Thursday, July 30, 2009

It's YOUR Body After All

Personal responsibility is an issue near and dear to my heart. Hearing President Obama urge Americans to take charge of their health made me smile; it was so parental and so true. "No, you'll spoil your appetite" No, you can't have THAT for dinner" "Yes, carrots are a healthy snack" "Didn't the doctor explain that ice cream gives you a tummy ache because you're allergic to milk?" Parenting thrusts ordinary humans into the roles of nutritionist and pharmacist and ER nurse, and does it all without training or support. Sure, you can look on WebMD (what I would've given for that when the Little Cuter's 2 month old body was covered with the world's most awful rash!) and read the labels and use your brain, but most of it comes from experience.

And if your experience has been watching your parents shove Big Macs into their faces while driving 2 blocks to the grocery store for chips and soda then that's what you're going to pass on to your kids. The saddest part of walking through the food court at the mall is watching obese parents and their rotund children carrying trays laden with goo. I have to restrain myself from slapping the trays out of their hands; if looks could kill, the food court would be tiled with chubby bodies.

G'ma and Daddooooo never exercised until they were in their 70's and arthritis and hip replacements forced them into it. Dadooooo was proud of his upper body's ability to get him up the 17 steps to the attic without being able to really bend at his hips. Just try to do 17 dips in a row on an uphill plane and you'll see that his pride was well-founded. Installing the chair lift during his final illness was harder for him to bear than the illness itself. "Use it or lose it" had been his mantra, and the lift was a physical reminder of his inability to follow his own advice.

G'ma, on the other hand, thinks that exercise is something designed for other people. Ask her to show you her current physical regime and she'll raise her pointer finger a few times while smiling sweetly in your direction. When I called to tell her that I'd run 5 miles for the very first time in my whole entire life, her response was classic G'ma : "But didn't you sweat????".

She's a good listener and incredibly obedient, though, so she was an All-Star in her Fall Prevention Class at the physical therapy office last year. It was hard and her muscles ached, but she was competitive enough to push through the pain and complete more reps than the octogenarian in the next chair. Following the class with a brownie was less than optimal, but, as she reminds me on a regular basis, life without chocolate is not living at all. As long as her weight is stable, who could begrudge an 86 year old her favorite foodstuff? Not I.

Tuesday's Wall Street Journal quoted a recently discharged hospital patient at a 4th of July picnic: "I told the girl, 'I'm going to have a hot dog. If I'm dead in the morning, I'll never know.'" Except that she wasn't dead, she was back in the ER. And someone was paying for her inability to say no. She's in my age bracket, so my health insurance premiums include her indulgences as well as my trips to the gym. And while the doctors and nurses are fixing her up, resources are being expended on someone who'll be back again soon. And again. And again.

Similarly, smokers think that lung cancer will just kill them. But, no, you don't wake up dead one morning. Instead, you drown in your own fluids in a noisy and decidedly uncomfortable fashion. Snickers for breakfast lead to diabetic amputations. Drinking soda instead of milk 3 times a day provides your bones with all the opportunity they need to lose mass and shrink your skeleton to a shadow of your young adult self.

It's hard to recognize the truth of all this when you are young and feeling invincible. That's where parenting comes in. And now, it seems, the government may be stepping into the equation as well. At one Town Hall meeting after another, President Obama has been preaching the gospel of patients' responsibilities as well as patients' rights. Paying physicians for keeping their caseloads healthy (as opposed to paying them for the number of visits and tests done) only works if the patients are ready to accept their role in the process. Building financial incentives to stop smoking or lose weight or join a gym into health care reform is my favorite part of the whole scheme. (Well, maybe my 2nd favorite... right after coverage for pre-existing conditions.)

I wonder if Americans are ready to be responsible for themselves in this way.

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