How to Be Seen & Heard in the Doctor's Office
How prima ballerina Tiler Peck’s career-threatening injury paved the way to health & self-discovery
I love the ballet. At Christmastime in the 70s and 80s, my mother would take my brothers and me to the Nutcracker. Getting there wasn’t pretty. The prospect of putting on party clothes and sitting quietly in velvet theater seats for two hours would induce screeches of Noooooooo!!!! The ballet is so boring and long. I have a fever! Actually my head hurts too!!!
A few hours later, installed in our seats and chomping on Jujyfruits and M&Ms, our sulking would melt into rapt wonder. The violins! The glitter! The twinkling weightlessness of dancing fairies and mice!
I credit my mother with getting us to the theater every year. She knew what we needed. To this day, each December I do the dishes and feed the cat with Tchaikovsky blasting in my ears.
Which is why I was thrilled to talk with Tiler Peck, the principal ballerina with the New York City Ballet, on my podcast this week.
Tiler is not only an elite athlete, she has the wisdom of someone three times her age. She totally gets that mental and physical health are inseparable. Naturally, she and I had loads to talk about.
In today’s episode of Beyond the Prescription, Tiler shares her insights about doctors, self-advocacy, and the power of knowing our own bodies and minds. We discuss doctors’ duty to treat the patient — not just their test results — and the importance of more holistic approaches to health and well-being.
So, what exactly put Tiler on this path to self-discovery?
It started with a pain in the neck. In April 2021, Tiler sustained a severe herniated disc in her neck. The injury was completely unexpected and caused significant physical pain, making it difficult for her to move, let alone dance. It also had a huge impact on her mental health and sense of identity.
Tiler struggled with feelings of uncertainty and insecurity. She said, "When you're told that you might not dance or even walk, you start to think, 'Oh my God, what is there? What am I? Who am I? Am I more than just a dancer?'" She sought the support of her long-time physical therapist and consulted with multiple doctors. When Tiler asked one doctor what he thought about pursuing physical therapy before — or instead of — surgery, he asked if her physical therapist would take responsibility should she become paralyzed.
Tiler went from abject despair to dogged determination to heal on her own terms.
Tiler was determined to find a treatment plan that would allow her to continue dancing. She was worried that the surgeons she spoke to, who were opting for disc replacement or fusion, didn't fully understand the unique physical demands of ballet and the importance of épaulement, the position of the shoulders, head, and neck, in a dancer's technique. She said, "They'd say, 'Oh, it's just one segment, so if you get a fusion, you won't even notice that you don't need that,' but I'm not a football player. I need to be able to use my upper body."
Finally, she met with a doctor who saw Tiler as a whole person — and not just the owner of an abnormal MRI. He advised taking time off to rest and rehabilitate. This approach aligned with Tiler's instincts, and she decided not to have surgery.
To be clear: Tiler would have agreed to surgery had her life or limbs depended on it. She is not “anti-doctor;” she is simply someone who asked the right questions and listened to her body. Indeed, the more Tiler used her body as a roadmap, the more she became determined to seek a nuanced approach to her neck.
It was not always the easiest path for Tiler. The injury and its aftermath were emotionally and physically challenging. She has had to take things slowly, gradually increasing the intensity of her workouts and rehearsals as she worked to regain her strength and flexibility. In the process, she also learned more about herself than she ever imagined. From the physical manifestations of emotional distress to the power of saying “no,” Tiler’s seven months of immobility provided her with important lessons about her body and mind.
She’s also had to surrender control and be open to new ways of dancing and being her authentic self. But she was determined to return to the stage. She said, "I'm not going to let this injury define me. I'm still Tiler Peck, and I'm still a dancer."
She learned what I’ve had to learn myself — and what I regularly discuss with my patients — that our personal stories live in our bodies. And that when we listen to our bodies, they can give the instructions to heal. That is what Tiler did.
As a result, she came back to ballet stronger and smarter.
This week, Tiler is dancing as the Sugar Plum Fairy in the New York City Ballet’s production of The Nutcracker!
I will be watching on a livestream as she dazzles millions of eyeballs. Thanks to technology, I can be in my pajamas while wrapping holiday gifts and not in a velvet seat! I also know she will be holding many generations in rapt wonder – The violins! The glitter! The twinkling grace and joy of the Sugar Plum Fairy!
Have YOU ever felt dismissed by a doctor? Or that your doctor has been too quick to make a diagnosis or jump to a treatment plan?
Here are some tips to make sure you’re being heard by your medical provider:
Make sure you explain to your doctor exactly how you work, live, and move your body. While X-rays and MRIs are crucial for making diagnoses, they are only a snapshot. A photograph of your neck, for example, doesn’t tell us anything about how you sleep, move, or sit at your desk. It doesn’t tell us about the stress you carry in your neck muscles or the time you feel off a jungle gym as a youngster. Ask yourself this: Does your holiday card photo accurately reflect your family dynamics and real-world functionality? (Mine doesn’t!) So be sure to explain the relevance of your pain, immobility, or other physical woes to your regular life. It matters more than a photograph.
Make sure you understand the doctor, too. Having been a patient myself many times, I fully understand how it can feel as if we’re not being heard when the problem isn’t actually the medical advice — it’s the communication around it. When doctors are hurried, we might seem disinterested. When doctors understand a problem quickly, we might seem presumptuous. In other words, because doctors have seen a lot of patients and might quickly recommend a treatment plan, patients might assume that we don’t care about the patient, their goals, and even their story. While sadly sometimes this is true, I think many doctors simply lack the adequate time to break down the nuances of their decision-making process to the patient in front of them. As a doctor, I have benefited when patients say things to me like:
Could you explain this to me in a bit more detail?
I want to make sure I understand the risks and benefits of this [medication/test/treatment plan] — could you go over that again?
Could we schedule a phone call when you have more time once I’ve digested all of this information?
Yes, we have lots of training and expertise, but at the end of the day, you know you better than we know you. Our job is to contextualize risk — and not to tell people what risks to tolerate. And yes, doctors are busy and worn out (like many other human beings), but we should never ignore the patient’s story. In it lies the best “data” to help us help patients live longer, better and on the patient’s terms.
Trust is the glue in medicine. Communicating nuance is our forte. We are better off when we allow space and time for both.
HAPPY HOLIDAYS FROM MY FAMILY TO YOU & YOURS!
I will see you next week. Until then, be well.
Love,
Lucy
P.S. A holiday favor! If you have time (ha!), please rate and review the podcast by clicking here and scrolling down to the review section. Most of all, I hope you give today’s episode a listen here, on Apple or Spotify, or wherever you find podcasts!
P.P.S. If you’ve been enjoying my weekly newsletter and podcast, maybe you’d consider giving a paid subscription to a friend!
I think the book, "How Doctors Think" by Jerome Groopman, MD should be required reading. It covers doctor-patient decision making very well, and it is a great resource for patients trying to make the most of the time with their physician. And for doctors, too, who often have their own bias like anyone, it can help them from reaching the wrong conclusion.
Thank you Dr. McBride! This story of Tiler Peck sounds similar in some ways to my own. I was diagnosed in the summer with cervical dystonia and the neurologist said the only treatment was botox. This didn't sit well with me so I did some of my own research and found an amazing program online using neuroplasticity called the Dystonia Recovery Program by Dr. Joaquin Farias who has worked successfully with patients with much more severe dystonia than mine. I'm really excited about this program and I'm glad I listened to myself and my own gut discomfort with botox. I also love what you said about not telling patients what risks they should tolerate. Thank you!