Two most common type of challenges in medicine

My patients mostly only have just two challenges:
1. Not paying enough attention to what the body needs; (Eg. 400 grams of non-starchy vegetables and fruits per day; appropriate physical activities)
2. Paying excess attention to what the mind don’t need. (Eg. suffers craving or aversion that is self-inflicted; a past that is unchangeable; or a future that may never happen).
Pain, suffering and illness opens up tremendous opportunities to redirect their misdirected attentions.
I ask my patients what is pain? After they have a brief moment to ponder I offer my take. The body has real need but often the mind is busy paying attention to some imagined needs. Pain is how the body speaks to the mind. Let’s say there is a bright orange warning lights on your dashboard and you decided to visit the mechanic. The mechanic sees that you are in distress and covers it up with some duct tape. You are then reassured that the tape has been shown by research to stop the annoying orange light. You are also offered alternative class of duct tapes in the event that the firrst-line doesn’t work well enough and should you be able to see the light come through the tape.
The other day, at the after hour clinic, a patient was in the exam room waiting when I entered. I noticed the near-empty prescription bottles of Percocet and Celebrex in front of her on my desk. She had pain from back to her left foot. After a detailed history, I explained to her that her “pain” is alerting her mind of three challenges.
1. Sciatica from nerve root compression in her lower back partially due to poor posture and weak core; solution: posture exercises and intra-abdominal compression lumbar-decompression exercises guided by pain.
2. Gluteal claudication likely due to iliac vessel disease as she had history of MI and the body wants to redirect her mind from cigarettes using pain. I sent her for doppler and lab studies but encouraged her to focus, in the mean time, on lifestyle management till a treatment plan can be made after the tests.
3. Osteoarthritis of the right knee due lacrosse injury when she was younger. I reminded her that the body is a miracle and has fantastic potential to self-heal provided it receives the proper care; and that the pain is the constant reminder to help the mind stay attentive to the essential nutritional substrates found in 400 grams of non-starchy vegetables and fruits per day, redirect attention from the thought of cigarettes and discover the “appropriate” posture and activities that prevents repeat injuries and permits healing with time.
She thanked me for the explanation and the plans; and asked me if I would dispose of the unfinished prescriptions for her.

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