For those of us who have a driver’s license, education is what we got to pass the written exam; training is the actual lessons in a dual-control car.Â And the difference is that we can drive after being trained, but not after being educated.
What this has to do with a pediatric blog is to understand why we don’t have all the answers.
This lesson was recently driven home to me in a most impressive fashion.Â I drove my son to a weight-reduction camp, and returned a month later to pick up a much different person.Â 16 pounds lighter, yes, but that’s the least of it.Â I picked up someone who learned responsibility, self-respect, self-reliance, confidence, and strength.Â I picked up someone who was trained in all the values I had tried to teach, by precept and by example.Â And I picked up a lesson in what pediatricians can and cannot do.
There was a three day seminar for parents on the last weekend of camp which I attended.Â It was a full-time, all-day, three-day training session which tried to cram into our heads the same information and the same habits which the campers had a full 4 to 8 weeks to absorb.Â For the parents, it was, of course, a partial failure — demonstrating the need for the 4 to 8 weeks in the first place.Â It was a success in setting up for our continued education — by our highly trained children.Â
At the seminar I had the unenviable task of listening to the parents relate the stories of how ineffective their pediatricians were at weight control.Â Obviously I knew that already; not only have I not been effective with my patients, I have not even been effective with my own son.Â This is where education is ineffective by definition, just as it cannot produce a driver, pilot, physician or carpenter; and training is beyond our capabilities: it requires a complete takeover of the patient’s life, with continued vigilance and sticking to the principles of healthy life when they are not necessarily enjoyable.Â Physicians provide services; and weightÂ control cannot be a service.Â It is a way of life.Â It can only come by breaking of prior habits and starting new ones.Â It was no surprise that the camp director was a former paratrooper with a nursing degree; what the campers got was boot camp with compassion and care.Â And for all our medical training, dammit, Jim, I’m a doctor, not a drill sergeant.
Â So let this stand as a most enthusiastic endorsement of the camp in question.Â As for your doctor, by all means, ask his or her advice.Â Try the standard advice we all dispense: family meals (as opposed to eating in restaurants, especially fast food), not drinking your calories (not only are sweetened drinks not good for you, but, contrary to popular opinion, neither are juices), small portions, limiting screen time to less than 2 hours a day (that’s non-homework computer, video game, and TV combined), never eating while watching TV or using computer/video game, eating as much as possible fresh fruits or vegetables, whole grain foods, and low-fat meat and dairy, and increasing activity levels; but we will not come into your home and make you do it.Â Because, to paraphrase a great man, I want to be your doctor, not your mother-in-law.