All this work, only to be outdone by a bag of Oreos

December 18, 2007 at 10:04 pm (Clinical rotations)

When Claire got admitted to the hospital for pneumonia, I knew we were in for quite a long hospital stay. Claire was morbidly obese (her BMI was 51) and although 31-years-old, she had more damage done to her body in the previous three months than most members of the AARP had experienced over their lifetimes.

At my hospital we have a diagnosis known as the “trifecta” in which a patient has hypertension, high cholesterol, and diabetes. Claire had the trifecta. Everyday we tried delicately to manage her sugars; unfortunately, we were losing the battle. Each morning I read off her chart as her blood sugar measurements from the day before were 262, 280, 230, 305. We tried desperately to get her sugars down and threw insulin at her as if it were I.V. saline. Her body was impervious. It was as if the cells in her body were made of Teflon and no insulin could ever penetrate them.

We scratched our heads over her predicament and wonder just how someone can build up a tolerance to insulin. We had her on a no-carb diabetic diet throughout the day and gave her only water and coffee to drink. Finally, on the fourth day of admission, I asked her why her sugars were so high and if she’d been sneaking food. She confided in me that her friends and family visit her at night and bring in cake, cookies, brownies, and anything else they can get their hands on. As she said, “I like to eat.”

We were all greatly annoyed. Here we’ve spent all this effort on trying to manage her diabetes, only to be outdone by a bag of Oreos. Likewise, many patients throughout the hospital are grappling with similar issues of neglect. A lifelong smoker comes in to the clinic to be told that he has lung cancer and then cries out, “How could this be? Was it something that I did? I feel like it’s all my fault.” Naturally, physicians have to put on a professional air around their patients and passionately explained to them that there are many factors which go into causing cancer. In reality, I just want to scream out, “Did you ever bothered to read the side of the box? It says right there it causes cancer.”

I’m constantly amazed by politicians who claim that we need free, universal health care available to everyone in the United States. And somehow, all Americans will instantly become healthy, will give up high fructose corn syrup, and will take up jogging three times a week. Presidential candidates from all political spectrums tout preventative medicine as if it’s some kind of cure to all of the country’s woes. As Claire demonstrated, if people want to eat, they’re going to eat.

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2 Comments

  1. Tea said,

    Politicians don’t give a damn about universal health care. They want votes. If they think that this will get them votes, they will say they support it. Keep them happy and they will look the other way with other issues.

    It sounds like Claire’s family and people like them need psychological help. Are you ever allowed to tell them that their condition becomes mental when their lives revolve around their condition and they want to maintain status quo even in the hospital? That is like an alcoholic’s family celebrating a stint in rehab with booze. These people are thinking with their brain stems!

    I am seriously into yoga. It never ceases to amaze me when I am in class and people comment on how small I am in spite of having nine kids and I keep myself up with one class a week. They complain that they are quitting because it’s not working so I ask what they do at home. Oh– the surf the net, watch movies, etc.– all sedentary. Well, what happens in class is a tiny sliver of their lives! Ten yoga classes a week are better than nothing but if you are going home and eating the foods (that yoga and exercise make me just not want) that aren’t good for you anyway, then sit around doing little, it won’t do much for you! You should go home and go for walks on the weekends, teach your kids what you do in class, eat good foods that happen to be fun to make and even grow some if you can because the kids love it so much and being outside is good for you. It’s the same with medicine. Correct me if I am wrong, but doctors facilitate healing, most do not “heal.” You save lives in emergencies, but for the most part, you are health trainers, not magicians.

    This is a really excellent article and you say what many wouldn’t dare to say.

  2. peggy said,

    I agree with Tea! I’m a mother of seven, grandmother now many times over. We’re all in excellent health for all the reasons Tea mentions (though daily swimming and an exercise routine at home were it for me rather than yoga). Our society for several decades has blatantly encouraged irresponsibility in almost every realm of our lives (it takes a village?) and that includes refusing to be responsible for our own health. The outcome is, as Tea says, people expect doctors to “make it all better” as though they were still toddlers. Instead, doctors have the knowledge and expertise to do things to help us heal when things go wrong despite our best efforts. For that, I’m eternally thankful for them.

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