Register now to:
- access free premium content from The Lancet and its specialty journals;
- comment on blogs and share your opinions;
- and stay in touch with the latest news from TLS.
Recently, I attended a global health presentation about the worldwide shift from infectious diseases to chronic ones. When current medical students go into practice, ailments such as diabetes, hypertension, and obesity will be rampant. Many researchers attribute this change to improvements in healthcare; or in other words, patients can now live long enough for certain conditions to develop.
In the midst of the tables and diagrams in the presentation, our group debated different policies and initiatives. We made a list of lifestyle changes that could be shared with every patient. Many hospitals and physician offices have pamphlets offering advice for management. Prevention and lifestyle advice are essential components of treatment for current and future patients.
However, after I was home, reading the end of a novel, I realized that something was missing from our discussion. The thought came to me as I studied the novel’s main character. She struggled with obesity as a result of depression and parental neglect. It was only when she cut ties with an abusive family member that she was able to adapt a healthier life, both physically and emotionally.
In the same way, each patient will also have a different, complex story when it comes to his or her chronic condition. A list of lifestyle changes is not akin to a list of medications that can be dosed and prescribed to consistently work. When I saw a patient who was resistant to a particular antibiotic, I was able to look up a substitute. The path is not as clear when it comes to prevention and lifestyle advice.
In addition, for two patients with similar chronic conditions, an underlying psychiatric concern might the culprit for one while a genetic mutation may be responsible for another. With the increase in chronic conditions, specialized care is even more imperative for treatment.
While tracking trends through graphs is important, it does not cover the entire picture. Instead of viewing patients as entire populations, it’s effective to remember them as individuals with needs.
Each case will be unique. The definition of adequate healthcare will continue to change but certain themes always prevail. Evolving medicine and novels have one significant lesson in common: while the stories might appear similar, they rarely are.