Surrendering for Better Health

Verso01_1203261263I was traveling for business last week and one evening I relaxed by watching some television (which was kind of fun since I’m not able to watch TV at home). A little channel surfing in the hotel room turned up a World War II documentary that held my attention for a couple of hours.

There’s a lot to find interesting about WWII, but what struck me this particular evening was the similarity of the end games in Europe and Asia. In both cases, at a certain point, the war was effectively lost to the aggressors, Germany and Japan, but neither could surrender. The insiders knew it was over, that it was just a matter of time. Yet still they fought, absorbing overwhelming punishment from the Allies rather than surrender. Much of the death and destruction of the late war period could certainly have been avoided by an earlier surrender.

After the eventual surrender, of first Germany and then Japan, reconciliation and reconstruction could begin. Uncomfortable truths were confronted. Some leaders, not all, were held accountable and it was a very painful time for all concerned. Eventually the situations improved markedly as physical and cultural rebuilding progressed. Today Germany and Japan are modern, friendly nations and our allies despite their wartime behavior. But the Allies’ generosity, charity and forgiveness required for this positive outcome could only come after their unconditional surrender.

It left me thinking about the benefit of “early surrender” elsewhere in life. One thing I’ve learned in my business role is that it’s best to lose gracefully. Pretty often business dealings aren’t going your way, and you can’t always force it. You may be “losing” a deal or a negotiation, or even your job. When losing is a certainty, then it’s best to accept reality, make peace with the situation, cut the best deal you can, maintain friendly relationships, learn from it, and move forward. Easy to say, hard to do.

My thoughts also naturally went to the lifestyle illnesses, like obesity, type II diabetes, hyperlipidemia and hypertension. These conditions typically attack patients as relentlessly as the Allies fought the Axis late in the war. The attacks always begin slowly and, at first, things seem fixable, but they almost never are. Also the lifestyle conditions usually progress despite treatment, which is aimed at the result, not the cause, of the problem. For example the blood sugar and the blood pressure may be lower this year but the underlying diabetes and hypertension are often worse.

Clinicians will recognize the following rough sketches:

  • A little numbness in the feet.  No big deal.  A poorly healing wound on the big toe.  A couple of hospitalizations for surgery/antibiotics to “save the foot.” Toes are amputated here or there.  Gangrene and/or poor healing leads to amputation of the foot.  Bad news.  (And don’t forget this is happening to the other foot too.)  Wheelchair for life.
  • Chest pain, catheterization, stent(s).  Stable, for a while.  More chest pain.  Medical therapy. Minor stroke. Heart bypass and carotid artery bypass.  Slow recovery.  A few decent years.  A big heart attack and another stroke, this one significant.  Years of progressive debility.  Death.

Trust me. It really is like that. Diabetes, hypertension and the other lifestyle illnesses are persistent and remorseless foes for most affected patients. The patients go on fighting, using all the defenses in healthcare in an attempt to neutralize the enemy’s attack. That’s normal in the healthcare world. But for many, the war is lost; it will just take a little more time. If only they could surrender.

Yes, surrender. Surrender is the answer, because what these patients are fighting for is to maintain their lifestyles. These foes are self-made. Our habits create the enemy, but we sure like our habits, even if they are killing us. If patients were to “surrender” their lifestyles and to accept the terms of the peace treaty – less meat, more vegetables; less processed food, more natural foods; less calories fat and sugar; more exercise; a lower body weight; less alcohol and no tobacco – the war would be over and the reconciliation and reconstruction could begin.

Few will do it of course. Surrender is scary. It involves admitting your complicity in the war, and it will cost you your lifestyle, a lifestyle that you probably enjoy. But, be assured, as with the real war example above, the ultimate outcome will be a major improvement. You too can be better, but you have to give up first.

What do you need to surrender to improve your health?