In one of my favorite sections of David McCullough's biography of John Adams, the author relates a vivid scene of Adams and Benjamin Franklin about to share a room in Newark, N.J., and not being very happy about the prospect.
They argued over whether to keep the window open or not. Adams, saddled with a head cold, didn't want any part of the chilly night air. Franklin enthusiastically sought out the fresh air. Franklin won; the window was left open through the night.
Adams may have been reluctant about the window, because he had a history of colds. He was also into a bit of self-diagnosing. "You know I cannot pass a spring or fall without an ill turn and I have one of these for four or five weeks—a cold as usual," Adams wrote to his wife, Abigail, according to historians. "Warm weather and a little exercise with a little medicine, I suppose, will cure me as usual."
Franklin had his own ailments. He may have had diseases linked to his diet, with biographer Walter Isaacson noting he had gout and kidney stones.
What if Adams and Franklin had been under the care of a lifestyle management coach and physician? Adams would have certainly been encouraged to keep exercising, and he might also have been helped with a strategy to combat his perpetual colds, such as washing his hands more often. And a coach might have introduced the idea that fresh air is pretty good. (Adams, too, had stress issues. I'll get to that later).
As for Franklin, a lifestyle management coach might have led him toward cutting back on certain foods and preventing the gout to begin with.
Today, there is increasing debate about physicians entering into lifestyle management for patients, and seriously, not about whether rooming house windows should be left open or closed. But there are other areas, of more consequence that come into play, including stress, and especially eating habits.
Gout is still an issue in this country, which it was in Franklin's day, as it is often linked to diet. But obesity and the spread of diabetes are becoming of far more concern in modern day America than in colonial times.
And unlike Adams, who sometimes tried to figure out his own health plan, more patients now are turning to physicians for their long-term maladies linked to diet. And the physicians, trapped by time, and in some cases uncertainty involving nutrition, are finding that adding a lifestyle coach to a practice is both good business and good for patients. Others, however, say that lifestyle coaching generally may not be long-lasting enough to truly help patients over the long haul.