Foreword by Dr. Robert Boyd Tober

from "A Nurse Practitioner's Guide to Smart Health Choices"

Carla Mills has written a book that could transform the lives of millions of Americans by showing how we can reduce our risks for major disease. During twenty-eight years as an emergency room physician, I have looked in the eyes of more than 100,000 critically ill patients, and, in so many cases, I have seen tragedies that could have been averted by applying the knowledge in this book.

I have told a thirty-nine-year-old female who had diabetes that she had to have her leg removed because of the lack of a blood supply and the onset of gangrene. In her own eyes, I saw loss and bewilderment ... but only a faint understanding that the cigarettes she so diligently smoked for the past nineteen years had destroyed the last remnants of blood flow to her leg.

I have seen confusion in the eyes of a forty-six-year-old man when I told him he was having a heart attack. Despite his history of high blood pressure, and his own father’s early death from cardiac arrest, he thought everything was okay, because up until that last moment, he seemed to feel just fine.

Serious and often fatal health events result when we remain ignorant of our risk factors for catastrophic illness. At times, my patients remind me of high-flying trapeze artists at the circus. Some people choose to put strong nets beneath them. Others are either confident enough, or careless enough to fly through the air (and life) without preparing for a safe landing. Most of the diseases that I treat are the final result of choices in life that sent patients flying through the air with no nets underneath them. Many of those who plummet downward land in the emergency room, which is the final safety net for those lucky enough to reach it.

Carla has written a book that sets the record straight on just how much choice we all have about how healthy we remain throughout our lives. She has carefully detailed for us just how we can all string “nets of safety” beneath us with our lifestyle choices. She shows us where the largest gaps in our own nets are, and where we are at risk for falling through them.

Sadly, our current healthcare system is overwhelmed and fragile. It is a mistake for us to count on this overstretched system to look after us, and it is not likely to get better anytime soon. We must look after ourselves and take matters into our own hands. That is why Carla’s book is long overdue and so desperately needed. This wonderful and clinically gifted Nurse Practitioner has created a friendly and comprehensible path for us to follow through a maze of controversies in healthcare.

As a physician facing more than twenty critically ill or dying patients during a busy ten-hour shift each day, my primary task is to figure out exactly what is wrong with a patient on arrival. There is little time or opportunity to communicate to patients how the choices they have made have led to the current crisis. I have to overcome a lifetime of abuses in order to stabilize, and hopefully save, the patient’s life. From now on I plan to keep a copy of Carla’s book in my black bag. I am going to ask individual patients to read particular paragraphs or chapters while I run to tend to the next patient.

This book should be required reading for every patient and every practicing healthcare provider in America. If everyone carefully followed the lessons taught here, my business in the emergency room would be reduced by 75 percent!

Yes, there will always be accidents. There will always be bad luck. There will always be infectious diseases and unavoidable health problems, but destiny, for the vast majority of us, is a matter of choice. Carla’s book puts the choice back in your hands.

Robert Boyd Tober, M.D., F.A.C.E.P
Medical Director, Collier County Emergency Medical Services
Medical Director, Neighborhood Health Clinic
Medical Director, NCH Wound Healing Center
Voluntary Professor of Medicine University of Miami School of Medicine