Insights into Healthfulness – THE DOCTOR IS IN

By: Dr. Frank MacMillan – May, 2015

This month, twenty years ago, I had conferred upon me a Doctor of Medicine degree. It has been both an honor and a privilege and I have had an amazing experience practicing in our community, from Lowell to Newburyport, and from Boston to Manchester, NH. During this time, I have also gone from being a young man with very few personal health related concerns, to being a parent, a husband, and now a middle aged man with a large practice of patients with health concern, from anxiety to serious and life threatening disease. While I still believe myself to be an aging young man, I am more mindful of the struggles that we all face regardless of age, and more personally attuned to the risks and fears we all will face eventually.

Having turned 50 earlier this year, I have reached a few milestones reminding me of my own risk of health consequences of aging and of some of my own lifestyle choices. Like many my age, I have accumulated a lot of responsibility and stress. I have a family in need of housing, food and education. I run a business with people who need to be paid a decent wage and benefits. I have a panel of patients who need access to information, medicine, testing and counseling. On a personal level, I quit smoking at age 20, have struggled with staying at a reasonable weight and getting enough exercise, and worry about heart disease and cancer like many of my friends and family.

As it turns out, the benefit of medicine to good health and longevity turns out to be not so much individual healthcare, but rather in the realm of public health. Since the end of the second World War, our life expectancy has nearly doubled. Things like clean water and air, safe food, vaccinations, and reduced tobacco exposure far outweigh standard medical interventions like control of hypertension and cholesterol as far as gains in life expectancy are concerned. Our most serious public health challenges include persistent tobacco use, obesity and the epidemic of opioid addiction.

Recent experience with Ebola virus and others, tells us that it is abundantly clear, that we also live in a global world where infectious diseases can be transported and exported to the opposite side of the globe within a matter of hours, making a lack of good governance a direct risk to our own national security and public health. Failed states like Afghanistan, even Pakistan are reservoirs of poliomyelitis infection that threaten our well being. For better or worse, we are our brothers’ keepers.

So, my words that I want to impart on my community for better health are straightforward. Individually, the most bang for your buck is to not smoke cigarettes to begin with, and to quit right now if you are doing so. Physical addiction is 2-3 days at the most, and withdrawal is unpleasant but not intolerable. Change your brand, so you don’t enjoy it as much, pick a date, and if you cheat, forgive yourself and resolve to be a non-smoker the following day. Do that each day until you are free of the habit.

If you are overweight, understand that obesity kills. It can be beaten, but understand we all need to eat. Eating fewer sugars and starchy carbohydrates will make you less craving of more food, and easier to lose weight. If you are already diabetic, fewer carbs will make it easier to reduce medication or insulin, making it easier to lose weight. Weight loss needs both diet and exercise. Do your best to do both.

Get yourself and your kids vaccinated. The link between vaccination and autism is completely debunked. Not to say that there are no risks to vaccination, but autism is not one of them. If you are not appropriate for vaccination due to immune deficiency or egg allergy, etc, you depend on “herd immunity” to keep you well. It is in everyone’s interest for near universal vaccination for serious vaccine preventable illness.

Lastly, infectious diseases are a serious threat to public health. Failed states require our attention whether you are liberal or conservative. There is an obvious political dimension that we need to accept as the most consequential and powerful nation on Earth. Poor governance, failed public health infrastructure like as has been seen in West Africa with Ebola virus, is an immediate threat to our own public health in the United States, and Band-Aid solutions like travel bans are not an adequate response. If you doubt that statement, I am interested in how you will be solving the problem of illegal immigration.

In the US, we are blessed with a robust local, state and national public health infrastructure. Do your part by supporting good governance, clean water and air, tobacco cessation, vaccination and responsible diet and exercise. We need better strategies to deal with addiction. We also need economic opportunity to reduce government dependency and empower families to succeed. Success depends upon shared commitment and understanding that we are all in this together. Your efforts will help others. You know what you need to do. Now go do it.

mACmILLANDr MacMillan specializes in Gastroenterology and Liver disease and is a member of the North Andover Board of Health. Dr Macmillan was recently elected by his peers to be vice Speaker of the House of Delegates at the Massachusetts Medical Society, and alternate Delegate from Massachusetts to the American Medical Association. Dr MacMillan is on staff at Holy Family Hospital Haverhill and Methuen, Anna Jaques Hospital in Newburyport, Lawrence General Hospital, and Parkland Hospital in Derry, NH and is the President of the Massachusetts Gastroenterology Association. Dr MacMillan also serves as Massachusetts Governor of the American College of Gastroenterology and is a Fellow of the College.