The Eleventh Commandment
by Mike Litrel, M.D.

inconsiderate, unworthy slob.

Hence the Eleventh Commandment: Thou shalt not sigh when a woman is talking to you.

After all these years, to my complete astonishment I broke the Eleventh Commandment just the other day.

I was listening to the complaints of a new patient in my office. For twenty minutes she did her best to explain what was bothering her. She did not feel like herself. She was unhappy. She didn't have the energy she used to have. She was simply not enjoying her life.

It is an honor to be a doctor. Strangers come to you, trusting, seeking your help to make their lives better. Often, you really can help someone - and let me tell you, nothing puts a smile on your face faster.

But after a decade of practicing medicine, you also develop a pretty good instinct for what is not fixable. Physical complaints are generally fixable. Pain, bleeding, bladder leakage - these we know exactly how to treat. But emotional complaints are more subtle - and ironically, more common. The underlying cause can be elusive. You take a history. You run tests. You rule out any serious disease, or substance abuse. You also look at hormone deficiencies, or whether counseling might help.

As I listened to my patient, I couldn't help but think about the probable outcome - that eventually, through a combination of treatments, she might feel better, but that we might never know the exact answer to her problems. And as I ran down a mental checklist of all the things we needed to look at - it happened.

I let out a big fat sigh.

I knew immediately what I had done from the look on my patient's face. I apologized profusely. (That's the Twelfth Commandment, by the way, but that's another story.) And I explained what I was thinking.

We all live two kinds of lives. One is our life as a biological organism. The other is our life as a spiritual being. As biological life forms, we suffer from physical ailments. These can dull our enjoyment of life. We take care of these ailments with medicine, surgery, or lifestyle changes.

But biology is only the mechanism of living. The reason for living is spiritual. Not only emotional suffering, but physical suffering as well, is often a manifestation of underlying spiritual issues. There is no way to test for these problems and they are not fixable with a pill - hence my frustration.

But each problem we experience carries gifts from our Creator - the gifts of understanding, and of grace. We must have faith to understand this. But when we approach our problems from this viewpoint, we are able to see the purpose to our lives. And we begin to understand that God has made us so much more than just this body we inhabit.

I sigh, because I can only do so much. We sometimes watch the people we love suffer needlessly. We cannot fight their battles for them. We can only bear witness.

My patient and I spoke together a long time. In the end, a few diagnostic tests were arranged, and a book or two recommended. She would renew herself for that very personal journey we all must make, toward real health - of both the body and the spirit.

I look forward to hearing about her journey, and to helping her as I am able. And despite my sigh, or maybe because of it, I think we departed friends.

Dr. Litrel is a surgeon in private practice with Cherokee Women's Health Specialists in Woodstock and Canton. He is a Clinical Professor at Emory Medical School and the Medical College of Georgia. Dr. Litrel lives in Woodstock with his wife Ann and their two sons, Tyler and Joseph. (mikelitrel@attbi.com)

Years ago when we were newlyweds, my wife Ann taught me a valuable lesson. It was a lesson so important that I have come to call it the Eleventh Commandment.

"Thou shalt not sigh when a woman is talking to you."

The circumstances were as follows: Ann was asking me about something monumentally urgent. To be specific, my dirty socks. How did they end up in the living room? Especially, how did one sock end up on the floor, and the other in the branches of our new ficus tree?

I was stumped. How should I know? I must have been in a hurry when I took them off, I guessed.

Mind you, I had something important of my own going on at that moment. I was watching a football game. As I recall, I was rooting for Michigan, who actually had a chance of going to the Rose Bowl that year.

Speaking years later as a board certified women's health expert, I can tell you now with authority that when a woman asks you a question while you are watching a sporting event, there is a correct way to respond, and an incorrect way. The correct way is to turn down the volume, look deep into your beloved's eyes, apologize for being a ____________ (fill in the blank - in this case, an inconsiderate slob), and promise to never do what you just did, and have been doing all your life up until now, ever ever again.

And there is the incorrect way. Men have an instinctive hesitation to admit guilt. It's actually an inherited trait, passed down on the Y chromosome through untold generations of males. It's the fear gene - the fear being that once you admit guilt for one thing, more interruptions and accusations will only follow.

So instead of admitting guilt, I emitted a sigh. It was a big, heartfelt sigh, and in it was the implicit communication that not only did I not care about where my socks had ended up, but also that I would really appreciate it if Ann would talk a little less during the game, and smile a little more. And maybe bring out some chips, too.

The afternoon didn't go too well after that.

The details of the football game have faded in my memory. But the emotional bruises from fifteen rounds of spousal conflict still linger. You see, women have a tendency to put up with a lot from men. They notice all sorts of little things that bother them, but which they usually choose not to mention. And unless you strategize well, these things come pouring out all at once at the most inconvenient moment conceivable, in a barrage of words that drive home the point that you as a man are basically an