"Mom, what did the doctor say about your liver function tests?" Martha and her mother Leah spent plenty of time on the phone the days before the follow-up doctor visit talking about what this abnormal blood test could mean. With a heavy sigh Leah said, "Well, the doctor looked like he was having a hard day, and there were lots of people in the waiting room and they looked very sick, so I didn't ask." Martha said, "If you took care of yourself with just a fraction of the nurturing you give to everyone else in the whole world, you would be in great shape."

Leah's life is guided by two words: "Be nice." In her perfect day, everyone gets along, she anticipates and meets the needs of others and goes to sleep knowing she's a worthy person because people tell her so. Leah avoids conflict and she would never dream of making a scene. When she gave the cashier at the grocery store a $20 bill for a $7 item and got back $3 she didn't say a word. Her perfectionism usually heads off criticism, but sometimes it backfires. She tried to help her adult son, who said with annoyance, "Mom, stop being such a people-pleaser." Leah's darkest fear is that she will not give enough and wind up all alone, abandoned by her friends and family.

While being nice sounds like a good idea, there's a problem. It doesn't work. People pleasers often take care of others at the expense of themselves. Activities that promote health, like the daily walk and a good night's sleep are sacrificed when someone else is in need. Trying to avoid or ignore conflict and anger is like trying to hold a beach ball under water. Unexpressed feelings can pop up as physical ailments, such as heartburn or depression or back pain. When your value as a person is defined by what other people think about you, and you don't measure up, food or alcohol medicate the emptiness.

If you're a people-pleaser who gets sick, the same behaviors that got you to the doctor in the first place may stand in the way of getting good health care. You might not want to "trouble your doctor" with your problems. If you have side effects from a medication, you might simply stop taking the pills rather than tell your doctor that you want to try a different medication. A cross look from the front office staff when you ask for a copy of your medical record may be all you need to decide that you're not doing that again.

The bottom line is that being nice can be hazardous to your health. It erodes your health and impairs your ability to get better if you're sick.

I invite you to examine how being nice is working for you. Serving others offers great rewards. Serving at the expense of yourself comes with a huge cost that ultimately limits your ability to serve. You can be freed from the imprisonment of people-pleasing. If you want to treat yourself with more love and respect, here are some thoughts.

Re-think being nice.
People-pleasing is a learned behavior that can be unlearned. Although habits may be deeply ingrained, small changes can make a huge difference. Next time you're asked to volunteer, instead of jumping in with a "Yes", say, instead, "I'll get back to you on that." You will come to understand that "no" is a complete sentence, and you can utter the word! If you can't imagine doing this, use this "fake it till you make it trick"...tell yourself that you're taking care of your children's father, your mother's daughter or your pet's owner.

Take care of yourself every day.
Get exercise, nutrition and rest every day. Do something that recharges your batteries every day no matter what. It's a cliché, but when you're on a plane you're instructed to put on your own mask before taking care of others.

Bring an advocate with you to the doctor.
Engaging in acts of self-care, like going to the doctor, can feel like swimming upstream to a people-pleaser. Being nice takes the form of being a good patient who doesn't make waves.

Here is something critical to remember: You are not there to take care of your doctor; your doctor is there to take care of you. In the past you may have made your medical choices by raising your antennae and tuning into what you think will make your doctor happy. You certainly want your doctor's opinion, and in most cases you will agree with your doctor's recommendations. However, sometimes getting good care means making waves, like asking , "What are the other treatment options?" or requesting a more complete explanation or seeking a second medical opinion.

While it's always a good idea to take a second set of listening ears to a doctor appointment, it's particularly important if you're a people-pleaser. An advocate will assure that you and your health care team stay focused on taking care of you.

Accept help.
People-pleasers can give from dawn to dusk, but they rarely accept help, even when they're sick. When I ask my patients who are people-pleasers how it feels to help a friend struggling with illness, the answer is a broad smile. Then I remind them that when they accept help, they give their friends a chance to have those same good feelings.

If you are a people-pleaser, your heart might be racing. I assure you I'm not asking to give up serving others. I'm suggesting that a healthy life is a life in balance, and I encourage you to treat yourself as nicely as you treat others. When you take care of yourself, you offer us the gift of most fully who you are. Then you can really serve.

It's more important than ever to take an active role in your healthcare. The best way to get top-quality, safe and effective healthcare is to actively and knowledgably participate. Visit MedicalBridges.com for the tools to get you there.

Copyright © Vicki Rackner MD, 2005
Vicki Rackner, president of Medical Bridges, is a board-certified surgeon who left the operating room to help employees become active participants in their health care. She is a consultant, speaker and author of the 'Personal Health Journal', author/editor of 'Chicken Soup for the Healthy Heart Soul' and author of the lead story for 'Chicken Soup for the Breast Cancer Soul.'

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