What Have You Done To Yourself?

I work with alcoholics and opiate addicts who are in active physical withdrawal from their drugs. Night after night they are brought onto my unit on stretchers, in wheelchairs or on the arms of concerned family and friends. Often these people look and smell aweful, unbathed, unhealthy, and unhappy. My first task, once they get in, is to take their vital signs. I watch them through the corner of my eye, trying to be unobtrusive in their terrible moment, while the blood pressure cuff inflates. I wonder again and again, “What have you done to yourself?”

This is a question all of us need to answer and not to each other first, but to ourselves. Dr. Michael Stein wrote presciently in The Addict: One Patient, One Doctor, One Year of his experiences as a practicing internist. In his practice he treats people with maladies ranging from hypertension to diabetes to opiate addiction.

In his considerations, Dr. Stein put forward the idea that the most significant gains in overall health for people in the twenty first century will not be a result of science and hygiene, as in the previous centuries, but in lifestyle choices. The CDC reports on their website that two thirds of Americans are over weight or obese. It is not just the heroine addicts who resist making necessary lifestyle changes in the face of life endangering consequences.

What does this mean for the current health care debate? Work on the legislation that could change the way Americans access the health care system is under profound scrutiny perhaps as I write this. Our democratically-elected congress is literally pulling together new law that could make it possible for all American families to enjoy the security hundreds of millions of people in other modern democracies have in knowing health care is accessible and affordable to them. Let’s pray fairness reigns out over the bullies of industry this time.

But the possibility of these remarkable changes will not answer my question. Americans deserve excellent health care at affordable prices. However, health cannot be purchased. How we choose to live is the first and most necessary step towards good health. No legislator or doctor can hand that to us. It is something we must choose and then work towards every day.