EVOLUTION is as much a process of minds as of bodies and species. Not that it's painless or even clear. Or even mental. The quick succession of a violent earache and a wrenching fall have imposed humility on me. Which is how it happens, since it's arrogant to think that one can voluntarily be humble. Humility comes suddenly and its nature and source are not necessarily predictable.
Aging adds its load. A visit to a doctor I trust (finally!) makes me realize some assumptions that had kept me confident in the past, like the idea that I'm a naturally healthy person who can use intelligence to work through almost every problem. I thought of myself as conscientious, tolerant, and aware of my own prejudices. All this is fantasy coming home to roost just as I break off relatives who are even more deluded IMHO. Which is an arrogance in itself.
I've shared their social prejudices, which are mostly those of my mother, which she owes mostly to her father. They are standard conceits about prosperity, how to get it, whether cheating counts, and whether it means you deserve it. Everything she tried to enforce in me went to that goal, but somehow (probably from books) I picked up a different set of values based on idealism to the point of fantasy. I was good in school and we thought I had a high IQ (whatever that is) and those were my protection against normalcy, mediocrity, compromise. Learning went higher and higher until now I feel as though I'd been upended and all my past book-learning and classes have been shaken out of my ears in little pieces.
The whole equation and set of definitions was based on a world view that has gone out-of-date, still operable for most people but not for me. When we radically change our understanding of what a human being is, then the principles of how we work, even in the most small and practical loops of performance like staying healthy, must also change. In fact, the history of health care in "civilized" countries has been arbitrary, baseless, and sometimes lethal. The base requirement is not the health of the individual but that profit can be wrung from it for the benefit of the right people.
Too much is pharmaceutically based, because that is something that can be mass manufactured, priced, traded, profitable, on the stock market. And the pervasive problem of drugs appears. When one is vulnerable to intervention, a class of "intervenors" arises, people who have the power to prescribe. At first it was only the privilege of doctors who by education and good character can be trusted to affect us intimately, naked and cut open. But then, since that was an awarded degree with considerable power, it became possible to hand off the powers in bits through institutions large and small. When authority, control of control, is in league with profit and government, good character becomes a liability rather than a qualification. Good character no longer protects the patients but rather enables the money-chasers.
We have expected "doctors" to be reliable judges of sanity, but we allow dubious and zany people to become doctors, with the result that now we have a dubious and zany president who is protected from intervention by a rule invented to give politicians the benefit of the doubt, the Goldwater rule.
Back to myself. When I went to meet with this doctor for the first time, asking him specifically to "stabilize my health regime", I threw all the pills into a box and took them with me. He was very serious about sorting and understanding each and made careful decisions. He was serious about my lifelong familial constipation and addressed it without embarrassment -- even asked for an x-ray. (The big blob did not look quite like a baby.) I thought only in terms of the three major diseases: heart, lung and diabetes. Yet I remember that when I did my hospital chaplaincy, expecting to talk about "God", the people were obsessed with their bowel function. After all, it is the world passing through us.
I fell soon after -- I mean physically, not just off my high white horse. Landing on my knee was so painful that I ended up using every OTC med I had: aspirin, Advil, Tylenol, etc. which carried me through but also left me dumb and staggering, unable to drive. Then I saw that none of my OTC meds had gone to the doc with me, including Pepto, papaya tablets, Alka-seltzer, Bengay, sublingual B6, Beano, (Including several kinds of laxative which I don't buy in town because the clerks arre too interested) and etc. In fact, I have a few "health section" grocery store bottles (magnesium), prescribed by an earlier person: a sub-doctor and enthusiast of herbs, natural cures, and anthropological substances. We call smoking and drinking "self-medication" and know they have devastating potential consequences, but never call them medicine.
Part of the nature of a human being is determined by the nature of the institutions and community in which they are embedded. By choosing a place as remote and unregulated as it is, I've risked several things. Over-dependence on transportation -- the nearest hospital is thirty miles away. Our once-a-week town clinic is geared for pill regulation and blood draws plus maybe minor trauma. Distance in medicine equals medical hierarchy: to get a better doc, one must drive; to get a better level of support in terms of powerful machines and peer sharing, one must travel; meds travel, brought per need, not kept on hand. If the delivery system fails, no meds. To interface with Medicare or insurance companies, one must do it by phone or mail.
In fact, for the several days I was practically immobilized, the only person to inquire was a thousand miles away, responding to a blog. Mail piled up. The isolation that made it possible for me to write became an insecurity. Not quite a hazard. I have refused most friendships and community connections on purpose, on principle, knowing it had a dark side. More specifically, my balance of individual/community is a little too strong on the individual side. Maybe.
I do have a community online. It does count towards health and outreach, but maybe not quite enough. An educated woman in town had to reach out to members of her garden club in another town to find someone she would trust to drive her to health care. The ambulance is expensive. In winter it risks the lives of the drivers. Most safeguards here are family-based. Singletons are not enough alike to form a group.
The plan of my doc has returned me to "normal" blood glucose scores, though the number is controversial and there are challenges to using blood glucose scores as indicators anyway, since they are great little sales items. Maybe the real causes we should be watching are quite different and since there are so many definitions of Diabetes II now (4 or 5), much deeper in the body systems. "Metabolic syndrome" is the current term of art.
My basic principle is open and alert reflection and necessary adjustment. The real problem is that since modern medicine began with middle class families who lived predictably, prescriptions are attached to regular meals and bedtimes. What does it tell a free-form woman like me who eats out of one bowl, walking around, and sleeps when she's sleepy?
No comments:
Post a Comment