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    Heart Healthy Choices

    Interview of Denise L. Davis, M.D.

    This is a transcript of the Audio: Heart Healthy Choices. To listen you may download download Windows Media Player External Site.

    Dr. Denise Davis: I'm Denise Davis. I'm an internist in Berkeley and very interested in preventative care of patients. I'd like to intervene before the crisis happens and I'd like to help patients care for themselves before a crisis occurs. As we move past the Neanderthal stage in medicine toward care of the whole person and away from crisis management toward prevention, there are opportunities at every visit for a patient to coach him or herself or for me to provide some coaching towards prevention.


    Good results occur frequently when patients change the way they eat and change the way they exercise and I've seen patients, one woman comes to mind whose cholesterol dropped 100 points when she went from a high saturated fat diet to a very low fat, high fiber, colorful plate diet and began to exercise regularly. The colorful plate diet is a plate overflowing with a variety of fruits and vegetables, whole grains, a small portion of lean protein and very small amounts of good fats. An example of a good fat is olive oil, my daughter's favorite on pasta, and other good fats include the oils that are in almonds, walnuts and avocados. Those good fats don't clog the arteries. The fats that are solid at room temperature, as I like to encourage my patients to visualize, become a solid fat in their arteries also and can contribute to stroke and heart attack.


    Important choices include care of the body in terms of diet, the healthy diet that I've already described. But those choices also include emotional healthy choices, good relationships, what I call sticking with the winners, surrounding one's self with people who are encouraging and models of success, not in terms of success only financially, but success in terms of meaning and purpose. There are also good choices to make in terms of education, whether that education is formal or informal. So patients who know more about their health and come to me with printouts from the Internet are a step ahead of the game. I'm happy to be seeing patients who have begun to educate themselves before the doctor visit. And lastly, the broad realm of meaning in people's lives. I think that good choices include making choices for meaning, for creating a better world and having a greater purpose and a calling in life. That connection to purpose and meaning can affect people's health in many ways. It lowers stress levels and lowers the chemical composition of the body that negatively influences health, so lower fight or flight hormones like adrenaline result in a lower heart rate and lower blood pressure and a better overall feeling of good health. That's important.


    Young women have a right to high quality healthcare. They have a right to work with a doctor or other healthcare provider who is respectful, compassionate, listens well and gives those young women a range of options in terms of caring for themselves. Doctors like that exist. There are many of my colleagues who are experts in all of those areas. And because in relationship-centered care, we acknowledge that relationships between a doctor and patient are reciprocal, the patient can help the process along by coming prepared with goals, coming prepared with questions and thinking about what's most important, even before the visit with the physician.


    Relationship-centered care is a term coined in the '90s by a group of doctors who had gotten together to formulate criteria for good holistic care of patients, not just focusing on the nuts and bolts and the physical health, but focusing on what then was known as the biopsychosocial school of medicine. It is a mouthful, but simply put, we recognize that the relationship between the doctor and the patient is the foundation for all healing and therapeutic activity. That trust and reliability and compassion not only are pleasant for the patient and the physician, but result in better control of diseases.


    For instance, we know that patients with diabetes have better control of their blood sugars when they have a good relationship with their doctor. I think that it's all right to ask for what we want as patients, so that if we need a little extra time to discuss an issue that may be sensitive and requires some education, that we can ask for that and I encourage my patients to do so. I have in my practice a cadre of young women who are making excellent choices in their lives.


    Many of my patients are young women who have already devoted themselves to their own education and are pursuing formal education, either as undergraduates or graduate students and whose focus is not on popularity or makeup or young men, but instead on making a difference in the world. And I've had a few patients who have already served in the Peace Corps or other service organizations and who have a dream for their lives and I'm quite certain that they will make a difference in our world.


    I want to hear your concerns as a young woman. What you think and what you feel and what your concerns are -- are my concerns. I want to know more about how you feel about school and what your goals are. I want to know more about what you eat and whether you're eating a diet that's healthy. I want to know more about what kinds of physical exercise you do on a regular basis. Do you enjoy running, do you enjoy swimming and do you avoid sitting on the couch and watching television. I want to know more about who you love and you like and who teaches you about healthy living. I want to know more about what your goals are, not just over the next week or the next month or the next semester, but what your goals are for what I hope to be a long and happy life.


    It's helpful for me to start young women on the right path by remembering four aspects of health.

    1. The health of the body with eating and exercise,
    2. the health of the emotions, the feeling life, choosing people who are good influences,
    3. the health of the mind, learning more about one's self, learning more about the world, reading, listening to programs just like this one about better health
    4. and then the realm of meaning and purpose in one's life. Whether young women get that through Girl Scouting or church or synagogue or mosque, it's not important to me where they get it, but that they do receive that wonderful teaching that is bound to lead to success.


    (Recording Ends)

    - INTERVIEW CONCLUDED -

    Go to the Heart Health Audio Web Page


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