What do we pay doctors to do?

Use medical instruments to collect data? Record that data in our charts? Perform procedures? Prescribe medications? Give referrals to other medical specialists? Recommend home care remedies and strategies?

Have I forgotten anything?

The author of a new memoir would say YES!

Kurt Eichenwald has written an astounding memoir, published last year, about his lifelong struggles with epilepsy . . . and people. He tells a story that made me cringe and kept me riveted. I was especially intrigued because his story has so many similarities to my own.

I do not suffer from epilepsy. I have not suffered from drug side effects to the extent that Eichenwald has. But I have suffered from debilitating medical issues. I have also suffered from drug side effects. And I have suffered, like Eichenwald, from the missteps, overconfidence, and occasional outright hostility of other people, while I was trying to attain the medical care I needed.

Perhaps one day I will write my story. But I’m not sure I have much to express that Eichenwald hasn’t already brilliantly covered in A Mind Unraveled.

Experiencing a health problem is scary. Full of fears and anxieties, we turn to doctors for their expertise; and we believe what they tell us. We want to believe; we feel that we have no choice but to believe. But Eichenwald tells a horrific story of doctor after doctor failing him. He was misdiagnosed, multiple times. He was treated with condescension and disrespect, multiple times. He was prescribed medications that almost killed him, multiple times. He was wrongly informed that his seizures were not epilepsy, but a psychological disorder, multiple times.

Finally, after years of worsening epileptic seizures, and years of taking seriously high doses of medication without proper physician monitoring; after years of not knowing where he would wake up next, or with what debilitating injuries; after years of enduring discrimination for having a disability, and personal trauma and that almost resulted in him giving up on life entirely—he finally stumbled upon a doctor who was willing and able to help him. Here’s what happened during Eichenwald’s first consultation with Dr. Naarden:

“After twenty minutes, Naarden had already spent more time speaking with me than any other neurologist ever had.”

What?! No other neurologist had spent more than a total of twenty minutes talking with their patient about a serious, debilitating medical problem?

During that first visit, Dr. Naarden went on to speak with Eichenwald for much longer than twenty minutes. And he continued talking with his patient. He talked with him not just during the initial consultation, but during future visits. And this communication went both ways. The doctor listened very carefully to Eichenwald’s story and asked follow-up questions. He also told Eichenwald, in detail, what he knew about Eichenwald’s current medical situation, what he didn’t know about it, and what he would like to do in an attempt to learn more.

This communication was essential to a correct diagnosis of Eichenwald’s disorder. It was also essential to the series of careful, logical steps the doctor had to take to get Eichenwald’s epilepsy under better control, as well as to prevent high levels of drugs from further damaging the patient’s health. Finally, it was essential in instilling a sense of trust in Eichenwald, who by then had understandably given up on trusting any doctor, and was hesitant to do anything one advised him to do.

When a doctor talks with a patient about a medical issue, this is not wasted time. This is an integral part of the data-gathering process. Anecdotal information from the patient is equally as valuable as measurements obtained from diagnostic tests. When a doctor does not gather information from a patient, key pieces of the puzzle go missing. The doctor is then forced to jump to conclusions.

I was shocked that no other doctor had spent time talking with Eichenwald . . . but I was not surprised. The same thing happened to me. After encountering a series of doctors who misdiagnosed me and gave me wrong treatments and advice, which significantly worsened my problems, I finally stumbled upon one who was willing and able to help me.

How long had each of the unsuccessful doctors spent speaking with me about my health issues, total?

Yep, less than twenty minutes.

How long did the successful doctor spend speaking with me—during my initial consultation alone!—about my health issues?

Yep, more than twenty minutes.

So, what do we pay doctors to do?

The inquisitive one was having a busy day!

Before work, the inquisitive one went on a run. (The inquisitive one did a speed workout.)

At lunchtime, the inquisitive one took a friend’s dog for a walk. (The friend was out of town and had recruited several people to help care for the dog.)

After work, the inquisitive one took the nephew to soccer practice. (The inquisitive one was helping as an assistant coach.)

“How are you?” said the head coach, when the inquisitive one and the nephew had arrived.

Since the nephew was busy shouting “Watch this!” to another boy, the inquisitive one answered:

“Good! Busy day.”

“What did you do?”

“In the morning, I went on a fartlek run—”

The inquisitive one paused, feeling embarrassed at having said that word while surrounded by 6-year-old boys. But no one seemed to have noticed. So the inquisitive one continued:

“During lunch break, I took my friend’s Shih Tzu on a walk—”

The inquisitive one paused again, feeling even more embarrassed.* But again, no once seemed to have noticed.

It was time for practice to begin, so the head coach said “Cool!” to the inquisitive one and then called out to the young boys:

“Okay, everyone, come over here and sit on your ball!”

All the boys gathered ’round, most sat on their balls, and a few looked attentively at the head coach as he demonstrated how to do a soccer move. Suddenly, one of the boys shouted:

“My name is Poopy Pants!”

All the boys burst out laughing. The head coach continued talking about soccer. He had just quieted them down . . . when the inquisitive one, having reached the last straw in the personal tickle meter, suddenly laughed!

It was a short and loud laugh; and the inquisitive one immediately got very quiet.

Everyone within earshot—young boys, head coach, parents on the sideline, bored siblings—turned and stared at the inquisitive one.

And then, a moment later, and all at once, everyone burst out laughing.

You see, the inquisitive one’s laugh had sounded like a cross between a small dog’s bark, a fart, and a little kid pooping his pants.

And, I mean, that’s funny.

*The inquisitive one could've avoided embarrassment by pronouncing the name of the dog breed correctly.

Everything in moderation, including moderation.

Heard that before?

Now you have, in any case.

Feel free to attribute that quote to me.

After all, I wrote it.

(Look above, if you don’t believe me.)

Take it and run with it, Internet!

Origin of the Quote

Oh, so you require more persuasion before quoting me on that? You wish to know who said “Everything in moderation, including moderation” before I did?

That’s easy—it was my date the other night. We might have been discussing whether we should order more small-plated food. Upon which he uttered the aforementioned string of words. Or perhaps it was another round of drinks that we were contemplating. Or was it dessert? I can’t remember; I was pretty inebriated at that point.

I’m confident that he said it, though. I remarked that that sounded like good wisdom, and that I should write a blog post about that. He remarked that that sounded like an excellent idea. And we flagged down the waitress and put in another order . . . of whatever it was we were contemplating ordering.

In any case, once I had recovered from that bout of immoderation, I decided to investigate the origins of the saying. If you believe the Internet (and—let’s be honest—who doesn’t??), the first part was said by everyone from Socrates to Aristotle to other illustrious, sandal-wearing dudes; while the latter part was tacked on by everyone from Benjamin Franklin to Oscar Wilde to Julia Child, not to mention several less famous, but surely equally redoubtable, personages.

What difference, I ask, is one more soul in this little parade of elocutionists likely to make?

Analysis of the Quote

Lately, I’ve had Taylor Swift’s album Reputation on repeat. Its first song “…Ready for It?” has a relevant lyric:*

I see two extremes here. Trying too hard to win over a crush seldom works. As for not trying at all . . . at first blush, this seems like a good strategy. Swift’s narrator is certainly captivated by the man in question. She launches into an extended fantasy about captivating his desire as he has captivated hers, and all that will happen as a result.

However, if the narrator’s crush is truly not trying at all, is anything likely to happen between them? Doubtful. Sure, she could throw herself at a man who isn’t trying at all to win her love. But if he’s really that uninterested in her (or uninterested in love with anyone, or cynical about any possibility of love), her dreams about him touching her, while they’re someplace with low lighting on some island, begin to sound more creepy than romantic.

The narrator ends the song by repeating these words:

If he’s not trying at all, then the answer is clearly no, he’s not ready for it. Playing a game with someone who isn’t trying at all is no fun at all. But if he’s only acting like he’s not trying, but actually putting in a highly nuanced effort to win her affection? Now he’s starting to sound pretty cool . . . and like he knows something about the wisdom of moderation.

And maybe, while they’re on the island, he’ll ditch the whole moderation thing and go wild!

And then, being the wise man he is, he’ll give Taylor** a good-bye kiss, fly home, and mow his lawn.

Uses of the Quote

In conclusion, I wrote the saying “Everything in moderation, including moderation.” (See the opening line of this blog post, or, actually, to save time, see the previous sentence.)

You can quote me on that.

For example, you can quote me on your next batch of T-shirts, mugs, coasters, knickknacks, wall hangings, notepad covers, or other trinkets you plan to sell on Etsy.

Feel free to go nuts with it!

Just, after you go nuts, back off for a bit.

Moderation, people.

*For a more complete analysis of the song, see the blog post by Clifford Stumme, a.k.a. the Pop Song Professor, called What does "...Ready For It?" by Taylor Swift mean?

**The name of the song's narrator is (coincidentally!!) Taylor.

One of my favorite parts of the novel Eugénie Grandet, by Honoré de Balzac, is a snippet of dialogue. In this brief exchange, Balzac clearly shows how different his characters’ mindsets are. The husband and wife are not living in the same universe!

The snippet of dialogue is also a great example of spin. That is, it shows how the crafty use of language can greatly affect how an audience feels about a person or issue. Check this out. The family has just learned that Monsieur Grandet’s brother was, before he died, a bankrupt:

Isn’t that hilarious? Maybe you had to be there (in the middle of reading the book), but I think this is brilliant comedy. First of all, the wife and daughter are so clueless about the world of finance that they do not know the word bankrupt. Second, while all the characters perceive the words dishonorable and guilty as negative, the husband thinks of them in terms of a relationship with other people, while the wife thinks of them in terms of a relationship with God. Third, the way Monsieur Grandet twists words around is truly—dare I say—presidential.

Here is a checklist for manipulating people by being conniving with language, in case you are interested in going that route:

1. If you want someone to believe something is bad, use the worst-sounding words you can, regardless of their truth. Dishonourable, guilty, and thief are excellent examples.
2. If someone replies to you in a way that doesn’t fit your worldview, immediately condescend them. Do not delay! Delaying will give them a chance to question your authority. You must immediately strike back. Make that person feel that they are wrong, wrong, wrong, and it’s impossible that they could ever be right—unless, of course, they agree with you.
3. If there are established laws or mores that contradict your worldview, use language to paint them as bizarre and nonsensical. Your audience should get the impression that the happenstance of the laws or mores existing have no history; they must have just plopped into the world without people noticing or thinking too hard about them. Make your audience believe that changing these laws or mores is not a matter of critical thinking about issues, but of common sense.

So what is the most dishonorable deed a person can commit?

Honoré de Balzac’s novel Eugénie Grandet seems to imply that, contrary to popular belief, money can buy happiness!

One of the main characters in the novel, Monsieur Grandet, glows with happiness upon learning of the multiplication of his funds, and when beholding his piles of gold. He even, upon receiving especially good news concerning his accounts, literally sings and dances.

But the novel also implies that an increase in money does not cause an increase in happiness for everyone, just for those rare people who are true misers. Monsieur Grandet’s wife and daughter do not experience greater happiness from the acquisition of money. In fact, as the reader is surprised to learn, they don’t even know how much they are financially worth, or that their fortune dwarfs the net worth of many of their neighbors combined!

The tragedy of this scenario is that Eugénie and her mother, not comprehending that they are multimillionaires, also do not comprehend the true nature of their “friendships.” Money-hungry men and their money-hungry relatives come regularly to the Grandet house to court Eugénie. Poor Madame and Mademoiselle Grandet think that these people like them for themselves, not for their money.

At the point that the reader learns of this wretched situation, Balzac tosses in the following aphorism:

“How horrible is man’s condition! He does not own one happiness whose source does not lie in ignorance of some kind.”

It’s a Balzacian aphorism; but is it true? I would like to debate this question with you. I would argue that Monsieur Grandet’s joy in acquiring money would be significantly lower if he were not so ignorant about its detrimental effects on his family, as well as on himself. Further, his wife and daughter would surely have been horrified to learn that the people praising them did not genuinely like them.

On the other hand, ignorance can lead to misery over the long term, as is evident by witnessing these characters’ deteriorating lives as the years pass. Thus, learning key facts about the world, and acting accordingly, can save one from sorrow. It can also bring one a quiet contentment that, while perhaps of a different nature than the bliss of ignorance, is still a form of happiness.

What do you think: is ignorance necessary for happiness?