With Mayo Clinic oncologist Edward T. Creagan, M.D.

A cornerstone of medical management is the history from the patient; a physical examination; and appropriate X-rays and blood studies. For example, if a patient develops cough, thick sputum production, shortness of breath, and fever, and with a haziness on the chest X-ray and an abnormal blood count, the diagnosis in all likelihood is pneumonia and treatment can be prescribed.

What about stress? There is no simple blood study. There is no simple CT scan or X-ray to diagnose the condition. We may be stressed out, frazzled, and not know it.

Let me explain. A recent press release from Southern California addressed the following situation. The patient was a woman in her late forties who was juggling a career; caring for her elderly parents; managing a household; and dealing with the trials and tribulations of two young children. Over a number of months, our individual became irritable; put on 20 pounds because of a voracious appetite; had a profound feeling of unhappiness; and experienced overwhelming fatigue.

A variety of studies were essentially normal, yet the patient was miserable. A conscientious family practitioner took a careful history and added up the number of hours per week that this individual was devoting to others such as her job, her husband, her children, and her parents. "When is it time for me," the patient asked? The doctor informed her that she had to be proactive, she had to be preemptive and carve out time each day for yoga, for meditation, for walking, or just quiet reflection unplugged from all the gadgets that drive us crazy.

So, an important lesson. If we do not take care of ourselves, we are hardly in a position to care for others and after all, if our health deteriorates, nothing else really matters.

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