Things I Don't Say to Patients

1. Get plenty of rest. 

Rest treats fatigue, but that’s all. I tell patients with minor illnesses to stay in bed only if that’s where they want to be.

2. Watch your diet. 

For minor illnesses, proper nutrition isn’t very helpful. If you have no appetite, forcing food down makes you feel worse without accomplishing anything useful.

3. Drink plenty of liquids. 

There are two problems here.

A.  More water evaporates during a fever, so replacing it is a good idea, but a healthy adult can safely ignore this for a day or two. If the fever lasts longer, a doctor’s first step is not to replace liquids but to find out what’s happening.

B.  Since the dawn of history, people have believed that a sick body is full of toxins. This is common sense (almost always wrong when applied to your health). Nineteenth century doctors prescribed drugs to produce vomiting or diarrhea, and patients knew this worked because they could see the smelly stuff pouring out. We no longer believe in “purges”, but enthusiasts (doctors among them) still believe that urinating expels toxins, so they advise you to drink 6 or 8 or 10 glasses of waters a day.

4. Be sure to take aspirin or Tylenol. 

“But then the fever came back,” patients tell me as if this were bad. In fact, these drugs wear off after a few hours. The fever of common infections won’t harm a healthy person, and aspirin or Tylenol won’t shorten the course of any ailment.  It’s all right to take them to feel better but not essential.

5. Keep warm.  Keep cool. 

We shiver when our tem­perature rises and sweat when it falls. That’s how the body warms up and cools down. Shivering or sweating are not necessarily ominous signs; nor is it good “when the fever breaks.”

A Doctor's Routine

“Under your tongue… under your tongue… close your mouth… don’t bite!”

Seeing a thermometer, the guest had unbuttoned his shirt and lifted his arm. Over much of the world, doctors take a temperature in the armpit. It’s often a struggle to make them understand.

Once the thermometer is in place, I announce that I will wash my hands. This produces minor panic, and someone rushes to the bathroom to tidy up. After returning and announcing the temperature, I sometimes take the blood pressure. It’s not useful for most ailments, but patients, especially the elderly, often expect it.

After the examination, I announce the diagnosis and hand over an appropriate medicine. Then I give advice. You probably think it differs from patient to patient, but this is only partly true. I give several bits of advice regularly. These include:

“Rest doesn’t make this go away any quicker.”

Despite the universal belief, this is true for almost every illness, and it’s miserable to be confined to a hotel room during a vacation. I encourage sick guests to get out.

“You’ll feel bad for a few days, and then you’ll feel better.”

Once a doctor performs his magic, patients often expect immediate results. I receive plenty of calls the next day from guests wondering why they’re still sick.

“If you call, I answer in person.”

I demonstrate by holding up my cell phone. Of course, your doctor also encourages you to call, but have you tried? You reach voicemail or, if you’re lucky, a receptionist, and then you leave a message and wait. I want to spare patients this hassle. But I also don’t want them to call the hotel to let them know they’re not feeling better.