PRACTICE WHAT YOU PREACH

Dear Dr Proctor

‘Practise what you preach’ and ‘physician heal thyself’ are well-know pieces of
advice. How healthy are doctors, and to whom do they turn if they fall ill?

Dear Well-wisher

I wish I could tell you that doctors are, on the whole, splendid physical and
psychological individuals, and ideal role models in health and ethical matters
for the general public. Sadly, this is not the case. Many doctors do not enjoy
good health. From the start of their student days the keyword of their lives is
pressure. Recourse to stimulants during training is common, if only to remain
awake during long, continuous periods of duty. When, briefly, the pressure and
responsibility of study or work ease, binge-drinking is all too common.

Not many years ago, doctors were among the heaviest smoking sectors of the
community. They have much lower life expectancy than, for instance, judges
who often are allowed to continue working long after the normal retirement
age, even when signs of encroaching dementia are clear for all to see.

Doctors also have the highest suicide rate of any profession. The main causes
are feelings of helplessness, faltering confidence as they lose touch with the
latest medical advances, work pressure, and the accumulation of guilt from all
the unconfessed but often tragic mistakes they have made during their
careers.

Most student doctors go through a phase of acute hypochondria. They soon

learn that seemingly innocuous symptoms can be harbingers of doom, and that
apparently well bodies can fail catastrophically with little or no warning. There
is scarcely a medical student who, before graduating, has not convinced him or
herself that the end is nigh from some distressing and incurable disease. In
later years doctors tend to become blind to their own symptoms. Many die
prematurely from unhealthy lifestyles or failing to attend to conditions that
could have been cured or controlled if treated earlier.
So, the next time you visit your doctor, pay him or her at least as much
attention as he or she gives to you. Is the skin tired and pallid? Do the fingers
tremble? Is the posture slumped? Are the eyes bloodshot? Does the breath
smell of alcohol? The chances are that you will see several of these signs in
your exhausted, demoralised and guilt-ridden doctor. If you begin to lose
confidence in the physical and psychological wreck of a person who is
supposed to be restoring you to full health, who could blame you?