Person on the Page

I closed my eyes and imagined myself at the edge of a glistening brook.  A bare breeze rustled the leaves on the trees surrounding me as water gurgled gently over smooth stones. The sky’s cloudless blue cast a pastel peace over the scene. Here in this imaginary place, I felt my face, my shoulders, my arms relax as my heartbeat slowed.

Then the examination room door opened, and a woman in a white coat entered. The scene by the brook disappeared, and with it my self-induced relaxation. The woman, a nurse, prepared to record my vital signs before my consultation with the doctor. My eyes adjusted to the room’s harsh lights as I rolled up my sleeve so that she could place the blood pressure cuff on my arm. I dreaded what was coming.

My home blood pressure monitor has a three-color system for displaying results.  Green means that the measurement falls into the preferred range.  All is well. Yellow means that pressure is elevated. Better keep an eye on it. And red indicates full-blown hypertension. At home when I take my blood pressure, it generally falls into the green range, with an occasional yellow.

Let’s just say that when the nurse took my blood pressure that day in the exam room, the numbers were fire-engine RED.

Now that I’m older, I suffer from White Coat Syndrome, a recognized physiological response to being in a medical setting. When I go to an appointment at a hospital or doctor’s office and am greeted by health care professionals, whether they are wearing white coats or not, my blood pressure zooms from green to red, no matter how resolutely I breathe, visualize or meditate.

At age 65, I become anxious at the thought of going to a doctor. What unsuspected malady could a lab technician uncover that might spell the beginning of the end?  And those twinges and other minor physical discomforts I took for granted over the years? They may have been the early warnings of some catastrophic illness that will make its debut as a physician approaches with a stethoscope. Now when I visit a doctor’s office, I’m scared.

“Are you taking medication for hypertension?” Ms. White Coat asked. “Your blood pressure is very high.”

“No, I’m not,” I replied. “I don’t have high blood pressure.”

She stared at me.

At that point, I felt like a teenager confronted by her parents about staying out past her curfew. I had some creative explaining to do. Ms. White Coat seemed to think I was lying.

At home, I check my blood pressure routinely. My fitness tracking watch keeps tabs on my pulse and the amount of time I spend exercising. I pay attention to how many calories I consume and strive to eat health-promoting foods. I do these things because I believe we can play a major role in maintaining our wellness. I believe we have a high degree of control over our health.

But a question repeats in my mind: “Do we really?”

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My favorite pop culture health and nutrition gurus preach that we do. Neurosurgeon and CNN medical correspondent Dr. Sanjay Gupta, for instance, insists that the level of control we can exert over our own health is significant, and that healthy habits such as regular exercise, a diet low in processed foods, mental stimulation and social connection foster wellness.

Physician and author of blockbuster bestsellers How Not to Die and How Not to Age, Dr. Michael Greger tells us,

We have tremendous power over our health destiny and longevity. The vast majority of premature death and disability is preventable with healthy lifestyle behaviors. We have to take personal responsibility for our own health.

I want to believe them. I do believe them, most of the time.  But when I go to a doctor’s office and am confronted by a Ms. or Mr. White Coat who wants to know why I’m not taking hypertensive medication, when I don’t think I have hypertension, my faith is shaken. Despite all the control I try to exercise over my health, when my blood pressure suddenly rises into the red zone, I feel that I have no control at all.

Facts are facts. The blood pressure reading taken at the doctor’s office was alarming. The nurse continued to stare at me as I insisted that my readings at home are much lower. She then explained that, even so, an instance of White Coat Syndrome can be an indicator of a collection of physical conditions known as metabolic syndrome, which may include elevated blood sugar and cholesterol, obesity and developing hypertension. My fire-engine red reading might be a warning of these other possible threats to my cardiovascular health.  Or, the nurse admitted, it may be what is known as White Coat Effect, an overreaction of the sympathetic nervous system in response to visiting the doctor.

“We need to keep an eye on this,” she said.

When I returned home from my appointment, I did exactly that. 

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I began measuring my blood pressure three times a day and recording the results on a spreadsheet. I color-coded the readings to match the colors designated by my monitor so that as I looked at the spreadsheet I could see easily how often my blood pressure was low, elevated or high, and so that I could detect any patterns that might emerge.

After several weeks, the spreadsheet was a sea of green with a rare yellow here and there. Just as I expected. 

I know I am lucky.  I have enjoyed good health for most of my life.  I am grateful for that. 

And I recognize that we do not have full control over our health. Genetics and environmental factors exert their influence. Our most heroic efforts to promote our own wellness may not be enough to counteract those factors. I may not like that fact, but I understand it. Still, I cling to the hope that we can exercise some control and, as a result, enjoy a high quality of life.

I imagine myself taking my mostly green spreadsheet to my next medical appointment to show that, despite whatever alarmingly red reading my anxiety produces, I do not have high blood pressure.

See, Ms. White Coat?  I wasn’t lying. 

Cover Photo: Property of Author