Saturday, November 12, 2011

Family Medicine: The Quest for Wholeness

Many times in our lives, we'll seek wholeness or a sense of oneness with who we "really" are.  These identity quests can be enlightening, overwhelming, devastating, and/or satisfying.  As we interact with other people, we would like to deliver our whole self to the engagement.  Unfortunately, that is seldom the case.  Mis-alignment with our whole self speaks to the numerous distractions that we notice almost continuously.  Our whole self often eludes us when we'd like to show our best self (or at  least, put our best foot forward) to others for special situations.

A case in point is people who go to doctors and want to look, sound and act sharp for their physician.  In my Family Medicine office, we often have people call to cancel appointments because they are "too sick" to see me (their family doctor).  "I'll call back and reschedule my appointment when I'm feeling better," they say.

My medical training offers lists of ways to seek wellness via good medical prevention:  Exercise for 30 minutes five days weekly, eat five servings of fruits and vegetables daily, control your blood pressure, control your cholesterol and your weight (now we may comment on your body mass index, which is about the same thing).  I most recently heard an excellent talk to this effect by Dr. Colin Kopes-Kerr in which he reviewed the science behind these five main recommendations for good medical health, which is the best way to prevent early demise from common chronic diseases.

The World Health Organization has another perspective on the meaning of health.
Definition of Health by the World Health Organization :
"Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity."  The word "complete" in their definition makes it beyond what I could commit to as a Family Physician.  The patient may commit to COMPLETE physical, mental and social well-being, but it's not covered by their medical insurance.  That definition, though, would get closer to wholeness.  It is a goal that is achievable from time to time for brief periods.  It is not a medical goal, it is a personal health goal.

Beyond these concepts, the wholeness I refer to is physical, intellectual, emotional and spiritual (PIES).  Patients may have strengths or needs in any or all of these four parameters, but seldom function at their ideal (personal goal) levels in all four at once.  Physicians may be able to interact with patients about these factors, especially as they relate to their health goals and needs.  Patients may emphasize a physical problem and comment about the emotional impact of it, but seldom mention spiritual issues (often thought by physicians to be a sense of purpose or meaning) unless prompted by the physician.  Patients and physicians both can be trained to better relate to these issues separately as they relate to patient health.

"When is the last time you were yourself?" I often ask patients.  They (adult patients) usually seem to know. That state of being they refer to in response to my question may be as close as I get to hearing about the oneness they once had.  Exploring how they perceived their five senses in that state of wholeness helps me to facilitate their quest for realigning with it for the health benefits.  Still, that may not be "whole" wholeness for many.  

Many patients describe unique states of well-being in their prayer lives, especially some who describe times when they felt one with God while engaged in a religious or spiritual experience.  That experience of "ultimate" oneness is beyond any medical or WHO definition of health.  I marvel when I hear about it or experience something similar, but humbly recognize "real" wholeness as beyond the scope of my medical skills.   


  1. I had a friend once say that ideally ..we would be the same person around everyone. that would be true wholeness when we could just be ourselves consistently.

    But no one can do that. There are just times we have to wear other hats.

    I can relate to wanting to look good or feel better to see my doctors. Not the first time I had sepsis - I was very weak and looked bad all weak ..but the second time I was up early the next morning putting makeup on when my doc walked in to do rounds. My joke is ..if I don't try to look good concerned.

    I know doc's don't care ..but I think because we get to know you over time ..just like for anyone else ..we want to look good. Which ..the whole reason we may not is that we need to get in to see you. men probably don't think like this.

    I have never had a doctor inquire about my spiritual life, but over time it came out that my former pcp and another doc pray for their patients and we have had faith discussions and for me is not necessary but feels like a complete medical care package. I loved that my former pcp used to sometimes quote C.S. Lewis to me. :) Miss him.

    I have been saying recently ...that I am beginning to feel more like myself lately ...the way I used to be before all the sickness and people dying, etc. have had a lot of life changes over last 5 yrs and I felt like I lost my way as people died off ..the anchors in my life no longer there. And as you know ..most recently my close friend succumbing to cancer. I am already making peace with it.

    And I mean it when I say ...I am finally beginning to regain my bearings and feel like me again. Although wiser and more appreciative of life in front of me right now. And finally ...I am also tackling health issues ..making lifestyle changes ...really doing it. All part of the finding me again. Ha! Sounds so 70s ..find myself. But ..I feel like I've been on this journey and life got really shaken up and tumbled around. And now it and I am settling and I want to go forward into rest of my life.

    I also think that because I have always been a spiritually minded person ...but put it aside for awhile and this past year have been coming back to it just feels right and who I really am as well.

    I am sorry so wordy here and may come back and delete ..or you can if I went off track.

  2. Thanks for sharing from the heart, Sea Spray. Your message brings meaning to my message. Thanks!