Practicing Gastroenterology Today: A View From the Bridge

  • Michael Kirsch
  • Published 2008 in The American Journal of Gastroenterology


Consider 2 patients who come to see us for routine appointments. Each is afflicted with the same chronic disease burden. Each tolerates episodic symptoms and adverse effects of medications. Once or twice a year, each is hospitalized for a few days to rein in disease activity that breaks through the therapeutic barrier. These two individuals have comparable medical profiles. We can easily imagine them sitting together in a doctor’s waiting room commiserating about their medical woes. However, in this hypothetical scenario, no such conversation would occur as these two patients have entirely different viewpoints of their situations. The first patient is demoralized, sagging under the weight of his illness and treatment. He focuses on his dark situation and is depressed that he sees no path before him to lead him out of the abyss. He exists. The second patient enjoys his life. He is active, pursues avocations, and maintains meaningful personal relationships. Most often, he succeeds in sequestering his disease into a psychic compartment where it cannot easily molest him. With enough of his illness locked in the dungeon, he has energy available to create a sanguine life. His disease is not his avowed enemy, but is another challenge to manage. He lives. I am not judging these 2 patients, particularly because I have been spared from any chronic medical affliction. Certainly, the first patient described has every right to hate his disease and its destructiveness. However, can there be any doubt as to which patient has the better approach? We have all seen patients who are ruled by their diseases. Those who inspire us, however, are those who rule over their illnesses. How do they do it? Is their optimistic attitude congenital or acquired? For my sake, I hope it is the latter so that I have a chance to see the world as they do.

DOI: 10.1111/j.1572-0241.2008.02146.x

Cite this paper

@article{Kirsch2008PracticingGT, title={Practicing Gastroenterology Today: A View From the Bridge}, author={Michael Kirsch}, journal={The American Journal of Gastroenterology}, year={2008}, volume={103}, pages={2683-2684} }