Those Who Mind Don't Matter, Those Who Matter Don't Mind

“Be who you are and say what you feel because those who mind don't matter and those who matter don't mind”
Dr. Seuss

As many of you know, I started writing these weekly messages over three years ago. Because of a request from one patient to keep him motivated, the weekly message series was born. And from that came my book Brain Drain. To some, it seems odd that a doctor would dedicate so much time to write messages and a book seemingly unrelated to medical issues. But you see, the request from my patient a few years ago was not for me to provide him with the latest and greatest medical information. Instead, he asked me to motivate him. Motivate him to do what? Motivate him so that he could help himself; that is, make better lifestyle choices, think more optimistically, live more fully.

For most conventionally trained doctors, as me, the concept of self-help is not readily addressed. Since this is what he asked of me, the best place I thought to look was not one of my medical textbooks, but into myself. What did I begin to find? I found all that I wrote about in Brain Drain. I discovered that most of our thoughts and behaviors arise out of our primitive brain—the automatic brain (AB)—and make us fight or flee all that we should be experiencing in life. All those good lifestyle choices that we ought to be making, we end up fighting or fleeing because somehow they represent danger to us. Not only does the physiological reaction of fight or flight make us feel sick, and eventually over time can lead to medical disease, but the fight or flight from the proper life choices lead us to self-destructive tendencies.

In order to really understand this AB, envision yourself as a cave dweller 50,000 years ago (this brain that runs most of your life is little different now than it was then). You are constantly like a darting, nervous squirrel on the lookout for predators and other Homo sapiens that might harm you. This brain has you in constant fight or flight mode. When you fast forward to the 21st century, you see this same brain is doing the same thing. It is on the lookout for other Homo sapiens that might harm you. That is why one of the single greatest obstructions to proper lifestyle choices and proper life choices in general is the danger of embarrassment—what other people might say or think about you. This triggers your AB to do whatever it takes to remove you from this potential danger (real or imagined). When you do something that might be embarrassing, your AB, automatically detects danger, threat, and vulnerability and drives you to do something about it.

Let’s look at Joe’s situation. Joe asked me to motivate him to make good lifestyle choices. He was obese and because of that had developed Type II diabetes. His greatest fear, because of the diabetes, was that he would lose a limb, become blind, or have to go on a dialysis machine. Because of his obesity, I had no trouble seeing that he was making poor food choices (now those of you who insist it is genetic, remember my previous message that 35% is genetic and 65% is choice, and the ability exists to make the former less). Joe is the chairman of a fraternal service organization (for example, Knights of Columbus). They meet once a week. This is his social outlet, as well as his way to serve the community. Every week the menu is the same: burgers, hot dogs, pasta, wine, and beer. The meetings last 2 – 3 hours and the kitchen and bar are open for the duration. Needless to say, the men consumed copious amounts of food and libation.

I asked Joe to consider two things. First, I asked him to close his eyes and visualize himself as a thin, fit man. Second, I asked him to think what it would be like to substitute healthier foods at his meetings, perhaps lead a healthy initiative throughout all the lodges; after all he is chairman.

I’ll get back to Joe in a minute. Diane called me the other day because she had a panic attack at work. She was so scared and anxious, she exited the building. When I was an intern, at three in the morning, after caring for a young man who had just suffered a heart attack, I placed my head on the nurse’s station for a short nap. Suddenly, my head snapped up and I felt as though I could not breathe. I left the ward and paced in an area where no one could see me.

What do all these events have in common? The fear of what others are going to think of us. For Joe, he continues to make the same bad choices because, one, he cannot envision himself as a thin man because he feels his “largeness” insulates him from being viewed as wimpy. And two, he said the guys would laugh him out of the lodge if he started a “healthy” initiative. “Veggie burgers, whole wheat pasta, vegetables, they’ll think I’m some kind of a freak.”

Something triggered Diane’s panic attack, but what kept it going to the extent that she had to leave abruptly? She feared that someone would notice her. Was I afraid that I was having a heart attack like my patient? Maybe that was the initial jolt. But what kept my “breathlessness” going was the possibility that someone would notice me. Dying of a heart attack somehow did not seem as bad!

As a doctor, I feel my ultimate responsibility is to teach people how to help themselves. This self-help starts with recognizing that much of what we choose to do is to avoid the embarrassment of what others might think of us. In the long run, as with most things when we follow our primitive AB it leads us to a more vulnerable and dangerous place. So, when you make daily lifestyle choices, or need to make more challenging decisions, try thinking about what Dr. Seuss has to say about it. Remove the possibilities of what others might say, and follow your inner guide—the only opinion that really counts.