The $5T overflow: doctors mopping up the floor, while the faucet is left on. A cartoon illustrating the irony of our current approach to managing chronic disease, and ignoring root causes.

 

The $5T Overflow: Why are we focused on the wrong things?

I remember walking out of the student lounge and downstairs toward the exit… when a friend stopped me. “Hey, you should come to this guest lecture!” Why, I wondered to myself, when it was enough of an effort to make it to my required classes. The guest lecture was for an elective course I wasn’t even enrolled in… I was curious, though, based on the amount of foot traffic. It was highly unusual for this many students to be crowded into our main auditorium, almost standing-room only, especially at this evening hour. Whether it was because I had nothing better to do, because I trusted the friend who invited me in, or because I was just really curious what the fuss was all about–I followed Chad into the lecture hall, where I quickly lost sight of him in the dimming lights and swelling crowd size.

I decided to stay in the back, in case I needed to make an already anticipated quick escape. Instead, I stayed through the entire lecture.

The first time I heard Dr. Dean Ornish speak at Baylor College of Medicine in Houston—which, it turns out, was also his alma mater—was a revelation. It was like a ton of bricks falling… or a bolt of lightning. Because most of my professors’ voices sounded like the continuous drone of a Charlie Brown schoolteacher at that point (2nd year of medical school, 6 years into pre-med and medical training…), it was probably this cartoon he shared early in his talk that most effectively hit home:

Original cartoon depicting the irony of physicians addressing downstream aspects of diseases, treating signs and symptoms while ignoring root causes. Shows to doctors mopping up the floor, while the faucet is left turned on.
via Dr. Dean Ornish

It activated a lot of latent thoughts, and brought them to the forefront in a whole new way. All these buried questions about the irony of the physician lifestyle, how stressed out we all were, how much we undervalued sleep, and took our relationships for granted… These were the main issues! They deserved to be thought about, brought to the forefront, analyzed and acted upon. It legitimized my n=1 beliefs in the value of meditation, yoga and exercise. 

This was in 2003, one year before the American College of Lifestyle Medicine was founded. In fact, I didn’t even know the American College of Preventive Medicine existed, or that it was possible to do a residency in prevention… Instead, Dr. Ornish’s talk left lingering doubts and growing skepticism of our “sick care” approach; and our questionable rationale for ignoring the root causes of chronic disease. A few additional experiences eventually crystallized my direction towards prevention and lifestyle medicine as a physician entrepreneur…