Usually it is women who turn me on. “Doctor, what do you think of Henk drinking three beers a day? Especially now that he has had a TIA?” Or: “Bram is actually only allowed one hour a day on the iPad, but he is often on it for much longer. Perhaps you could explain that that is probably why he has headaches so often?”
And so it is that I plead against excessive alcohol consumption, too much screen time, all forms of smoking, and precisely for exercise, a good night’s sleep, and calling 911 immediately in case of acute neurological deficits. Wife or mother is nodding with satisfaction; the patient adopts a guilty attitude.
I generally don’t mind being used for this kind of purpose. I am sure that I give advice that actually promotes health and I also try to look for the nuance: a 95-year-old who enjoys a small glass of gin every evening, I will not limit that.
However, I always find one subject more difficult: “Doctor, what should Piet change in his eating pattern to prevent the next stroke?”
There have been some important gaps in my medical studies. We have learned too little about palliative care, as well as about limiting the prescription of heavy painkillers. A worldwide (corona) pandemic has never been discussed. But the subject of ‘nutrition’ has also remained painfully underexposed. Patients often think that, with my BMI around 19, I can easily shake a healthy weekly menu out of the sleeve of my white coat. Unfortunately, nothing could be further from the truth.
I am – there is no denying – someone who has been labeled a ‘picky eater’ from childhood. Some people outgrow that, but I’m still put off by certain textures, smells, colors (especially green) and tastes. I don’t like tomatoes (“But there are tomatoes on a pizza too!”), onions (“You can’t taste those in the pasta!”), cucumber (“That doesn’t even taste like anything!”) or lettuce (“Who likes there’s no lettuce?!”).
All in all, I accept just enough fruits and vegetables to keep me from succumbing to scurvy, but that’s about it. Funnily enough, I have a lot less problems with most foods that will never make it to the fifth wheel. A favorable package of genes, a fast metabolism and ten hours a week of sports ensure that I (still) get away with it. That explanation is just less helpful to my patients.
In the end I stammer an answer: “A varied diet. Lots of fruits and vegetables. Don’t snack too much. Low in saturated fats. Something like that.” This is clearly not specific enough for the questioner, who puts on a disappointed look. My mind involuntarily turns to the frozen pizza I’m going to eat tonight. In an attempt to please the wife, I add a sentence: “Can I also write a referral to a dietician?”