On Securing Your Own Mask Before Assisting Others Or: Physician, Heal Thyself by A. White-Stern

Ashley Paige White-Stern considers herself an ethnographer and writes about her journey from food to medicine at “The Spoon and the Sword.” As a future physician with academic mind, she plans to integrate several fields, including ecology and population health.  Follow her on Twitter at @MsAPWS.”

“You’re premed,” she said, surprised.  “I never would have guessed that.  Most of the premed students I see on campus don’t take very good care of themselves, and they really aren’t interested in fitness.”

This was the response of the personal trainer I was seeing on campus when I mentioned that I was undergoing a deep revision of my own personal health habits, spurred by a recent fitness challenge I had undertaken.  What started as a mere thirty-day workout regime had blossomed into a new level of fitness and a deeper appreciation for athleticism, proper nutrition, and health.

 What has shocked me about this journey into the land of health and fitness is how rogue it is: there is quite an array of myths and faiths, various levels of expertise, not a little charlatanism, as well as misinformation, posturing, false gods and promises, and so on.  There are a few – a very few – doctors who attempt to clamor above the din, but by and large, the prophets of fitness are self-appointed, and they may or may not be trustworthy.

Doves on a Building by M. Pitter
credit: M.Pitter/In Parentheses

Why is this?  Why are physicians so sparsely populated in this terrain – a terrain which in all honesty could (and I would argue does) have a significant impact on public health broadly speaking, as well as the individual health of so many?  And what about the health and fitness of our doctors themselves?  When was the last time you went to see your physician and thought to yourself, “gracious, I want to be healthy like that”?

I’m not (yet) in the position to answer these questions, but I am in the position to do something: and what I have chosen to do is to make a simple, fundamental commitment.  I commit, as a future doctor, first and foremost, my own optimal health.  This may seem blasphemous, but it is entirely reasonable, and is very much in the vein of the safety announcements on airplanes: put your own oxygen mask on before assisting others.  Even if the others are children or infirm elderly.  In the field of medicine, I will interpret this as a commitment to making sure that I am – first and foremost – well rested, nourished, and hydrated.  It means that the cornerstone for my professional success will be a commitment to mental and physical balance.  It means I will take the command “physician, heal thyself,” more or less literally, making sure I’m fit to be dispensing advice or health care to others.  It does not mean that I will not have moments when I will have to push myself to deliver care, nor will it mean that I will act self-interestedly.  It means, however, that I know I will be most effective and wield the most influence over my patients as one who leads by example.

It is important to make these declarations and commitments early on in this journey.  One reason is accountability.  The central reason, however, is in response the famous quote of Rabbi Hillel’s “if not now, when?”  If I don’t cement the habits of health and nutrition now, how can I be expected to do so once I’m in medical school, or in residency, or when I (God willing) have a family of my own?

We are, unfortunately, expected as ambitious doctors of the future, to make non-insignificant sacrifices in order to prove our thirst for the profession.  Yes, sacrifices I have made: I have missed important family birthdays, school reunions, countless social events.  There have been nights where I have not slept enough (tonight will be one of those nights).  Dating has proven to be close to impossible.  And yet, I refuse to sacrifice my habits of health: I realize that being balanced, whole and integrated is requisite to healing others with integrity.

So, I push on, through this premedical program, and deeper still into a journey to discover my own most vibrant self.  I wish it didn’t need mentioning, although it probably does: health and nourishment does not refer to 100-calorie snack packs or Jenni-O Lean Cuisine Low Carb Turkey dinners.  Or whatever people consume that has been marketed as “a smart food choice.”  Proper nourishment means a plant based diet, as locally derived as possible, minimally processed, lightly cooked: food you can purchase at your local food co-op, farmer’s market, or pick up at your CSA farm share.  Likewise, fitness refers not to a particular physique but to an overall state of body that involves cardiovascular health, general flexibility and suppleness, muscular strength, and agility.

Although it seems not always to think so, the world of medicine has a role to play in the public discourse on health, food, and fitness.  All too often, it seems, dieticians and nutritionists are seen as second tier professionals, while the “true” guardians of health could often use an overhaul of their diet and exercise practices.  This has been, but does not always need to be the case.  The tide is turning, and more young doctors are importing lessons learned from yoga class, or sustainable agriculture.  I’m looking forward to contributing to these developments; to impacting public health by safeguarding it, to using principles of fitness and nutrition as preventative medicine, and thereby to bring integrity to the fitness industry as well as to medical practice.

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