A few weeks ago, while I was sitting at a crowded bar on a popular open mike night in my new island home, a man I’d met a few times before started telling me about the problems he’d been having with a new blood pressure medication.  This is not unusual.  Once people find out I’m a doctor, especially if they’re the most peripheral of acquaintances, I’m bound to find out intimate details they’d never tell their friends.  Suddenly I’m craning over the person in the bar seat next to me, shouting over another spirited rendition of Wagon Wheel what I hope is helpful advice.  But also vague advice, because I know nothing about this man’s medical record or his exam.  It ends up being much more than I meant to say, and much more than the poor man is willing to listen to in the midst of swinging drinks and belted choruses.  Because the problem with pills is not so easy.

I’ll start by saying pills are neither all bad or all good.  Millions of people are alive today because of pills.  That said I have strong reservations about how Western Medicine uses pills.  When I went to Medical School there was no emphasis on how exercise and nutrition can prevent and combat illness, and very limited emphasis on how to help people make better lifestyle choices when it came to alcohol, tobacco, or drug use.  There was, however, a pill for almost every disease.  Even if the pill did not cure the disease it could reduce some of the symptoms.

This is not surprising.  Throughout history humans have used various plants, animals, and inanimate objects as ways to help heal.  And human nature seeks an easy fix.  Not to mention, pharmaceuticals are incredibly lucrative.  But after ten years of practicing medicine I know that pills alone are not the answer.  In fact any medication, even a medication as ancient and benign as aspirin, can have life threatening side effects.

There are some people who will always need medications.  Type I diabetics, for instance, who cannot produce insulin.  Or people like a friend I had in medical school whose family history of high cholesterol was so bad two of his brothers had had heart attacks before thirty.  But many of the patients I’ve seen suffer from health problems that could have been prevented or reduced by significant lifestyle changes.  There are so many variables that effect a person’s health-from genetics, to stress, to environment-all of which we have limited or no control over.  In fact, we have little or no control over anything that happens to us.  We do have control over two important things, though.  What we put in our bodies and what we do with our bodies.

Here comes the hard part.  Taking pills is the quick fix we seek.  Changing how we eat and drink and how we exercise is not.  Changing these things takes a significant amount of hard work that can seem overwhelming and impossible.  But it’s not.  Take small steps, challenge yourself, keep going.  You may still end up needing to take pills but I guarantee you’ll need less medication overall.  And its never too late to start to make these changes.  Even small changes like losing 5 pounds, walking twenty minutes a day, or eating less processed foods will give you significant health results.

So that’s what I tried to tell my acquaintance at the bar, a pretty hard sell over half-price cocktails and greasy appetizers.  Preaching health at a happy hour is like promoting abstinence at a brothel.  But that’s my story and I’m sticking to it.  -The Anecdotal Doctor