How you live dictates how you die—but where to start?

The gap between knowing and doing . . . .

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It was just a few months into my new position as a family physician in the heart of the South after 10 years on the West Coast. I was just re-discovering the sweet tea, fried chicken, Coca-Cola, and Little Debbie habits I had forgotten were so commonplace.  Don’t get me wrong, EVERY place in the U.S. is struggling with a processed food addiction, but the South unfortunately leads the charge in terms of the MOST unhealthy diet in the world.

            My next patient was a 58-year-old smoker with heart disease, lung disease, and diabetes. He had lost enough weight for me to ask if it was our error on the nurse’s note.  He said “No error- I did what you said.” Somewhat shocked, I replied, “What did I say?”

            “I went plant-based!” he said.

            Truly stunned, I tried to remember what I had said to him.  But the truth is, it’s not about what I said—it was about HIS readiness and confidence in that moment. He was a truck driver, and told me he had simply brought a cooler full of plant-based food with him on the road. I happened to present the evidence based suggestion of a plant-based diet at a time when he was motivated and ready. The seemingly obvious barrier of his profession and the typical highly processed “interstate” diet was not a barrier to him

Over the following months, we worked as partners, reducing his medication doses, and eliminating some meds entirely. His diagnosis of diabetes was removed (one of the BEST rewards as a Lifestyle Medicine doc!) and at a subsequent visit he mentioned nonchalantly that he had also quit smoking. “I was eating so clean, I thought how could I keep smoking?”

I wish I could say it was so simple for everyone, and that he never faced a relapse. I can’t. We all have challenges, addictions, obstacles, or environmental situations that slow or even halt our progress. I mention this story not to falsely present simplicity in the very complex world of behavior change and Lifestyle Medicine, but rather to create HOPE.  Also, because this patient completely shifted my close-minded idea of which patients could and would succeed.  Though support and knowledge is important, a well supported, well educated, seemingly “in charge” patient is not a “shoe in” for lifestyle change. Rather, our perception of obstacles and connection to purpose seems the great equalizer.

As I continued in this Tennessee family practice, I saw the most inspirational transformations. The key to health behavior success is to answer: WHY do you want to live longer? We must recognize that health is not the ultimate endpoint but is a pivotal means to fulfill our purpose. Within this context, we can begin to succeed.

            As a physician, I strive to partner WITH my patients, rather than play the “doctor dictator” as trained. This shift in focus from the prescription pad to the patient-made “action plan,” gives you, the patient, a sense of POWER and CONTROL over your own vitality, RATHER THAN HOPELESS DEPENDENCE on the pillbox and ever-increasing medical bills.  I am so inspired by a patient who transforms herself from a medical victim into a personal health owner and advocate!

Are you interested in starting your journey to true health? Would you like to create a community around health promoting lifestyles? Start with a few questions and then find a Lifestyle Medicine physician to support and partner with you on your journey. Here’s how:

  1. Answer this:  WHY DO YOU WANT TO LIVE LONGER? Play with grandkids? Learn the guitar? Contribute to a cause?
  2. BE PRESENT. Get kindly curious about your daily habits: Nutrition, Physical Activity, Sleep, Stress. Notice what your regular habits are and ask if they are getting you closer to your purpose.
  3. Ask: WHAT AM I READY TO SHIFT? For example, if you smoke, there is no doubt you do this for a reason. That reason is most likely NOT because it will lead you closer to the health you need to achieve your purpose, right? More likely, you smoke because of stress or frustration. If you are not ready to quit smoking, don’t start with that. Try something you are ready to do, like adding some self-care or stress management techniques. Build your confidence, and then readdress it thereafter with compassion and honesty.
  4. Write down a REALISTIC and SPECIFIC action plan. What WILL you do? This is not the time to wistfully dream. It’s better to walk for 5 minutes every day, than to write down a plan for 1 hour at the gym on 5 days per week and not do anything. After a month of daily walking, you have the habit building confidence and you can consider moving up from there. There are plenty of tips on how to make a “S.M.A.R.T. (Specific, Measurable, Attainable, Realistic, and Time-bound”) health goal available. Check out
  • Once you have written down your action plan. TELL SOMEONE! Find a friend health care provider, or health coach who will help you stay accountable.
  • If you don’t succeed, don’t criticize or give up. Rather, REVISE your action plan and pat yourself on the back for any shifts you did make.
  • Celebrate your wins and keep going! ONE STEP AT A TIME WITH YOUR “WHY” IN MIND.

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