Sunday musings 3/26/12
Sunday musings (courting controversy)…
1) Volume. If you undertrain you may not finish; if you overtrain you may not start.
Lotta meat on that bone, especially around Games season.
2) Enabler. One who provides either implicit or explicit support of dysfunctional or harmful behavior.
I am an American physician, a specialist. Universally reviled, and nearly universally acknowledged as being at the root cause of what people regularly call our “dysfunctional healthcare system.” Funny thing, though, but my specialty includes providing ongoing care to patients with chronic eye diseases. I actually bridge the divide between specialty care (highly complex, single–organ surgery) and chronic primary care. Every day in my office I see patients with type II diabetes and other diseases that are at the very least highly influenced by lifestyle decisions.
We do not really have a healthcare system in United States, but rather a sick–care system. We actually do a pretty good job in pediatrics with a well thought out, well–established system of well–baby and well–care visits for the vast majority of children in America. Somewhere after our children leave their pediatricians in their teens the whole concept of well–care seems to disappear. No longer guided by the doctors of their youth, Americans are left to their own to make decisions about where their priorities will lie. This is certainly true of health and wellness.
There is an article on CNN.com today written by a very well spoken, highly intelligent and intuitive primary care physician from New England in which he cites a couple of examples of patients who got sicker when they decided they could not afford care for their illnesses. His approach disappoints me greatly; the appeal to the emotional is just one more way that our American sick–care system is the great enabler of our Nation’s un-well.
Think about it. We actually have the very best sick–care system on the planet. We manage to keep incredibly sickly and unwell Americans alive, and to some degree functional, in SPITE of horrific and horrible health–related decisions on the part of these individuals. Cardiac bypass surgeries and coronary artery stents. Evermore complex oral diabetic medications layered one upon the other. Heroic, simply brilliant surgical interventions to replace the joints of people who managed to double and triple the “load” they were meant to carry.
Our “health care system” not only enables our population to abuse their health and their fitness by rescuing them from their excesses, but in its present and proposed future forms it also insulates them from the responsibility of being healthy. There are certainly a minority of people who cannot afford sick care, but that number is buried by the number of people who choose to not be able to afford either health-maintenance or sick care. You only need to spend one day in a doctor’s office watching people finish a conversation on their iPhone ($499 + $100/month) about a game they watched on ESPN last night ($80/month for cable) before heading to the brewpub (smothered fries!), as they walk out to their new car ($500/month) to retrieve their iPad ($699 + $60/month) and catch a quick smoke ($5/pack, 1 pack/day), just before they complain to their physician about how hard it is to pay for their diabetes medicine.
3) DWB. Driving While Black. No matter what the story eventually turns out to be, there is very little that is good that is likely to come out of the Trayvon Martin debacle. Not for the Martin family, not for that neighborhood watch guy, and probably not for society as a whole, at least for quite a while. Why? For the simple reason that it is now 2012, we’re still having this conversation, and nobody has demanded change.
Let’s go back a bit, shall we? How about a trip to 1979 and suburban Rhode Island. I’m driving the family beater, my close friend in the passenger seat waves at a police car as we drive by on our way to the mall. My close friend, STILL my close friend, happens to be a very large Black man. You guessed it–flashing lights followed by “license and registration (no please).” Why? A version of Driving While Black.
“Come on, bingo. That’s ancient history. Things are different now.” Well, let’s move forward a bit. Dinner chez bingo sometime around the year 2000. My good friend the Rev. Mel and his beautiful wife are joining us at our house for dinner. Mel, a black Baptist minister, drives a bullet-proof Mercedes sedan. Never more than 5 mph over the speed limit. The Woodards were late for dinner. When I teased him about it Mel just shrugged his shoulders and said “DWB.” Even impeccably dressed for a dinner out, Mel was still a Black American man.
Now? I young black man in a hoodie returns from an errand, surely guilty of something until proven innocent. A non-black man approaches the youth, surely someone to be feared until proven otherwise. The fault, my friends, lies on BOTH sides of the conversation. At this late date in history it no longer matters what came first, you know? One side of the conversation needs to openly acknowledge that the vast majority of the other side does NOT participate in violent criminal activity. This part of the community needs to openly acknowledge this and aggressively teach that lesson to people of all ages. The other side of the conversation needs to openly knowledge that their ARE small parts of their community who DO engage in violent crime and to go about the hard work of isolating them as the outliers that they are and shunning them as a pox on BOTH communities.
We need to be done with the blame game. Indeed, indulging in finger-pointing at this late historical stage is also a type of enabling. By taking the easy way out, blaming this one for not fighting harder against unsupportable prejudice or pointing the finger at that one for some weak justification for criminal behavior is quite simply enabling the prejudiced and the predators to continue their pathologic behavior patterns.
NONE of us could have influenced the tragic outcome of that encounter In a random Florida neighborhood. ALL of us…Black, White, and other…have the duty and the responsibility and the ability to do the hard work necessary to prevent what STARTED it.
Start now.
I’ll see you next week…
Comment #16 – Posted by: bingo at March 25, 2012 8:38 AM
Tags: Crossfit, healthcare, healthcare reform, trayvon, trayvon martin
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