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.