Let Me Tell You, the Fat Lady's Gonna Deafen You With That Aria

I saw this yesterday, but didn't have the chance to comment because the blog was down. Make sure to follow the link to Jeff's commenter, Sarah.

Leaving aside my wondering what this rebuke would have sounded like if it came from this guy's mouth (new season starts September 13th! WooT!), I will admit to being of two minds on this one. I sympathize with the doctor. He was just telling the truth, and there's certainly no shame in that. However, I also emphathize with the obese woman: in an effort to get her to change her wicked ways, the doctor apparently laid out the worst case scenario and, in the process, insulted her. While I can understand why he did it, it doesn't change the fact that, to a certain extent, obesity is the result of a personal choice. (I'm sorry, but I'm not buying that everyone who is morbidly obese in this country is the victim of a thyroid problem. Sorry, but that's just not going to fly.) This woman is making a personal choice to be fat. And I defend that choice. If she wants to do something about it, fine, but if she doesn't, she shouldn't be insulted by her doctor in an effort to scare her into doing something. It's her choice. But, when it comes right down to it, in America, you are not allowed personal choice when that choice is deemed bad for you by the powers that be.

How do I know this? Well, I'm newly minted ex-smoker, and I can tell you from experience that there was no end the many doctors and dentists I visit wouldn't go to in an effort to get me to quit. There were lectures from my gynecologist, telling me that I was increasing my chances for cervical cancer, colon cancer, ovarian cancer, breast cancer, heart disease and, of course, lung cancer. I'm not even going to go into the dire threats exhorted that I shouldn't even THINK about getting pregnant while I was smoking. The stupid pap smear and breast exam took less time than all the lecturing did. I was told by the same gynecologist that I had to exercise twice as much as a normal person would to keep healthy. Walking five miles a day, apparently, wasn't enough if you're a smoker. I should have been running ten miles a day. I've been told by my opthamologist that I'll be an excellent candidate for cataract surgery in forty some odd years. Clever, no? Then we have the dental hygienist: she, quite literally, bitched aloud about the fact she had to spend more time cleaning the back of my teeth than she would a non-smoker.

The husband has had to deal with the same sort of thing from the same dental hygienist. You see, the poor husband has had SO many bad experiences with dentists and orthodontists that he hates going as much as I do. The man, quite literally, had braces and one of those medieval spreader thingys attached to the roof of his mouth for much of his adolescence. The minute he got all that crap off, his teeth started working their way back to their original spots. (They didn't pull any extra teeth before he had his braces put on.) It did absolutely no good whatsoever, so he has good reason to doubt it when a dentist tells him something. Our dentist, who is good and who we like, nonetheless would like the husband to have his fully grown-in wisdom teeth removed. Why? Because he has too many teeth, a small jaw, and the hygienists can't get all the way back to clean them properly. Did you get that? They want him to undergo an oral surgery procedure that would cost us about two grand (we don't have dental insurance---and even if we did, it probably wouldn't be covered.) because it would make their lives easier. They've never suggested an alternative to surgery. They've never told him, hey, get some Plax or Listerine to keep that cleaned out. They did give him a special little toothbrush and he's used it faithfully, but it apparently doesn't work well enough for their tastes, because they keep on harping about it every time he goes in there. It wouldn't do the husband any good, either, as far as how his teeth look. There's not much benefit for him to have his wisdom teeth removed. Yet, consistently, they harp on about it, even though the husband has, quite bluntly, told them it's not going to happen. They've even come in to hassle me about having his wisdom teeth removed when I've been in the office at the same time. I assume they were working under the assumption that I would start guilting him into it, which isn't going to happen.

Therein lies the main issue, I believe: if you refuse to do things your health care providers would have you do, you're making more work for them, aren't you? They have to keep treating you over and over again for the same thing. They would prefer to stop the problem at the source. I could understand where it would be frustrating to have to treat people who, you deemed in all your infinite wisdom, were being stupid about their health. Furthermore, to have to treat the same things over and over again, well, that would just get boring, wouldn't it? Problem is if you lived your life according to all the studies that are released every day of the week, well, your life wouldn't be very much fun, would it? Not to mention when that information is contradictory. I would assume that every disease is preventable, and with the right amount of information scientists will ultimately come to the conclusion that you'll never get sick if you never bother being born.

I have to say, as one who's been where the fat lady is, I still find this all terribly amusing. I suppose that's bad of me, but it's kind of nice to be proven correct. Years ago, when I managed the coffee shop, my customers would, when they found out I smoked, tell me that they wished I would quit. That smoking was very bad for me. Some of them would leave it at that, and I would thank them for their concern, but there were others who would go further in their pontifications and would say that smoking should be banned entirely because it was a public health menace. That everyone had to pay for smokers behavior, whether it be through health insurance costs or their belief they could catch cancer through secondhand smoke, hence the majority opinion should rule. Ok, I said to them, that's your opinion and you're entitled to it. But, I added as I handed them their cup of joe, don't be surprised when they come after you for drinking coffee. Because we all know caffeine is bad for you. It leads to all sorts of health problems, and when they don't have the smokers to beat into submission anymore, well, they'll need a new target. It's the same, I said, if you're obese. Or if you drink adult beverages. Or if you do any number of things that the people in charge think are bad for you. Public health crusades, I told them, aren't so much about the specific actions individuals choose to make: that's irrelevant. Public health crusades are more about removing your ability to make choices the crusaders disagree with. They want to tell you how to live your life. Those choices could extend to any sort of behavior that causes health problems; smoking was simply the tip of the iceberg. Some of them could wrap their minds around this concept and it frightened them. Some of them couldn't see what the hell I was talking about because they believed the hype.

So, I will admit, I find this amusing. They came for me, a smoker, and people said nothing. Now they're going to come for them and they find it alarming. And insulting. Imagine if it was a smoker who had filed the complaint. Would anyone care? I can tell you from experience that they wouldn't give a rat's ass if a smoker was insulted by the lengths their doctor would go to to get them to quit. Believe me, I've heard worse than what this woman heard from her doctor. But no one cares about the smokers. Soon people won't care about obesity, either. Then they won't care about the caffeine drinkers. It will keep going on and on until life is just one big joyless, choice-free experience.

Have a great time in that world, kids. I'll be in the Republic of Kathyland by that point in time, drinking the wine and eating the brie the rest of the world has outlawed.

Posted by Kathy at August 25, 2005 12:42 PM | TrackBack