2011 is almost gone and God willing, 2012 will be with us soon. While this message is directed to my patients, I urge all patients to read this and to discuss them with their Doctors. They are my impressions on practicing in Ghana and based on that my hopes for the New Year Resolutions of my patients. In fairness, I have seen aspects of these things to a limited extent elsewhere. First, we need to take better care of our general health. I have been surprised at how many people drink heavily and how much they drink. In addition, far too many of us travel at night—the time when most of our accidents occur. Furthermore, it is regrettable that so many do not do basic health checks that are routinely done elsewhere. For instance significant numbers of female nurses, while admitting awareness of mammograms for breast cancer screening, concede that they have never had them. If the nurses who should educate the public are themselves not getting tested, how can they educate the public to get tested? Too many of us have never even had our blood pressure checked. Given the complications of high blood pressure, we should try harder to get our blood pressures regularly. While on this topic, we should eat better, exercise more and be careful who we sleep with. My next issue is on how we prepare to visit with our Doctors. Too often, many of my patients did not know their ages, their medical history or their medications. As they keep telling me again and again, “Me kogye insurance no na wo ma me bi nso miwire afi” (When I went for my insurance they gave me an age but I have forgotten). Many show up to see health professionals without their medicines or the ability to name them. As every healthcare professional reading this can attest, age, past illnesses and medications are very helpful to the Doctors and nurses in determining what is wrong and what to do. The next issue is how we interact with our Doctors. It seems too many patients are too afraid of their Doctors and sometimes, their nurses. Many patients, when asked why something was done for them or to them, profess ignorance. Even very well educated people, when asked whether test results had been discussed with them, will answer in the negative. It is common for a patient to say “The Doctor just looked at the test and gave it back to me.” One would expect that if the Doctor failed to initiate discussion of a test, the patient would ask. For instance, a simple question like “Doctor, was my test ok?” can lead to a discussion. Too often, this failure to discuss things with Doctors affects our health. It can affect the dosages and frequency of medications as well as the times for follow-up. Indeed, this does not just stop with patients. Sometimes nurses, pharmacists and lab personnel who have not understood Doctors orders have done the wrong things. For instance, I once ordered Glycosylated Hemoglobin, which is a test for monitoring Diabetes. When the patient showed up two weeks later, she had results for Hepatitis C. While the way HbA1C is written may look like Hep C to the uninitiated, the laboratory technician should have called. The error was repeated a few times and I had to write a note to the laboratory involved. Another issue, which has a bearing on our health, is how we relate to our friends and family. Too many of us are walking around with too many grudges and pains. These may be from difficulties in our marriages, with our children, our siblings, our parents or our friends. Often, we cause ourselves a lot of stress by dwelling on these problems. We are reluctant to forgive. And yet these grievances hurt both those who hold them as well as those against whom they are held. Indeed, they hurt those who hold these grievances more than those they are held against. As a result, they lead to higher blood pressures, ulcers, anxieties, depression and more drinking. Finally, I have been very concerned about the role of our faith in our health. I remember vividly two stories. The first was in connection with politics. I had gone to visit with party faithful in a village when I was informed that one lady was unable to come out and see me because she had a swelling of the foot. I decided to go into her house and see her. She had a right foot that was swollen, warm and obviously infected. She felt hot. When I advised her to come to the hospital to be treated, she replied that she had been told that her illness was “sunsum yareba” (spiritual illness) and that she needed prayers, not medicine. It took quite a few days to persuade her to come into the Central Regional Hospital where she had surgery under anesthesia, together with intravenous antibiotics and made a rapid and uneventful recovery. The other case was that of a priest, running a prayer-for-health camp who had come to see me because of headache that turned out to have significantly elevated high blood pressure. He was started on blood pressure medicines and counseled about diet and other things. I could not help wondering whether the lady who thought she had a “sunsum yareba” may have ended up in his prayer camp even while he was seeking care voluntarily with me. I recall driving, two decades ago, to an Indian Reservation with a Doctor to see an American Indian man who had gangrene of the foot from Diabetes. We pleaded for an hour for him to come to hospital for antibiotics and surgical evaluation of the foot but he refused. He said his Spiritual leader had told him he was going to die and that it would be futile to get into hospital. He died two days later. We should see prayers and the work of health professionals as complementary. The best amongst my profession know that it is difficult to be an effective healer without faith. Based on these experiences, let me suggest the following as New Year Resolutions: 1: I pledge to take better care of my health by reducing or quitting drinking, sleeping with one partner and or using protection and seeking, with the help of my Doctor, tests that will detect illnesses early and improve my health. 2: I pledge to prepare better for my visits to health professionals by taking my old medicines or medicine containers, tests and cards, to provide information during visits and ask questions to clarify information. 3: I pledge to forgive and to seek forgiveness from those I have wronged, to reconcile with my enemies and thus to reduce the stress levels in my health so that I can lead a healthier life. 4: I pledge, before or even while seeking prayers for my illnesses, to make sure that I have been evaluated by competent health professionals who are practicing by the Grace of God. 5: I pledge that whenever possible, I will travel during the day rather at night, to reduce my chances of getting involved in accidents. May God guide and guard all of us through a very successful 2012. Let us move forward, together. Afehyiapa! Afio Afe! Fe yeye Nami! Happy New Year! Arthur Kobina Kennedy, MD University of Cape Coast – Cape Coast Email: arkoke@aol.com 12th December, 2011