Viewpoint

Physician, heal thyself!

FROM THE CHIEF MEDICAL EDITOR

Larry E. Patterson, MD

When I’m performing an evaluation for ocular surgery, occasionally a patient will ask, “What’s the worst thing that can happen during the operation?” I usually look them straight in the eye, and with a hint of impish insincerity reply, “I could die while performing your surgery.” After a moment of mental digestion, the patient and I usually enjoy a big smile together and then I go into the risks of surgery that could happen to them. (Hey, you have your bedside manner, I have mine.)

But it makes me wonder. We doctors spend a lot of time making sure our patients are healthy, and sometime neglect ourselves. I could spend a lot of time talking about my strong feelings about fitness and nutrition, but for a moment I want to revisit a topic I touched upon when I turned 50. Well, last month I turned 55. Yep, I’m now quite officially one of the old doctors.

Back in 2009 I wrote about taking a mental function test. Not an IQ test, but something that helps determine how well your mind is functioning, how well you can learn and remember. I was devastated to score near the 50^th percentile. I really thought I was smarter than that. The doctor said I needed something new to stimulate my brain. So I embarked on an aggressive aviation training program, studying hard like I was back in college, learning tons of stuff about all things flying and getting my pilot certificate in just a few months.

I returned the next year for follow-up testing, and my scores improved to the 95^th percentile. Why? Research at that time hinted that our brains are like our muscles: use them or lose them. And a new article in JAMA Neurology confirms this (JAMA Neurol. June 23, 2014; Online First). The study of 1,995 Minnesota seniors showed that those at higher genetic risk of developing Alzheimer’s disease could change their future mental health outlook. If they completed more school and continued a life of intellectually challenging pursuits they could — sit down for this one — delay the onset of life-robbing dementia by nearly nine years! Even simple tasks like reading and playing music turned out to make a huge difference.

Keep in mind this was a well-designed prospective study that started back in 2004. The authors concluded, “Lifetime intellectual enrichment might delay the onset of cognitive impairment and be used as a successful preventative intervention to reduce the impending dementia epidemic.” I think this is news we should share with each other and our patients alike.

An update on me. Last year I did a follow up at the clinic and took that test again. While I haven’t studied to the degree I did six years ago, the testing showed my mind functioning in the 91st percentile. I think jets, turboprops or helicopters are next. Although with what’s happening in the regulatory and reimbursement environment, I may have to settle for something with a bit more financial restraint.

Sudoku anyone? OM