Calvin and Hobbes On Life and Patient Compliance

07-29-2008 | Categories:

Clinical Info

Calvin: Let’s say that life is this square of the sidewalk. We are born at this crack and we die at that crack. Now we find ourselves somewhere inside the square and in the process of walking outside of it. Suddenly, we realize our time in here is fleeting. Is our quick experience here pointless? Does anything we say or do in here really matter? Have we done anything important? Have we been happy? Have we made the most of these precious few footsteps?

From Calvin To Compliance

Calvin’s use of the sidewalk as a metaphor to explore the meaning of life triggers Donald B Ardell, in Calvin, Deep Questions And Promoting Exercise, to apply the same questions to the value of health education:

Worksite wellness professionals and other coaches and mentors should raise this kind of question, in their own fashion, now and again. Like Calvin, everyone wonders if anything we say or do really matters, if we have done anything important if, in short, we have made a difference? I suspect most worksite wellness promoters and other health educators of varied kinds have a hard time convincing themselves they have. I’m not sure about this, either.

Happily, there is some reason for cautious optimism. The post continues,

A few years ago, a study indicated that what we say does matter, what we’ve done is important and what we do does make a difference! It seems that as little as three hours of counseling over a two-year period can make an impact, if not on meaning of life matters that Calvin raised, at least on adult physical fitness. The two-year research project compared three types of education and counseling, all varying in intensity. Sponsored by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, the findings suggested that all manner of counseling seems to work equally well in for increasing the amount of physical activity. A special focus of the research findings was targeted to medical doctors, who were urged to engage in such counseling with patients. A summary of the study appeared in the August 8, 2001 edition of the Journal of the American Medical Association. “The study shows that doctors and their medical staff can help their patients, especially women, increase their physical fitness and that such an effort doesn’t take much time,” said NHLBI Director Dr. Claude Lenfant.

Commentary

I chose to post on this issue because (1) I’ve long been a big fan of Calvin & Hobbes so I jumped on the first semi-legit rationale to feature them on this blog, and (2) Donald Ardell makes an important point that isn’t often emphasized on this site.

Although I am a dedicated proponent of a tailored approach to improving compliance (i.e., selecting the most efficacious compliance-enhancing interventions for a given patient or patient group) and, indeed, promote that stance in a commercial venture,¹ there is substantial evidence, including the study Mr. Ardell references, that brief, non-specific counseling from a healthcare or wellness provider to exercise, to follow a healthy diet, to quit smoking, … can be effective for at least a portion of the population.² Given the small amount of time and the relative ease of offering such advice, there is little excuse not to do so and, as Calvin and Mr. Ardell would point out, profound gratification in providing this service to our clients.

For the record, Calvin and Hobbes do offer another approach to motivating others.