My patients are, despite what some may say about patients with heroin addiction, a fun-loving group. Some of my favorite moments in my medical practice are the times when we chit-chat. While some patients don’t always feel up to “yukking it up”, most are game, and usually I am as well.

I like to talk to patients about food. When I am taking a history, I’ll often inquire about nutrition. I used to say, “Do you eat a balanced diet?” and they would respond, “Sure, I guess so.” Then I’d ask, “Do you eat vegetables?” and they’d say, “Uh, sure, I guess so.”

Then, I discovered what has been a breakthrough in our conversations about food. Now I say, “I’d like to know a little about what you eat. Tell me what you had to eat yesterday.” Usually they pause, sometimes laugh because they think it is a weird question, and then proceed to tell me in great detail. “Well, let’s see, yesterday I had 3 bowls of cereal, an orange, a salad, and a piece of pizza.” I’ll try offering a little counsel, acknowledging and applauding their fiber intake, helping them identify problem areas (like a quart of ice cream per day), and suggest moderating the high-fat, low-nutrition choices. 

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I’ve also found a good way to talk about fiber. For some patients in any setting, it’s hard for them to grasp what fiber is, where it comes from, and what it does. I have had patients say, “Well, steak is very fibrous, does that count?” So, I say, “If it grows in the ground, it has fiber. You want to eat more things that grow in the ground. If it walks on the ground, there is no fiber, and you want to eat less of that.” Often, they look like a light bulb is going off, and say “Sure, I get that!” Mission accomplished.

Sometimes when they tell me what they ate yesterday, it sounds good, and it’s always a bonding moment when I respond, “Hey, that sounds good! Now I’m hungry!” They’ll laugh, we’ll chuckle a little, and on we go with the medical visit.

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A patient I saw recently was very hungry, and he was talking about how good a fried egg sandwich was going to taste when he got home from the clinic. I told him how good that sounded to me, and we exchanged a warm fist-bump. I recalled to him my grandmother making me and my brother fried egg sandwiches on toasted white bread when we were kids. I loved those so much; in fact, I still do. On rare occasion I will fry one up at home (usually when my wife is away) with 2 eggs over easy, loaded with pepper, slid gently between 2 pieces of multigrain toast, with mayo and sliced white onions. I think you’ll agree it doesn’t get much better than that. 

In moderation, of course.