world have given advice to their patients that they, themselves flagrantly ignore.

I used to work with a consultant vascular surgeon who, every week for the majority of his working life would amputate people’s legs because their smoking had clogged their arteries, causing their leg(s) to rot. And every week, at the end of his list, he’d take himself off to the smoking room to have a few fags before reviewing the post-op patients.

Drunk people are so annoying in the A&E department. Not only because they can be loud, rude and aggressive, but because the effects of alcohol itself mimics the symptoms of severe disease (dizziness, drowsiness, slurred speech, vomiting etc…) and makes it much harder to exclude potentially serious problems. I used to bemoan having to clerk in drunk people on a Saturday Night but I knew that, had I not had to work, I would probably have been in the same bar, dancing like a tool and being almost as pissed as they are.

I know doctors that regularly take recreational drugs, even though they of all people know the harm these substances can cause.

What I’m saying is that there is a large amount of hypocrisy running through medicine and a large amount of the “Do as I say, not as I do” attitude that comes with it.

However, on the flip side of this, being a doctor certainly gives a different perspective of life and health. We’ve all seen people die in front of us in horrible, but avoidable ways and, as a result, we are morally and duty bound to try and help the person in front of us from doing the same.

I suppose what it comes down to is this. We are no angels, we never said that we were. I guess that our hypocrisy stems from wanting our patients to have as good a life as possible and from trying to get them to avoid the suffering that lies further down the path that they’re on.

We’ll continue to do this, even if we can’t take that advice ourselves.


Dr Andrew Brown said...

You weren't hypocritical, you were just young, idealistic and not in possession of all the facts. None of these were shameful, you did the best you could at the time. You know better now, and will be a better doctor for it.

By and large I think patients quite like their doctor to admit to a few (small) faults. These help to place doctor and patient side by side rather than facing each other.

Mind you, as an anaesthetist you will often be behind the patient!

Dr Xavier Ray said...

It's not hypocrisy. It would be if you said "live like me" but then secretely smoked, over-ate, used drugs or regularly got drunk.
If you did all this you can still use your professional training to advise others or at least be able to give them the information to make their own choice. Your professional work and personal life are separate (though not in the eyes of the media or of our regulators but they are just government "bitches" now).
When I was a junior I regularly ate 4 meals a day and several beers and did not gain weight. Now in middle age with a sedentary job my calorie requirement is down to around 1800 and it is a real struggle to even stay where I am on the wrong side of the BMI line.
As you get older and fatter exercise becomes less attractive. I am more sympathetic to the lardarses I see now and I no longer tell them that there weren't any fat people in Belsen when they tell me they "don't eat anything".

It's fun to bank said...

No you're not a hypocrite. As Dr Xavier said it would be hypocritical if you said 'live like me', but you don't. It is also important to have understanding of what you are asking of a patient. Part of my job is smoking cessastion, I have never smoked and often get told I have no idea how hard it is to give up- and I don't. Some understanding in a battle a patient has to face is surely a good thing.

Tazocin said...

I've started biking it to work. I spent my first year as a medical SHO driving everywhere in a new city, scavenging boxes of chocolates on every ward and eating out far, far too much. End result? The same SHO who spent six months in Cardiology harping on about exercise, salt intake and weight loss gained over a stone of soft pudginess.

Though we may be more aware than most of the risks of overeating, a sedentary lifestyle, smoking, binge drinking etc, due to the stressful and unsociable nature of our job I think most junior doctors are guilty of unhealthy indulgences. There also seems to be something of a God mentality... I think a lot of doctors find it hard to contemplate being on the other side of the ward round some day...

DundeeMedStudent said...

your not a hypocrite your a human- if you didn't have any vices then you'd be perfect and we all know that can't happen.

Dragonfly said...

I've got the same BMI problem at the moment.....trying to correct it for many reasons, including professional integrity and personal health (and darn it, I cannot afford new clothes). Doctors who smoke pot while working in psych/emergency and looking after psychotic patients.......grrr.

Inotrope said...

Console yourself that an ever expanding waist-line probably indicates future exam sucess, indicating that you've been slaving over the books at the expense of anything more enjoyable...

COI: MRCP, FRCA and 10Kg gained. Last 5 years of life lost. ;)

I'm sure that there is a xmas BMJ piece of research there!