The other day i was eating lunch at a restaurant near my clinic, talking to the owner about vegetarian mexican food. he's this great chef who can do wonders with eggplant. a friend of his came in who looked really familiar to me but i couldn't totally place him. i said hello and we tried for a few moments to connect. well, it turns out that he remembered who i was later and found me in my clinic for a medical problem. he had been a patient of mine when i was a resident at the Family Practice Center in Albuquerque.

I was shocked he was still alive. When I had met him then, he was barely recovering from congetive heart failure with cardiac function below 20%. he had been advised by cardiologists and others to basically not move, maintain a sedentary lifestyle and cross his fingers for a few months or a year to live. I felt a little nervous then about advising folks against the advice of specialists, being a resident and all, but it was clear taht strategy was not going to work for this man. He was used to hard work and had alot of personal motivation.

So we worked out a strategy for him to slowly increase his exercise as tolerate, that he might have a sudden heart attack and die, but he was clear that just sitting around doing nothing was unacceptable. So after a few months his exercise tolerance improved from 2 minutes to 20 minutes. He was back on his farm working the fields (at a little slower pace than before) and his ECHO cadiac test showed remarkable improvement, if i remember correctly, up to about 50% function.

So here he was four years later still alive and healthy! so much for fear based medicine. and thank god that some patients actually take it upon themselves to teach us doctors about reality.

aziwa