New Books in Medicine

Lisa Doggett, "Up the Down Escalator: Medicine, Motherhood, and Multiple Sclerosis" (Health Communications, 2023)


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Lisa Doggett, MD, MPH is a family and lifestyle medicine physician and an award-winning author based in Austin, Texas. In 2009, she was diagnosed with multiple sclerosis. At that time, her daughters were 2 and 4 years old, and she was the director of a clinic for people without private health insurance.

Multiple sclerosis (MS) is a chronic disease of the central nervous system (brain and spinal cord) that often affects young adults. It can manifest with many different symptoms, and its impact varies from very mild to very severe. While there's no cure yet, medications to manage the disease and slow its progression have improved tremendously in the last three decades. There has also been a lot of research investigating the connection between lifestyle factors (like exercise and diet) and the disease's progression.

In 2023, Lisa published a memoir about her journey with MS: Up the Down Escalator: Medicine, Motherhood, and Multiple Sclerosis (Health Communications, 2023). The book (available as a paperback, e-book, and audiobook) depicts episodes from various facets of her life in the years following the diagnosis: her attempts to tackle the symptoms of MS, parenting challenges and milestones, and big personal goals, like running a marathon. Lisa also shares the stories of several patients and the everyday struggles of running a community clinic. As both a physician and patient, Lisa has a unique view of the health care system. She often contrasts her experience with the experience of her low-income patients.

Up the Down Escalator tells an impressive and often humorous story starting with an episode from Lisa's medical residency and ending with her first marathon. At the same time, the chapters can also be read as independent and thought-provoking essays. In the interview, we also hear about Lisa's journey as a writer: about her journaling habit, her op-ed pieces, and how a growing number of blog posts and articles slowly turned into this book.

A big part of our conversation discusses Lisa's recent career shift into lifestyle medicine. She has always been a "health nut", who exercises every day and follows a healthy diet. Through her MS, she has learned a lot about lifestyle's role in chronic conditions. In her work as a family physician, she often observed the complex interactions between medical, socioeconomic, and lifestyle factors.

All these interests and experiences have motivated her to explore the emerging field of lifestyle medicine. It's an evidence-based field focusing on the prevention, treatment, and reversal of chronic diseases via therapeutic lifestyle interventions. It's relatively new (the board certification was introduced in 2017), but it incorporates decades of research. Its six tenants include: a predominantly plant-based diet, regular exercise, restorative sleep, avoidance of unhealthy substances, stress management, and connection with others.

In 2023, Lisa obtained board certification in lifestyle medicine. Since then, she's been working at the Multiple Sclerosis and Neuroimmunology Center at the University of Texas at Austin. She supports MS patients in setting personal goals and adopting healthier habits. Lisa tells us how she partners with neurologists and other specialists at the center, and how medication and lifestyle factors work together to increase the chances of a better outcome and manage symptoms.

Links: 

  •  Lisa's website
  • American College of Lifestyle Medicine
  • Texas MS 150 Bike Ride
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    New Books in MedicineBy Marshall Poe

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