Michael Attas: 'Wisdom of the body' can confound even doctors

Waco Tribune-Herald (TX) - Tuesday, June 7, 2011

Author: MICHAEL ATTAS Guest columnist


He had a fourth-grade education, and was, for all intents and purposes, illiterate.

Yet he raised seven wonderful children and had adopted five others. All had graduated from high school and several from college.

He had 24 grandchildren at the time he became my patient, and was raising one of them.

He called his grandson, “my little buddy,” and his main concern was that he lived to see the boy grow up.

So all of our conversations were filtered around these basic facts of his life — what we could do to make sure that he lived to provide care for one of his grandchildren.

He had a combination of a serious valve abnormality of his heart as well as critical coronary artery disease.

He needed open-heart surgery that would consist of both valve replacement and coronary bypass. The odds of him living one year without surgery was 50 percent; he had less than a 5 percent chance of living two years without surgery.

That was five years ago, and he still is living a full life and raising his grandson despite all medical odds.

He chose to have a stent inserted in his coronary arteries, and declined valve surgery.

He knew the statistics, and made his decision and was willing to live or die by that.

He always spoke of himself as a “dumb” county boy, yet he had a deep wisdom about his body and science that was hard to describe.

It was “street life” smarts and not book smarts.

I respect that kind of integrity, and feel that he made a decision that in all honesty was best for him even though it went against every grain of my judgment as a clinician.

He seemed to have what I call a wisdom of the body — a deep understanding of his life when placed in the context of his body and diseases that we all share.

Why some people have this innate body “wisdom” and others do not baffles me.

It is not a matter of education. It is not a matter of socioeconomic class, wealth, status or religious beliefs.

It transcends race or ethnicity. Some people just seem to “get” their bodies and how they will respond to various treatment options much better than we health care professionals do.

As health care professionals, we come armed with science, statistics, even years of accumulated experience.

And we make our suggestions for treatment options, and can even get entrenched in patients doing what we want them to do.

Some physicians will even go so far as to terminate the physician patient relationship when a patient makes his or her own call.

Yet when we are honest, we know that all science can do is approximate a certain reality, a certain truth.

We often see through the glass darkly, and we are all reminded from time to time how limited and fragile our knowledge can be.

There are times when patients make their own decision and it turns out poorly — and all of us involved have a tendency to look at those cases with regret, hindsight or even resentment.

But like my patient, the grandfather, there are also numerous times when the patient “knows best” and the so-called collective wisdom of the experts are left lacking.

Wise patients will often listen to their body and their life’s journey and make sound decisions completely on their own.

And it is our job as healers to listen to those stories, respect their authenticity, and maintain our jobs as best we can in the face of what seems to be incredible odds.

Dr. Michael Attas is a local physician, a medical humanities professor and an Episcopal priest. Email him at Michael_Attas@baylor.edu.

Section: accesswaco
Record Number: 15397326
(c) 2011 Robinson Media Co. LLC - Waco Tribune-Herald

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Michael Attas: 'Wisdom of the body' can confound even doctors

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