by Nick Jacobs
October 23, 2007 at 7:45 pm
· Filed under Policy Makers, Prevention and Health Promotion, Disease Management, Population health management
Let me open this blog with a disclaimer. It is not meant to be a criticism of freedom of choice or belief. It is merely an observation of a reality. What has caused this reality may in fact have been the phenomenal pressures applied across the world by the marketing machines of our internationally based tobacco and alcohol companies, or it may be that those present have determined that it is better to live life at its fullest for as long as we have, enjoy every bite of the apple, and deal with the reality of transition when the time presents itself.
My last four days were spent at a world conference on cardiology where the work done by our research institute’s cardiac team on the impact of behavioral modification on this disease was our presented topic. Our research revolves around diet, exercise, stress management and group support, and the results observed from our patients have been nothing less than remarkable.
It is fair to say, however, that, upon observing the actions and choices of those present my heart sank. The secret of life appeared to be firmly seated in the minds of at least 40 percent of those in attendance that tobacco, alcohol, heavy fats and little exercise are the keys to happiness.
Don’t get me wrong, it was a wonderful event where my international neighbors treated us with respect and courtesy throughout the four days of the conference, but getting in and out of each session without walking through a blue cloud of smoke, without ingesting blocks of high fat foods and free from huge quantities of alcohol consumption would have been only a dream for most.
The lounge areas of the conference were filled with cigarette stoking physicians, pharmaceutical and medical supply representatives and staff. The dinners all included well used ashtrays, plenty of cocktails and the X files list of banned foods. As a vegetarian, it was almost impossible to get through even the opening courses of a meal without unbelievable scrutiny as to my personal sanity.
That being said, the content of their presentations were as clear at this international conference as they are anywhere, i.e., the following things are very bad for heart disease: high fat foods, stress, cigarette smoking, lack of exercise and, of course, poor genes.
What then is the problem? Denial? The high pressure life styles of these life saving physicians, cultural considerations, a laissez faire attitude toward the Boogie Man or just another version of man’s on going stupidity and ignorance toward what appears to be very clear evidence?
Maybe cardiologist know something that the rest of us don’t know. Maybe they know that life is finite, that health is finite, that, like the saying I once saw on a tee shirt being distributed by a cemetery: Eat right, exercise, manage your stress and you’re still going to die.
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Nick,
This is disappointing. The behavior described in your post may contribute to the low ratings many healthcare providers get on their ability to coach patients to rid themselves of unhealthy behaviors. Your post also recalls two events from my week—one personal and one professional. My 73-year-old mother, who had a quadruple bypass five years ago, was hospitalized with chest pains this week. The blockage they found will be treated with medication for now. However, on leaving the hospital ward I noticed a bulletin board devoted to discharge instructions. Every flyer on the board was related to the danger of smoking for heart patients. Secondly, in my professional life (as an editor in the healthcare industry), I am finalizing a book on Successful Management of Heart Failure Patients, which describes the effort behind the dedicated heart failure unit at Hackensack University Medical Center in New Jersey. I am impressed by the dedication of the two cardiac nurses who head this effort. They have done similar work at other hospitals and are doing a phenomenal job at reducing hospital readmissions among that population.
[…] Jacobs at the World Health Care blog describes the unhealthy behavior of attendees at a world cardiology conference. Happily, the […]
Regina wrote @ November 6th, 2007 at 1:32 pm
Just thinking as a type. I’m not a physician or involved in the healthcare industry in any way, but I do feel like that at times. You see, I have two chronic illnesses. Both are auto-immune diseases: insulin dependent, type 1, diabetes and Graves’ disease (a thyroid disorder).
I was a healthy kid, came down with chicken pox in college and shortly thereafter my pancreas gave out. I took care of myself, did what I was told, but decided to go to law school and lost my health insurance. Those years were stressful beyond measure, so much so that I’m abroad with decent healthcare now and it’s one big reason I’m very apprehensive about moving back to the States. It seems Graves’ is brought on by stress and a big part of stress for me is my health. Oh, how ironic is that? It’s disappointing to know that no matter what I do, how healthy I eat, how much I exercise, that I’ll still have these diseases. In terms of motivation. It’s a momentum killer. What’s also a momentum killer is knowing that I’m at risk for another auto immune disorder.
Anyway, I think there is a certain amount of live and let live as time goes on. Maybe for a lot of these people you talked about the momentum killer is due to seeing sickness up close on daily basis.
It’s not as excuse, but merely a reason they might choose to behave so recklessly.
Cindi wrote @ March 25th, 2008 at 9:52 am
My comment is coming from the wife of a 45 year old who had a heart attack in 2006. He had smoked for 30 years but had been quit, completely smoke free, for two years before the attack. He had two stents place and three more blockages treated by medication for, of course, the rest of his life. He is a self employed, successful business man. Not successful enough to keep up the health insurance for our family and the medication, which of course was not covered by the basic plan that self employed people can afford. I had always worked with him, keeping the books, raising the kids, and running errands for him, some days working with him out in the field. After two months of cardiac rehab, he was ready to go back to work. I also got a new full time job at our hospital 30 miles from home. It provides the insurance we need and I have a $15 co pay for all his medications, so $60 now covers what was just over $500 per month.
Well, recently, I found out that he had started smoking again. Live and let live is just not an option I can live with. His philosophy is that he could be killed in a car accident today, so why not enjoy every day. I can see that to a point, but what about my quality of life later on when his health fails again. You see, he has promised me a partner and best friend for the duration of our lives. I do everything in my power to stay healthy and I really expect that he should do the same. He does well with his diet, ok with the exercise, great with the medication and is keeping his cholesterol under control. So why go back to smoking now? He says he enjoys it….to that I say, “Who cares?” I enjoy eating chocolate and wonderful greasy comfort foods, but I don’t allow myself to do it whenever I please or I would certainly not remain healthy. Live and let live could only be appropriate when it does not directly affect anyone else’s life or future. I think he owes it to me to consider the quality of life for both of us down the road, as well as setting a good example for our teenage daughters. My life changed drastically after his heart attack.
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