Monday, March 29, 2010

We Still Need Healthcare Reform

You're driving your car and the brake light comes on. You take it to a mechanic, who disconnects the warning light. You pay him his fee and drive away again. Later, you crash into a tree and total the car. “Well,” you say, “it must have been the car's time. It was a few years old, after all.”

Okay, we really don't do that with our cars. But we do it with our bodies. We go along in our lives until something hurts. Maybe it's a headache, maybe it's something else. We go to the medicine cabinet and take a pill. If that doesn't work, we may have to see a doctor. We take the pills the doctor gives us, the pain goes away, and we continue on as before. Then our bodies disintegrate and we call it 'growing old'.

We really need healthcare reform. Oh, I know, the President just signed that law. But that wasn't healthcare reform, that was only changes in the way it's funded. Here are five things I think we should do to begin to reform healthcare:

I. Get over our fear of pain. The purpose of healthcare should not be to alleviate pain. Pain and other symptoms and signs are useful tools to tell us something is wrong and help us figure out what it is. I'm not suggesting that we seek pain, or suffer unnecessarily. But I think that we have grown so afraid of pain that we make it our main focus. Also, fear increases pain. If we can teach ourselves not to be so afraid of it, it wouldn't hurt so much.

II. Stop focusing on sickness and start focusing on health. Our bodies are wonderful machines that can let us lead full, interesting lives for decade after decade after decade. But most of us grow old pretty much as soon as we figure out what we want in life, and spend the rest of our lives wishing we had gone after it while our bodies still functioned. It doesn't have to be this way. Real healthcare focuses on health, not sickness. Real healthcare doesn't stop when the pain goes away, or the crisis is past. It doesn't start with pain or sickness. Real healthcare is caring for our bodies to let them be healthier and healthier.

III. Realize that fitness is part of the deal. We can't be healthy if we aren't fit. When someone terribly out-of-shape comes back from the doctor and says, “I got a clean bill of health,” something is very wrong. If that person is not sick or injured yet, he soon will be.

IV. Change the way we think about obesity.

A. It's not about weight. As long as we focus on losing weight, we're missing the point. If our bodies have too much fat, then we should lose fat. I know so many people (you must, too) who really try hard to lose weight, yet year after year their bodies stay pretty much the same. Why? I've observed three things:

1. If we focus on losing weight, we may end up with the wrong kind of diet. There are plenty of diets that help you get rid of water, not fat. Some of them actually dehydrate you, which of course is bad for your health and counter-productive to the goal. If you're carrying excess water, then of course it's good to get rid of it, but that's a separate issue. Diuretic (getting rid of water) diets will not help you lose fat.

2. When we focus on losing weight, the temptation is really strong to deprive ourselves of nutrition. In self-defense, our bodies conserve energy and conserve the fuel needed to make the energy. Of the little we do eat, the body stores as much as possible (we gain fat) and burns as little as possible for energy (we become sluggish). Our thinking can suffer, too. One very common way to deprive ourselves of nutrition is with 'diet' foods. These are foods that contain less nutrition than other foods of the same type and size. So not only do we lose nutrition, we also subject our digestive systems to a stress they were never meant to endure: dealing with the non-food fillers that make up the rest of the volume—at a time when our energy is already low from malnutrition.

3. When we focus on losing weight, progress can actually be discouraging. In the process of losing fat and getting the bodies we want, there are often times when we build muscle faster than we lose fat. There will be other times when it goes the other way, of course. But if we focus just on the pounds, we're likely to give up when the numbers on the scale go up instead of down. Even if we don't give up, we feel disappointed, frustrated, maybe even guilty. Our bodies flood with stress-hormones and then it's harder than ever to lose that fat.

B. It's not about shame. There's nothing shameful about carrying extra fat. It's bad for the joints, it's bad for the organs, it's bad for the esthetics, but it's not shameful. It's just a health problem.

C. It's not about acceptance. Acceptance doesn't help with pneumonia: antibiotics do. Acceptance doesn't help with obesity, either. Our bodies were not made to carry a lot of fat, and they don't have to. Don't use age as an excuse, either. You don't have to put up with it. It's your body: let it work for you.

D. It's not about size, per se. You've seen those skinny people who really are very unattractive because their muscles are not toned. They are just as unfit as their neighbors who are carrying excess fat, and almost as likely to become sick or injured. So it's not about size, really.

E. It's about health. I had an accident that left me in bed for months, unable to exercise, and I became quite chubby. When I recovered, I was tempted to diet. I began, and my energy plummeted. I lost a few pounds and then nothing more happened. Then I started just enjoying a variety of nutritious foods—including a lot of traditional weight-loss no-no's. I have plenty of meat and plenty of cheese, lots of whole milk, eggs, you name it. Of course, I don't ignore vegetables and fruits. I have all the sugar I want, but very little in the form of cakes and cookies, to save my appetite for the more nutritious stuff. Eating like this, I have energy, so I use it. In spite of having another injury in the meantime, after a few months I'm almost back to my pre-accident size. Please don't say it's my genes that made me lose the fat. It was listening to conventional weight-loss wisdom that made me keep it.

V. Realize that our bodies are run by our brains. Our doctors don't heal us. Medications don't heal us. Even diet and exercise and oxygen don't heal us. Our bodies use all these things to heal themselves. And our brains are in charge of it. Study after study has shown that the way we think about our bodies has a very strong influence on how healthy we are. I think that we, as patients, should find out exactly what is going on with our bodies, take charge, and choose to be healthy.

Wednesday, March 17, 2010

How to Help Haiti

Shortly after the September 11 attacks I attended a meeting for those interested in helping the victims and fighting backlash hate crime. It turned out to be a group expression of good feelings: tolerance, acceptance, sympathy, etc. Nothing was accomplished and nothing was planned. I got the impression that most of the participants left feeling generous and involved, but the fact is that we didn't help even one person.

Now it's Haitians who need us. How can we really help this time?

  1. Give. Worried about fraud? Be careful, of course, and choose wisely. But ask yourself two questions and compare the answers: "What will I lose if I give and my donation is diverted by fraud?" and "What will someone in Haiti lose if there is no fraud and I don't give?"

  2. Tweet. Sign into Twitter, enter "Haiti" in the search box and retweet anything you think others should see. This will help keep the plight of the Haitian people in the minds of many who can help. Here's an excellent article by OperationSAFE's Jonathan Wilson about more ways to use Twitter to help.

  3. Look for specific needs. I would start with a "Haiti" search on Twitter, but do whatever works best for you. Think about whether you know someone who may know someone who can fulfill these needs, and then ask. Don't be shy: remember that you're not asking a favor for yourself. Most people I have contacted have been delighted to learn that there's something they can do. For example, you may be able to find someone to translate a document into French, or you may be able to find someone who knows how to fix a particular piece of medical equipment.

  4. Listen. I recently asked an American volunteer working in Haiti if there was anything I could do to help her. Her response was, "Knowing someone is out there helps me not feel alone in this, no one has time for each other here." Emotional exhaustion and burnout are a real danger for workers in Haiti, and listening can really help. Two recommendations: let them vent without judging, and once in a while remind them that you're listening.

  5. If you pray, then pray. If you don't pray, then take some time in a quiet place for reflection. It may sound like just superstition, but it really will help you stay focused and keep your priorities straight.

There are many more ways to help, of course. These are just a few ideas that may help get your own brain started. And don't forget to take care of your family first, and that includes yourself. You can't help anyone if you neglect yourself.