Ageology: Dr. Paul Savage. July 1, 2013. Photo by Andrew Collings.Honesty is the first chapter in the book of wellness.

Every patient who walks through my door wants or needs something.  Sometimes they don’t know what it is and they need my help to figure it out.  Other times they know exactly what they want and look to me to help them achieve their goals.

Either way, the first step to success for every patient is the same:  Honesty — with themselves and with me.

At first blush it may sound as if I’m stating the obvious, but experience has demonstrated that the vast majority of patients who are unsuccessful in meeting their wellness goals are not honest with themselves.  By extension they cannot be honest with me.

I have experienced this challenge over and over in my practice, and the outcomes are always the same.  Without honesty there is no success.  It’s important to note that when I talk about patients being dishonest, I am not speaking about people who are willfully lying.  Often times, patients have altered perceptions of reality, they believe what they need to believe to continue functioning at any level, they simply don’t know the truth or where to find it.

I’ve run up against the honesty challenge personally as well.  For a large portion of my life, in fact, I experienced first-hand the terrible toll dishonesty takes on one’s self – physically, emotionally, spiritually and mentally.

I am a gay man who grew up in a different time and in a place where gay was largely considered a “choice” that could be “willed” away.  And like many gay men of my generation I passionately hid who I was in an effort to live up to what society expected me to be:  Not gay.

I lied to myself and to others for years, and the fear of being “discovered” consumed me.  I did not realize it at the time, but my being dishonest affected my health, my self- image, and my ability to accept and give love.  My dishonesty bred fear.  Fear bred stress and fear and stress stand as the enemies of health and wellness.

My many achievements during those years did not quench my shame.  I became a physician.  I launched a successful career in emergency medicine.  I was a good person. I strived to be an excellent doctor.  Still, when I looked in the mirror I saw a man who was burned-out, overweight and tired.  I saw a man who was lying to himself and to others. When I did finally look that man in the eyes, told him that he needed to go get help, to find someone who could teach him how to become the man which he wanted to be.

That was when my path to wellness truly began.

It may seem strange to read about the challenges of a medical doctor.  We tend to keep our “failings” to ourselves in an attempt to appear strong to our patients.  Very often this is what us doctors think that patients need us to be.   But I am an integrative metabolic medicine (IMM) doctor and I practice what I preach.  As such, I believe that sharing my personal insights helps patients see that there can be a path forward, and that the first step has honesty indelibly etched on its well-worn surface.

Integrative medicine physicians treat the whole patient – body, mind and spirit.  We reject the traditional approach to treatment that evaluates a set of symptoms and prescribes remedies piece-by-piece.  The traditional approach simply masks most problems and in some cases doesn’t even accomplish that much.

IMM asks questions, it doesn’t simply seek lab numbers.  IMM asks why and how and who and, by the way, for how long.  Our goal is simple:  to help every person seek his or her own truth so that they can live healthy lives of quality and meaning however they choose to define them.

In practice, this means helping patients who have obscured their personal truths by encouraging them to take small steps toward accepting their larger, honest reality.  For the obese patient who insists he “really doesn’t eat all that much,” it might mean encouraging him to keep a food diary for a week.  Once he sees that he really is overeating and accepts it, for example, he can then take the next step, which might be learning to control portion sizes and limit snacks. Setting a small goal and helping him accomplish it will show him that he has the strength to take the next step, and the next and the next….

The bottom line is this:  Without honesty, finding a true path to sustained wellness is littered with weeds.  Weeds are ugly.  They obscure the beauty of the garden and frequently have thorns.  Ultimately, this means that the patient cannot find their way to wellness and health until they truly embrace step one:  Be honest.