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Dr. Lane’s Thoughts About His Aging CDL Patients
It occurred to me only today (11/23/2024) that I have had a misconnect with my patients concerning their health. I know that I have often been impatient with my CDL drivers when they tell me that they try not to take their medications for high blood pressure or for diabetes because they ‘don’t need them” or because they ‘checked their blood pressure today’ on their home machines or ‘their doctor told them they don’t need to take their medicine daily (a complete lie – no doctor ever told a person with HBP that they don’t have to take their medicine daily unless the reason was because of a huge weight-loss in a person 50 years old or younger).
These people who I serve are not trying to be recalcitrant or stubborn insomuch as they are upset and sad about their health because they are aging. It is not the cost of the medicine or even the mild side-effects, it is not the schedule or the responsibility of taking medicine – it is the fact that their body needs intervention of some kind that is not due to a catastrophic (like an auto accident or a disease event).
What these people are upset about is that they have clear memories of being young and every doctor’s visit ended with the words “He is healthy and growing fine. See you in a year.” Maybe there were vaccines or a few issues that crop up in a normal lifespan but each visit was routine and seemingly unnecessary because everything worked perfect in this guy’s body.
Now, he is getting older and sicker by the day because he is no longer young and this guy is mad and sad and feeling like his health is no longer under his control. When he was young good health meant running outside to play a game with his friends or to cut back on bad food (sweets or soda or, later, alcohol).His body returned to ‘healthy’ very fast.
As an adult the good health he expected from his youth has been replaced with medicines, EKG machines, colonoscopies, fecal-testing, and other things that monitor him for bad problems and are the basis for declaring him ‘unhealthy’. Why would anyone want to learn about what is bad about themselves when they feel good and can meet the expectations of being a good husband, father, friend, son, and neighbor?
It isn’t the wrinkles or extra weight that bothers them about getting older, it is the degradation of their body and the slowing of their responses – that constant message of a pending terminal stage of life.
These men do not just want to say to me ‘I’m fine, I don’t need anything’ they want to say it to the world, “I don’t need any help! I’m young and healthy!” It isn’t just about their health; it is a message that they want to tell their children and friends – ‘this high blood pressure is temporary’ or ‘this diabetes will pass’ if they are just given a little while to get back to the gym or eat better food. The men resent that anyone feels that help is needed.
In their past the gym or changing their food was a complement to their already steady healthy state and now it is being increasingly urged on them in a way that suggests ‘the gym and changing your diet is no longer a possibility in your life; these things are necessary and immediate means to STAY ALIVE!’
I know that all these men should get screened regularly, especially for heart disease and cancer, the two leading causes of death. Even if you feel healthy, even if you believe you’re free of genetic risks, just get those checkups, colonoscopies and calcium scans – it is all that I can do to urge them to look into these tests to indicate a present or pending problem.
But to return to the premise of this essay – these men find these messages irritating and depressing. The real issue isn’t their bodies and health, it is psychological: what happened to me and my youth that now I must be vigilant to signs and signals (both visible and invisible) to the slow decline of my youth and a constant drumbeat that each day is closer to my end.
I am only a CDL medical examiner and am no more that a observer of the tide of humanity that comes through my office; a witness to men as providers and workers who want to push back their health to a times of youth and the calendar cruelly tells them that ‘this is not possible; intervention is needed.”
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