When the Body Says No: What 25 Years in Medicine and My Own Health Journey Have Taught Me
By Dr. Maribel “Bella” Khoury-Shaar, MD
Collaborating Physician, Monarchs Therapy
For more than 25 years, I have had the privilege of practicing primary care medicine.
Like most physicians, I was trained to listen carefully to symptoms, review lab results, look for patterns, make a diagnosis, and develop a treatment plan. We ask questions like: Where does it hurt? When did it start? What makes it better? What makes it worse?
All very important questions.
But after more than two decades in medicine—and through my own journey living with multiple sclerosis—I’ve learned there may be another important question worth asking:
What has been happening in your life?
When the Doctor Becomes the Patient
Being a physician gives you knowledge. Being a patient gives you a completely different kind of education.
Living with MS has taught me that firsthand.
Suddenly, I wasn’t only the person wearing the white coat and explaining what came next. I was also the person sitting on the other side, experiencing uncertainty, frustration, vulnerability, and all the emotions that come with living in a body that doesn’t always cooperate with your plans.
And believe me, my body and I have had a few disagreements.
MS has required me to slow down at times, adjust, listen more carefully to myself, and accept that health isn’t always something we can neatly control.
I want to be very clear about something: I don’t believe that stress, trauma, or difficult emotions simply “cause” illnesses such as MS. Human health is far more complex than that, and people should never be made to feel responsible for becoming ill.
But I do believe our emotional and physical well-being deserve to be considered together.
A Book That Made Me Think Differently
Recently, I read When the Body Says No by Dr. Gabor Maté.
I didn’t agree with or interpret every idea as an absolute medical explanation. That’s probably the physician in me—we can be an annoyingly skeptical bunch.
But the book made me stop and reflect.
It challenged me to think more deeply about something I had witnessed throughout my career: the relationship between stress, emotional well-being, relationships, boundaries, life experiences, and the way people experience their physical health.
And I began thinking about many of the patients I’ve cared for over the years.
Sometimes a patient comes in with fatigue.
Or headaches.
Or difficulty sleeping.
Or stomach problems.
Or pain.
Or a racing heart.
Of course, as physicians, we investigate physical causes. We should. Medicine matters. Science matters.
But sometimes there is another part of the person’s story waiting to be heard.
They may be caring for an aging parent. Going through a divorce. Grieving. Struggling at work. Living with anxiety. Feeling isolated. Carrying responsibilities for everyone around them while quietly running on empty themselves.
The lab result is important.
So is the story.
We Are Not Two Separate People
Healthcare has traditionally been very good at dividing us into specialties.
There is a doctor for your heart. Another for your stomach. Another for your nervous system. And another professional for your emotional health.
Specialization has given us extraordinary advances in medicine.
But the person sitting in front of us is still one person.
There isn’t a physical version of you who walks into your doctor’s office and a completely separate emotional version who walks into your therapist’s office.
You bring the same heart, brain, history, relationships, worries, hopes, and life experiences into both rooms.
That’s why I’ve become increasingly interested in a more collaborative approach to care.
A Different Chapter in My Career
After more than 25 years in primary care, I am entering a different chapter in my life and career.
Part of that means taking a step back.
For someone who has spent much of her life caring for other people, “taking a step back” sounds wonderfully simple until you actually try doing it.
I’m still working on that part.
But slowing down has also given me the opportunity to think about what I want the next chapter of medicine to look like for me.
My role as a collaborating physician with Monarchs Therapy has allowed me to look at health through a wider lens and to work alongside mental health professionals who understand parts of a person’s story that may not always surface during a traditional medical appointment.
I bring the perspective of a physician.
They bring the perspective of mental health clinicians.
And most importantly, the individual brings something none of us can provide for them:
their lived experience.
The goal isn’t for a therapist to become a physician or for a physician to become a therapist.
It’s for us to recognize when our worlds intersect—and to communicate, collaborate, and care for the person rather than just one piece of them.
Sometimes We Need to Listen Differently
October is a meaningful month to have this conversation because World Mental Health Day reminds us to bring mental health into the open.
But perhaps we can go one step further.
Instead of only asking people to talk about mental health, we can become better listeners.
As a physician, I have spent much of my career listening.
But experience—and MS—have taught me to listen differently.
Listen to the symptoms.
Listen to the science.
Listen to the body.
But also listen to the person living inside that body.
Because sometimes the most important part of someone’s medical history isn’t found in their chart.
It’s found in their story.
And after 25 years in medicine, I’m still learning.
I think that’s one of the beautiful things about being both a physician and a human being.
There is always more to learn.
— Dr. Bella