I’ve a confession to make. I have a prejudice. There I said it. I know I shouldn’t. But I just can’t help myself. I don’t like women getting tattoos. I don’t like men getting them either but women especially. See I’m prejudiced. Generation X and Y are doing it in droves. Almost a third of women in their 20s have a tattoo. That is a frightening statistic because I bet when they all get older it’s going to be regret city. Get this. One third of all people aged between 18 and 30 have a tattoo, according to a researcher at James Cook University in Queensland. According to researcher, Eduardo de la Fuente, tattoos were once the badge of non-respectability. Reserved for prisoners, sailors and people wanting to identify themselves as part of a group operating outside the mainstream. But de la Fuente says that non-respectability began to gradually shift in the 60s and 70s. From the 90s onward it has become so respectable that tattoos are now a fashion statement. We are witnessing an explosion of people inking themselves. Researcher de la Fuente says there is a sociological/psychological reason for this. Fashion and haircuts used to be the principal vehicles for the expression of non-conformity. Now it’s the whole body. And if you are going to make a statement you may as well put it in writing. But they will all live to regret it. Mark my words. That’s not just me saying it. The Australian Consumer Magazine, Choice surveyed people with a tattoo and discovered that one in three regretted it later in life. Too late he cried. I mean why would you in the first place? Not only is it ugly, it’s painful and pretty permanent. Fortunately, there’s been a steady proliferation of clinics that specialize in tattoo removal. “Traditionally a tattoo was about belonging to a community where you expected to live your entire life,” Dr de la Fuente said. “But now people have several different personas and belong to several different tribes in their lifetime. As you get older there may be a new persona you wish to convey instead.” Ok. So grow a beard or get a dog if you really want you to be a different you. Eduardo de la Fuente asked a bunch of young women why they felt the need to have a tattoo. Lauren, 25, she says got a tattoo because it was something meaningful ( or should that be meaningless) to her, her mum and her sister. “It was a bonding experience for us but I think a lot of girls do it these days because their role models are doing it and it’s cheap, trendy and another way to distinguish yourself.” A quick look at young celebrity women show a kaleidoscope of inked body parts. Glee’s Lea Michelle has 14 tattoos, pop sensation Miley Cyrus reportedly has more than 20 while at last count singer Rihanna had 21 tattoos. But it’s not just young women getting in on the act. A recent trend has seen an increase in the number of people over the age of 45 getting a tattoo. According to Eduardo de la Fuente it suggests the “aestheticisation of the body” is becoming more popular even among middle-aged people. Now I’m really starting to lose hope. Famous actors Cate Blanchett and Amy Adams apparently celebrated their Oscar victories last year by heading to a famous Hollywood tattoo parlour, while 80-year-old actress Dame Judi Dench recently revealed that even she has a tattoo. Yeah right. A documentary which is due to be broadcast on Australian television later this month will show a vast cross-section of society getting inked at a tattoo parlour at Sydney’s famous Bondi Beach. Everyone from mums, to grieving grandmothers, to Dads celebrating the birth of their first child take part. The stories paint what I would call the nightmare scenario of one in seven Australians who get inked at some point in their lifetime. See, we truly are a nation of convicts. Heidi Haydon is one of the tattooed taking part in the documentary. Her obsession with tattoos kicked in after she was left paralysed from the chest down following a motorbike accident. “I used to draw tattoos and always wanted one but mum always talked me out of it,” she said. “But after leaving hospital following the crash, I decided to go ahead and do it, and mum even got one too.” I’ve only got three words to say. Ok. Six. Dumb, dumb, dumb don’t do it.
Life can be completely serendipitous. Most of what happens to us, coincidence-wise, is usually the opposite. It’s someone cursing or lamenting terrible misfortune. But occasionally, just occasionally, the magic wand of serendipity waves in our general direction and comes as incredibly welcome, good news. Yes good news. There is such a thing Dorothy, and it’s not a lot of make believe like the Wizard of Oz and those supposed magic red shoes of yours. It’s good news and it’s real.The kind of good news that causes spirits to soar and hope to renew.
The story begins 30 years ago in the pediatric ward of a hospital in Orange County, California. Pediatrician Michael Shannon has a battle on his hands. A baby boy has been born several weeks premature. The child weighs less than a kilo and only has a 50/50 chance of survival. But Shannon is not giving up. He is determined to save this young life. And that is what he sets out to do. Providing, round the clock treatment until the baby boy’s health improves and he is out of danger. Shannon doesn’t know the child’s name. Even if he does, he won’t remember. It’s all in a day’s work for Michael Shannon. He is modest but, by all accounts, as Doctors go, Michael Shannon is pretty special. Now you might think this is the end of the good news story but if you did you would be wrong. It is only the beginning.
Fast forward to 2015. Michael Shannon is driving along the Pacific Coast Highway, in California when he is T-boned by a truck and semi-trailer. It is a serious crash, which Shannon is lucky to survive. But Michael Shannon is still in serious trouble. His SUV is crushed under the truck and Shannon is trapped inside the cabin, unable to move. Worse still his SUV is beginning to catch fire. Fire fighters from Paramedic Engine 29 are returning to base from another call when they hear of Michael Shannon’s emergency. They respond within minutes and arrive at the scene to discover the SUV is now fully ablaze and the flames are burning Michael Shannon’s legs. The fire crew, quickly begin extinguishing the flames but one of the crewman is focused on rescuing Michael Shannon and won’t give up until he has completed the job. He begins by using the Jaws Of Life cutting equipment to slice through the metal, creating a hole large enough for Michael Shannon to be pulled through. It is a slow process but in the end he is successful. However, the fire fighter who had doggedly cut through steel to rescue Michael Shannon isn’t done. He then helps to carry his patient to a waiting ambulance and to hospital for emergency surgery.
Shannon is seriously injured and will take 45 days to recover. Two of his toes have to be amputated but he is alive thanks to the quick work of his rescuers, and by one of them in particular. The name of that rescuer, who cut Michael Shannon free, is Chris Trokey. He decides to visit his patient in hospital and it is then that both men discover serendipity. It turns out Chris Trokey is the premature baby that Michael Shannon worked so diligently to save 30 years ago. The baby he rescued became his rescuer. And for Michael Shannon it was nothing short of incredible. “It’s amazing to watch them all grow up, but to have one come back in your life, on a day you really need it, that’s really incredible,” Shannon said. Chris Trokey was equally dumbfounded when the penny finally dropped about his connection with Michael Shannon. “I didn’t know about it until I went to the hospital and started talking about it, Dr. Shannon. And I was like, ‘Oh my gosh, Dr. Shannon?’” Trokey said. “That’s when I found out.”
And serendipity even has a way of coming full circle. Chris Trokey is now a father himself. And guess who his child’s pediatrician now is? You guessed it. Michael Shannon. Ah serendipity. You’ve got to love it.
The medical profession in general, and surgeons in particular, enjoy an exalted status. It would be churlish not to say, deservedly so. Surgeons save lives, have great skills, earn salaries equivalent to the GDP of a small African country. But lately some aspects of the profession, and some individuals in it, are beginning to resemble the Emperor’s new clothes. The pedestal, they’ve been standing on, is listing 45 degrees.
And it’s all because of an Australian vascular surgeon called Gabrielle McMullin.
The fact that she is Australian, although I mention it, really is irrelevant. She could have come from anywhere in the world and her comments would, on the balance of probabilities, apply. McMullin didn’t shatter the glass ceiling for women so much as demolish the entire building, Metaphorically speaking, she threw a hand grenade into possibly the biggest and oldest boy’s club on the planet. What is so intriguing about McMullin was the fairly innocuous way that she went about it.
McMullin was speaking at the launch of a book she co-authored about gender equality ahead of International Women’s Day. Not to put too fine a point on it, she effectively blew the whistle on sexual harassment in the medical profession, though to be honest whistles weren’t strictly speaking what she was referring to about being blown. McMullin told the story of a young female neurosurgeon. The daughter anyone would wish to have. Excelled at school, always wanted to be a doctor. She was training and going places. Then a particular established neurosurgeon with a big reputation took her under his wing. Except of course he did more than that, didn’t he. The neurosurgeon with the big reputation keep asking her back to his rooms after hours. On one particular occasion she felt it would be rude to refuse. So she didn’t. It was dark, there was no one around and he sexually assaulted her. The young woman doctor was horrified, ran out of the room but told no one. Then she began to receive bad professional reports. She was lazy and incompetent and all of her years of hard work were in danger of ending in total failure. So, she complained and won her case. But she didn’t. As McMullin told her somewhat spellbound audience, despite her legal victory that young doctor has never been appointed to a public position in any hospital in Australasia. Her career ruined by this one guy, who on one particular night, asked for sex and was refused. Then McMullin very demurely dropped a clanger that is reverberating around the entire medical profession in this country. McMullin said realistically that young female doctor would have been better off giving that neurosurgeon, with the big reputation, a blow job that night. McMullin then went on to say : “ What I tell my trainees is that, if you are approached for sex, probably the safest thing to do in terms of your career is to comply with the request. The worst thing you could possibly do is to complain to the supervising body, because then, you can be sure, that you will never be appointed to a major public hospital.”
According to McMullin, to put it bluntly, gaining entry into medicine for women opens the door to a career marred by rampant sexism, and she says women need to be vigilant. “ We need to teach our trainees never to put themselves in a vulnerable position like that, no matter how nice, married and well-meaning the man seems,” McMullin said.
Now, it might come as no surprise that these comments caused a small earthquake. A number of people and groups have been dismayed by McMullin’s observations. A spokesperson for the Victorian Centre Against Sexual Assault, called the advice “appalling” and “irresponsible,” arguing that perpetrators thrive on not being challenged about their behaviour. “I would have thought highly trained professionals would be able to operate a better system than that,” the spokesperson said. “I actually don’t think that’s acceptable advice in this day and age.”
Similarly, the Head of Domestic Violence Victoria said: “It’s a sad indictment on us and the community when this is what women are being advised to do to benefit their career.”
Of course they miss the true meaning of what McMullin was saying. She was in no way condoning this kind of behaviour, far from it. The point she was making is that in one of the hardest University courses to enter and pass, where intellectually you have to be at the top of your game in a genre that represents the best and the brightest, there is still a sexist, chauvinist, misogynist boys club in the medical profession where women are expected to be on their knees at the beck and call of men. I may be overstating it slightly but you get my drift. Of course not all male doctors behave this way and it would be unfair and wrong to tar them with the one brush. But enough of them do and if women complain then their career is chopped liver. McMullin was being an anarchist and like all good anarchists she knew exactly where to throw the bomb.
And while she’s had her critics, Gabrielle McMullin also has her supporters. Plenty of women doctors have come out and publicly said it’s all true I tell you. One of them was compelled to publicly defend McMullin in a national daily newspaper. She wrote: “ Now lets consider the hundreds of other cases. The ones who didn’t make the news. The ones who, excuse my vulgarity, ‘got on their knees’, because it was easier. The ones who were too scared to tell anyone their boss made a pass at them. Or the ones who did confide in another doctor only to be told ‘keep your mouth shut and you’ll be fine’. Keep your mouth shut and you’ll be fine seems to be medicine’s catchphrase.
“ Dr McMullin is not the problem here. She is simply the messenger. The problem here is a system where reporting sexual harassment is vehemently discouraged. A system where a young doctor successfully takes her assailant to court and is never employed by that system again. A system where big names have stood up this week and said sexual harassment is not a problem in medicine. A quick glance at the female doctors I follow on twitter would disagree. We all have stories about sexual harassment at work some of them subtle, some of them shocking. And yet person after person (mostly men, although I can’t imagine why), have stood up and said sexual harassment is not a problem in medicine.”
Other female doctors also spoke to the newspaper. One of them said that male surgeons had routinely called her a “dumb b****” and a surgeon had told her to “get some knee pads and learn to suck c***”.
Another female doctor said there was a long history of reports of sexual assault and harassment being dealt with poorly, and that surgical careers of victims who spoke out were “obliterated”.
As you might expect, the Royal Australasian College of Surgeons was horrified by McMullin’s comments. The college issued a statement which said: it was “very disappointing and quite appalling that recent media reports have suggested that it is preferable for female surgical trainees to silently endure sexual harassment. “The college of Surgeons refutes this advice emphatically. “The inference is that this is what successful female surgeons and trainees have done in the past and this is deeply insulting.”
It sounds to me like a lot of RACS huffing and puffing. Surely what is really disappointing is that this kind of behaviour is happening at all. I will be honest and say for the life of me I can’t understand gender bias of any description. What is important is someone being good at their job. And if they are that’s the only thing that matters. I personally couldn’t care less who or what they are. And neither should anyone else. But I can’t help thinking was Gabrielle McMullin giving that advice from personal observation or personal experience? She was never asked nor did she volunteer an answer to that question. I will just suggest away the suggestion that there might have been more to it than just Gabrielle McMullin speaking up and out for her female colleagues. Not that any of this matters in the scheme of things.
The Australian Medical Association also weighed into the debate. Spokesman Doctor Saxon Smith said medicine had moved in a different direction in the past 20 years. “ Sure if you go back further than that then it may well be the case,” Smith said. “ But we know increasingly and the trend is that every graduating year for medicine is more female than male. There is a tide to turn.”
On behalf of female doctors I would like to say about bloody time and the tide can’t turn soon enough.
I hesitated before writing this. You can claim the high moral ground. The truth may well be on your side. Yet no matter what you say or do it sounds like a cheap shot. Kicking someone when they are down. It seems like an empty, pathetic gesture, even though, metaphorically speaking, they probably deserve to be kicked. It makes me worry about all kinds of things. I worry about the blowback because it’s always friends and family left to pick up the pieces and do the defending. It’s a moral dilemma but I’ve made the call so here we are.
This concerns the life and death of a 30-year-old Australian woman, called Jessica Ainscough, who was known as the Wellness Warrior. Images and video of Ainscough always showed her full of life, and the picture of health. But reality told a very different story. She may be called the Wellness Warrior but Jessica Ainscough was extremely unwell. She suffered from Epithelioid sarcoma, an incredibly rare, slow-growing cancer, in her case, first diagnosed in 2008. When I talk about rare form of cancer, the incidence, is in the order of 0.1 to 0.4 per million. It’s primarily a tumor that affects young adults, and it nearly always appears on the upper extremities, and wide surgical excision (which is doctor speak for amputation) is the only known effective treatment. It also tends to be a lethargic or lazy form of cancer, the antithesis of aggressive and fast growing. Patients diagnosed with Epithelioid sarcoma, have a ten year survival rate of 61%, but for patients aged between 17 and 30 years, in other words, just like Jessica Ainscough, the survival rate is much higher, about 72%. So that’s good news? Right? Well actually no it isn’t. Survival depends on treatment. And in this case the treatment is on par with the illness. Maybe, it’s even worse. The first line of treatment recommended consists of a very disfiguring amputation that in reality is more like a forequarter amputation. It’s an amputation that involves removing not just the arm, but the entire shoulder joint and the shoulder blade. It would have left Ainscough, without an arm, and a shoulder as well. It’s a seldom-performed operation and a wretched choice to be forced to make, unpalatable and disfiguring surgery. But, if it’s the difference between living and dying what choice do you have? Well, as it turns out, there are choices and there are choices. Ainscough made a number of choices. One of them, was choosing not to have the surgery. And, no surprises, making that choice meant living with the consequences. Without surgery, five-year survival rates drop alarmingly to 35 percent and ten-year survival, to 33 percent. As surgical oncologist and blogger, David Gorski, wrote so succinctly: “Jess Ainscough had a shot, one shot. She didn’t take it. What saddens me even more is that I can understand why she didn’t take it, as, through a horrible quirk of fate, her one shot involved incredibly disfiguring surgery and the loss of her arm.”
Ainscough would later write that she had prepared herself mentally to undergo the surgery, but doctors came to her at the last minute with an alternative, which was to do, what is known as isolated limb perfusion. According to the medical experts this is a technique sometimes used for soft tissue sarcomas of a limb or multifocal melanoma that can’t be removed without amputation to destroy the tumor. As the name implies, the limb is isolated from the body’s circulatory system and infused with very extremely high toxic doses of chemotherapy. The dose of chemotherapy is so high if it leaked back into the rest of the body’s circulation, the consequences could be catastrophic. Isolated limb perfusion can result in seemingly near miraculous results, and apparently that was the case for Ainscough. Unfortunately, the tumours tend to recur, and again that’s exactly what happened to Ainscough about a year later, which led to doctors recommending an amputation of her arm at the shoulder again.It was at that point that Ainscough rejected that option and became the Wellness Warrior. But, in assuming that title, Ainscough made a number of decisions that would be life changing in the truest sense of the words.
She put a stop to conventional medical treatment of her cancer in favour of Gerson therapy. A lot could be said about Gerson therapy but probably less is more. First of all, it claims to be able to cure cancer without a single shred of scientific evidence to prove or verify that claim. Gerson therapy involves eating extreme amounts of fruit and vegetables and undergoing up to six coffee enemas a day. Advocates of the therapy claim it allows the body to heal itself by boosting the immune system and removing “toxins”, despite there being no evidence that most cancer is caused by specific toxins or poisons in the body, or that these toxins can be flushed out by diet and coffee enemas, or even that a healing immune response exists, that if stimulated in this manner, could seek out and kill cancer cells. Emertius Professor John Dwyer from the University of New South Wales Medical School says coffee enemas are one of the worst forms of treatment because they can cause deadly bowel perforations. Gerson therapy also advocates the consumption of clay. Yes clay, to “detoxify the body.” This is what Ainscough wrote: “ When we eat clay, the positively charged toxins are attracted by the negatively charged edges of the clay mineral. An exchange reaction occurs where the clay swaps its ions for those of the other substance. Electrically satisfied, it holds the toxin in suspension until the body can eliminate both.”
If you think it sounds like arrant nonsense that’s because it is. Gerson therapy is many things. It is also mega expensive. Its clinic itemizes the charges for undergoing the therapy, which include a two week stay at a cost of US$11,000, travel expenses not included. Then you add the cost of the special juicer you must buy for US$2400, organic produce for one month US$750-$1200. In fact they recommend buying a second refrigerator just so you can store the large amounts of fruit vegetables and other supplements needed for the treatment.
The young, likeable, media savvy Jess Ainscough became the poster child for Gerson therapy. She wrote books, she appeared on television, made videos on Youtube explaining how to administer coffee enemas. She sold cookbooks and cooking supplies all the while extolling the virtues and curative properties of Gerson therapy and listing in detail all of various supplements she took as part of the treatment.
When she began Gerson therapy this is what she wrote:
“Some of you might think the list (of supplements) is a bit extreme, but I assure you that it is totally manageable. It’s nowhere near as much of a pain in the ass to get through as the medicine cabinet full of pills and potions I was taking prior to Gerson. I swear, as soon as we heard that a supplement had anti-cancer properties, I was all over it. I’ve taken everything from seacucumbers to bovine cartilage. This list is like a trip to the beach in comparison. The supplements a Gerson patient must take generally varies to suit the individual. But all the medications are designed to support the diet therapy by increasing the energy capacity of the cell and by increasing the rate of detoxification. “
But by the end of 2014, Jessica Ainscough’s health was deteriorating. She wrote this in a blog post:
“When I left you …….to begin a period of self-care hibernation, my plan was to get my health back in tip top shape and then spend some time creating some awesome new stuff for you. The reality, however, is that I’ve spent the whole time focused on my health. For the last few months, I’ve been pretty much bedridden. Let me fill you in on what’s been going on with me … This year absolutely brought me to my knees. I’ve been challenged, frightened, and cracked open in ways I never had before. For the first time in my almost seven year journey with cancer, this year I’ve been really unwell. I’ve lived with cancer since 2008 and for most of those years my condition was totally stable. I’ve had scans to detect what’s going on in my body, and I can report that the disease is still contained to my left arm and shoulder, however I do have a big fungating tumour mass in that shoulder that’s causing me dramas. Over 10 months of non-stop bleeding from the armpit has rendered me really weak (and uncomfortable) and as a result I’ve had no choice but to stop absolutely everything and rest. “
There was also the strong indication that she had finally returned to conventional cancer treatment. She wrote: “ I believe that as a result of my willingness to stop controlling my healing path and surrender to whatever the universe has up its sleeves to help me , I’ve attracted the most amazing healing team. I’m working with an oncologist who is kind, caring and non-judgemental – completely unlike any of the specialists I worked with in the early days of my journey. When we are open and in a state of surrender, the right people/situations/tools will appear. Final decisions and plans are now in process and I’ll keep you in the loop in the New Year.”
As I said at the start, I never wanted this to sound like I am attacking Jessica Ainscough. On the contrary I admire her. I think she was incredibly brave and courageous. I understand her desperation. And I am very sad that she is dead. There is also absolutely nothing wrong with cancer patients seeking alternative treatments so long as the treatment is in addition to what conventional medicine has to offer. In other words having both.
Ian Olver, the head of the Sansom Institute at the University of South Australia, says most people with cancer try alternative treatments, but the danger is when they become the replacement for conventional treatment. “Even if something has been reported in the press as working for someone, the critical figures are, will it work for 1 in 10 people, 1 in 100 or 1 in 1000, and that’s what evidence-based medicine is about,” Olver says. “In our health system you can basically be treated in the public system without a great outlay [of money], but sometimes they ask you to pay hundreds of dollars a week for alternative therapies”.
Jessica Ainscough was the poster child for Gerson therapy. I take no pleasure or satisfaction from saying she was also the poster child for why it doesn’t work.
Ainscough’s father released a statement on behalf of the family, which is how Jessica Ainscough should be remembered: “I’m so proud of my beautiful daughter for her achievements, style, grace, sincerity and affection. We are deeply appreciative of all the love and support coming in from around the world.”
Some time ago I wrote about what I considered to be Nanny State nonsense. A father was strongly criticised by his daughter’s substitute teacher, because she considered the school lunch, he packed for the little girl, was too unhealthy.
The teacher sent a note home with the child demanding that the father promise to do a better job in the future. In the note, the daughter’s substitute teacher, at Kirksville Primary School in Missouri, listed the unhealthy foods in the little girl’s school lunch, which included four chocolate bars, a bag of marshmallows, crackers and a pickle. It ended: “Please see that she packs a proper lunch tomorrow.” The letter was followed by a request for a parental signature, which the father refused to give, because he was so offended by the letter’s contents.
It turns out that the Dad in question, a man called Justin Puckett, also happened to be a family Doctor from Missouri. He posted the contents of the school letter on Facebook. Many might think and some might even say, as a Doctor, Justin Puckett, should know better than to send his daughter to school with a lunch containing so much junk food. But in his defence, the Doctor and father said “I have the ultimate responsibility to raise my children and I take that role very, very seriously and so maybe I took it bit more personally that there was some offence that maybe I wasn’t doing a good job in that duty, something that is my number one job.”
To be fair, Justin Puckett, also made the point that the teacher did not give an accurate description of what was in his daughter’s lunch: “Unfortunately, the letter didn’t have what she had, correctly. She had four pieces of ham, a whole protein meat, she also had some pickles, which we admittedly cheat on pickles every once and a while as a vegetable, because some fights just aren’t worth having. She also had four marshmallows in a Ziplock bag and then she had three very small pieces of chocolate, of which she ate one for lunch and then she also gave her brother and another friend one at an after school program,” Puckett said.
The reason I want to raise this issue again was prompted by a piece written by columnist Kasey Edwards, claiming that schools have assumed the role of lunchbox police. Suddenly, the morning snack and lunchtime has become a test to see if parents are faithfully following the laws of healthy eating.
Edwards makes the point that what seems like a really good idea, is questionable on whether it has anything, at all, to do with health. In fact, in the quest to promote nutrition, schools may be unintentionally damaging a child’s relationship with food. One school in Brisbane is so strict that children must show their lunch boxes to the class each morning. Quite frankly that is ridiculous and may well be in breach of the child’s rights. Edwards says it is harmful to the well being of children. She claims to know of one child, so anxious about having ‘bad’ food in his lunchbox, that he doesn’t want to go to school. Another school in Melbourne’s eastern suburbs conducts food inspections at the school gate, prohibiting ‘junk food’ from entering the school grounds. Of course banning anything only succeeds in sending it underground. Some enterprising pre-teens totally got the concept of supply and demand and realised that prohibition, as it was with alcohol in the United States in the 1930s, is a rolled gold marketing opportunity. These young entrepreneurs started a black market in the trafficking of doughnuts behind the school shed. “What more evidence do you need that food policing by schools is dangerous?” says Clinical Psychologist Louise Adams. “It’s teaching kids to hide their eating and to binge eat.” Adams says the risks far outweigh the benefits when it comes to schools having a food policy. “From the US research, we can see that this sort of food policing has not resulted in a reduction of body weight in children,” she says. “As a psychologist specialising in this area, all I can see happening is that children are developing a fear of food. Fear is not going to make children healthy; it’s just going to make their relationship with food disturbed.”
Edwards points out that at two primary schools in Melbourne, children are only allowed to eat fruit, vegetables and yoghurt for morning tea. She says this means by lunchtime, the kids are frequently starving which, is hardly conducive to learning. But even worse, it’s teaching children not to trust their bodies, and to develop an almost hysterical fear of certain foods.
Edwards retells the story of a friend who packed a single biscuit made by grandma for her daughter’s morning tea. The daughter came home feeling embarrassed that she had ‘bad’ food in her lunch box. “I put one biscuit in, not six,” said the friend. “What’s missing from this situation is the love and care that grandma put into making special biscuits for her granddaughter.” Can’t argue with that.
Edwards says as a mother she puts a lot of effort into teaching her daughter to listen to her body and to decide when she is hungry and when she is full. If she’s hungry and wants two sandwiches for morning tea, then she is encouraged to eat the two sandwiches. Her daughter is never told to ignore her appetite and only eat carrot sticks. Food is never discussed in terms of good, bad or unhealthy. So there is never shame or guilt about what gets eaten. And that is the way it should be.
Edwards goes on to say that the food policies of some schools undermine the efforts of parents to help children develop healthy relationships with food.
It also goes way beyond a school’s authority. Edwards says as a parent, what goes into her child’s lunch box is her decision, based on family values, her intimate knowledge of her child’s current appetite, preferences, wellbeing, the family budget, and what’s in the cupboard.
And as long as it doesn’t threaten the wellbeing and health of other children, then it is none of the school’s business. Clinical Psychologist, Louise Adams’ says her daughter came home from her school on Sydney’s northern beaches last week, upset because she had a muffin for lunch and was told it was unhealthy.”My daughter was told that she should only eat fruit and vegetables and there was such shame on her face, like she’d really done something terrible,” Adams says. “Kids go from just eating food and being in tune with their bodies, to being scared and feeling worried that they are doing something wrong. This is the breeding ground for an eating disorder.”
Adams says that schools should not be delivering health messages about food to children. It is not their place.
“Kids are very black and white,” Adams says. “Their capacity for nuance is not developed. If we tell them that something is good and something is bad, they believe that absolutely. Then they relate it to themselves, that they are then a good or bad person. Maybe we as parents need some support and help with how to provide a variety of foods to our kids, but it’s psychologically damaging and unnecessary to discuss it with children.”
But in saying this it doesn’t in any way undermine the need to take action to combat the consumption of junk food. The World Health Organisation, warns that diseases linked to lifestyle choices, including diabetes and some cancers, kill 16 million people prematurely each year and urgent action is needed to stop what it describes as a “slow moving, public health disaster”. Unhealthy habits like consuming too much fat, salt and sugar along with smoking and alcohol abuse, are causing an epidemic of diseases, which together constitute the leading cause of death globally. The WHO says this “lifestyle disease” epidemic “ is a much greater public health threat than any other epidemic in human history.
” Non-communicable diseases (NCDs), like cardiovascular conditions, diabetes, and a range of cancers, killed 38 million people around the globe in 2012 — 16 million of them under the age of 70,” the WHO says. ” Not thousands are dying, but millions are dying … every year in their 30s, 40s, 50s and 60s, not in their 80s and 90s.”
Forty two million children under the age of five are considered to be obese, and an estimated 84 per cent of adolescents do not get enough exercise.
In Australia, for example, some leading health groups have called on the Government to consider introducing a tax on junk food and sugary drinks.
“Despite at least six reports from task forces, obesity summits and research papers in the past 20 years advocating firm measures to stop marketing junk food to children, the advertising of fat, sugar and salt drenched products continues largely unrestricted,” the groups say in a joint statement. “Unless immediate action is taken to address dietary related illness there will be a significant increase in cancer, cardiovascular disease and diabetes.”
And while we clearly need to tackle this epidemic, over-reacting may end up making the problem worse.There is no doubt that the schools are well meaning and want to implement food policies with the best of intentions. But, as Edwards points out, there is scant evidence to show that these policies have resulted in a reduction of childhood obesity and conversely, eating disorders are skyrocketing, so maybe the time has come for schools to consider whether their cure is worse than the disease.
An interesting question was posed the other day. It went something like this: How keen are we to be clean? Clean as in hygienically clean as in washing our bodies. We still primp and pamper ourselves more than any of our ancestors. But quelle bloody horreur. The time for personal grooming is being squeezed out of our busy lives. It is being squeezed out as far as women are concerned but it’s probably equally true for men. What do I base this on? A survey, of course, conducted on more than two thousand women aged 18 to 50, by a British cosmetics company. Even if you don’t completely believe the findings they are nonetheless interesting and worthy of a discussion.
Four out of five women admit they don’t shower every day, and a third say they can go for three days without washing their body. The survey also found that almost two thirds can’t be bothered removing makeup before they go to bed, and one in eight own up to not brushing their teeth before they sleep.
When it comes to washing in the morning, only 21 per cent of females take the time to shower or have a bath every day, with 33 per cent admitting to leaving it as long as three days from wash to wash.
But to be fair, having a shower or a bath daily used to be a pastime only for the wealthy upper-class. Back in the days before we had convenient plumbing, almost no one would bathe every day.and almost everyone would have simply “freshened up with a quick wipe” in the morning and evening – which, according to that survey I mentioned is what 57% of women in 2015 are doing. It became, very much, a 20th-century routine to always include a daily bath. Later on, this morphed into taking a shower, by far the easiest way to wash off the dust, sweat and fatigue of a day’s hard work. This is what public baths were originally created for, when very few people had a bathroom; and we all know that coal miners had to wash before they would eat or sleep, as is true for those in the building trades today.
So where did this non-washing suddenly spring from? Eighty nine percent of those surveyed, blamed evening and morning tiredness for their lack of showering or bathing. I’m sure some people would be digusteded by this revelation. But is it disgust that is misplaced? Cleanliness maybe next to godliness but it is relative. Human bodies do not disintegrate if they are not washed for days even three or more days. So maybe we should be more forgiving of those who do not have the time or the energy for an evening or even morning grooming ritual. Maybe the time has come for us to acknowledge that most people lead busy,busy lives that get increasingly hectic as the day progresses. Many people have other things to do by 6pm, such as looking after children and cooking meals, worse still they haven’t even left work yet. Morning showers are more frequent, but not always possible in a family situation. I’m making a lot of excuses here. Just saying.
The curious finding in the survey is that parents, who don’t take an early evening bath, still regard it as an absolute ritual to bathe their children at 6pm every day. The why is because they are training their children in the habits of cleanliness, handed down directly from Victorian nurseries. But how effective are their efforts? How many parents find that their children’s grooming and tidying routines go on vacation immediately the children leave the surveillance of the parental home? The survey has an explanation for this. It may well be that the 63% who don’t bother removing make up or brush their teeth before bed, are young adults. They presumably have more important things to do with their time. But according to the experts ironically they will still, in all probability, train their offspring exactly as their parents trained them, because this is what humans do. It is how standards are maintained and passed on.
As one commentator pointed out, the really sad aspect of the survey is that even in the 21st century, personal grooming time is still a relative luxury, because we are still time-poor. We have almost completely lost sight of the extensive life-work balance that used to be the essence of the philosophy of Hygeia. Now I’m sure you all know about the philosophy of Hygeia. For those that don’t, Hygeia was the ancient Greek goddess of health. She gave her name to the philosophy of hygiene. The cult of Hygeia started in Athens in 600 BC, in connection with the cult of Athene, goddess of wisdom and purity. Statues of Athene and Hygeia stood at the entrance to the Athens Acropolis. Hygeia was a young goddess, daughter and chief attendant to Asklepios, the god of medicine. She was in charge of cleanliness and how to live a long life. She had two other medicinal sisters: Panacea (‘Cure-All’) and Iaso (‘Remedy’). The Romans named her Salus. In classical sculpture she was often shown holding or feeding a large snake, the symbol of medicine. Her other official symbol was a large water basin. Statues of Hygeia were erected in all the major healing centres in the temples of Asklepios. The cult of Hygeia was first spread about Greece in response to the bubonic plague, a disease symptomatic of poor hygiene.
In Greek ‘hygeia’ means ‘soundness’ or ‘wholeness’. Hygiene in medicine was about maintaining the ‘wholeness’ or ‘health’ of the body and keeping it fit. Hippocratic doctors formulated a philosophy of hygiene that covered almost every possible aspect of health – including mind, body and the environment. The influence of this philosophical thinking continued to impact on public health reforms during the past two centuries.
But with the passage of time and the Industrial revolution, hygiene became confined to the idle rich. They had the time because everyone else was too buy working to live. But reforms in working-hour legislation gave us a minimum of 10, then eight, working hours per day; then Saturday afternoons off; then Saturday mornings off; and finally the half-days that shops used to have on Wednesdays or Thursdays to allow workers time off for playing sport. All of these gains were painful and hard fought for and won from employers, but they’ve gradually been eroded by the pace of modern living. As one commentator observed, working hours have increased, under the same advanced capitalism that demands excellent personal grooming but spares us little time in which to perform it. Personal hygiene is now squeezed into our five-day working week, in an average office day which now ends (for both men and women) at 6-7pm rather than 4-5pm – if they are lucky.
As in the past, Saturday is still often the only day that allows time to get a haircut, or (these days) a pedicure, manicure, or a massage. You can get time off for the doctor or a dental emergency, but not the hairdresser, the yoga class, or for playing sport. So what does this all mean? Is it all just one giant excuse for being incredibly lazy and unhygienic? Or maybe we just don’t have time to be clean, at least not every day. The French don’t seem to have any hang ups about this. I’m sure it was Napoleon, who in a letter to Josephine, wrote, I will be home in a week. Don’t wash. That’s definitely pretty dirty.
I’ve been thinking about growing old quite a bit recently. Some may say too late, you’re already there. But funnily enough, I don’t see myself that way. As a child born in the 1950s, I am technically old and certainly middle-aged. But you know what? When it comes to living I say that glass, she is still half full so I give the two-fingered salute to old father time. But how long can I, should I, expect to live? Well, if your name is Ezekiel Emmanuel and you happen to be President Barack Obama’s health advisor, then the answer is 75. That’s how long Emmanuel wants to live, or so he says. He wrote an extremely provocative essay in the Atlantic Monthly, titled: Why I Hope To Die At 75, an argument that society and families and ourselves would be better off if nature takes its course swiftly and promptly.
Emmanuel writes: “Doubtless, death is a loss. It deprives us of experiences and milestones, of time spent with our spouse and children. In short, it deprives us of all the things we value. But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic. By the time I reach 75, I will have lived a complete life. I will have loved and been loved. My children will be grown and in the midst of their own rich lives. I will have seen my grandchildren born and beginning their lives. I will have pursued my life’s projects and made whatever contributions, important or not, I am going to make. And hopefully, I will not have too many mental and physical limitations. Dying at 75 will not be a tragedy. “
Already I am thinking Ezekiel Emmanuel is, quite frankly, talking through his hat. I mean on what basis is 75 an arbitrary cut off point? But for the sake of a debate let’s humor him. Emmanuel says over recent decades there was an increase in longevity but also a significant downside. That increase was accompanied by an increase in disability. In other words, we’re living longer but becoming more incapacitated. To bolster his argument, Ezekiel cites research from Eileen Crimmins, a researcher at the University of Southern California, who assessed the physical functioning in adults, and analyzed whether people could walk a quarter of a mile; climb 10 stairs; stand or sit for two hours; and stand up, bend, or kneel without using special equipment. The results show that as people get older, there’s a progressive erosion of physical functioning. More importantly, Crimmins found that between 1998 and 2006, the loss of functional mobility in the elderly increased. In 1998, about 28 percent of American men, aged 80 and older had some form of functional limitation; by 2006, that figure was nearly 42 percent. It’s even worse for women. More than half of women aged 80 and older had a mobility issue. Crimmins’s conclusion: There was an “increase in the life expectancy with disease and a decrease in the years without disease.” As people live longer their ability to function with normal mobility gets shorter. According to Emmanuel, health care hasn’t slowed the aging process, it has slowed the dying process. As far as Ezekiel Emmanuel is concerned, old age is just bad news that keeps getting worse. He writes: “ Even if we aren’t demented, our mental functioning deteriorates as we grow older. Age associated declines in mental-processing speed, working and long-term memory, and problem-solving are well established. Conversely, distractibility increases.
“We cannot focus and stay with a project as well as we could when we were young. As we move slower with age, we also think slower. It is not just mental slowing. We literally lose our creativity.” But having argued the point in quite extensive detail, Emmanuel comes to the end of his piece and does the full cop out. He says: “ Seventy-five years is all I want to live. I want to celebrate my life while I am still in my prime. My daughters and dear friends will continue to try to convince me that I am wrong and can live a valuable life much longer. And I retain the right to change my mind and offer a vigorous and reasoned defense of living as long as possible. That, after all, would mean still being creative after 75.”
It’s called having a bet each way. Emmanuel, a bioethicist, says he hopes to be dead by 75, having lived in his words a complete life. He won’t medicate, take a flu injection or even swallow an antibiotic, but then reserves the right to change his mind, which he is perfectly entitled to do. But what is the point of advocating being dead by 75 if you don’t really mean it? And, all of these ideas coming from a senior Obama advisor, implies that he must be trying to influence Government health care policy. But even if he isn’t, Ezekiel Emmanuel, will in all probability, change his mind when he creeps closer to that magic figure of 75, assuming he lives that long. Interestingly, he has identified an important issue. Despite what Emmanuel says, I firmly believe age is a state of mind. And depending on which state, that mind happens to be in, has a large bearing on how well you will fair as you get older. But you are fighting an uphill battle. A fair and humane society should respect an individual at every age. But that can’t be the case when Governments and economists and even the media talk about the problem of old age. An Australian researcher, Doctor Patricia Edgar, has written extensively about the issue of aging. She says American National Institute of Ageing studies show that negative stereotypes about ageing, images of the elderly as “senile”, “frail”, or confused, can become debilitating, self-fulfilling prophecies. “ Seeing or hearing gloomy examples about what it is like to be old can make people walk more slowly, hear and remember less well, and even affect their cardiovascular system, affecting health and longevity,” Edgar says.
She points out the result is hardly surprising. Tell anyone, at any age, they are a burden, with nothing to contribute and they will begin to believe and act accordingly. Here’s something that might surprise. Despite many of the resounding, negative observations, a significant percentage of older Australians and I suspect people from other countries as well, are living, breathing testimonies of how wrong you can be. They are living fulfilling lives , increasing their contribution to the work force. I’m not just talking about my generation of baby boomers who seem to be a unique social experiment. It’s the group directly following the baby boomers, which represents a larger demographic and will create an even larger bulge in the paid labour force. So what is the best way to correct the myths and develop responsible and productive policies that actually benefit older people? According to Patricia Edgar we should start with a new definition of ageing.
When is someone said to be old? Research says life expectancy above 30 is a very modern phenomenon driven by public health measures and falling infant mortality. Life expectancy at birth was 35 in Sweden shortly before 1700; in Italy around 1880; and in Russia around 1910. In Australia today, life expectancy for men who are now 65 is 85 and for women it’s 89. Older people represent the fastest growing demographic in society.
Yet, as Edgar points out we are still mired in the perception that 50 is the beginning of old age. South Australia’s Ageing Plan is based on interviews with Australians over 50. At that age we are entering “the second half of life”, not heading for God’s waiting room.
According to Edgar, by treating this stage as a period of aged obsolescence, we create a non-existent problem and undermine a resource, which could have significant benefits for society. She says in the 1950s, Americans identified adolescents or teenagers as a group distinct from children, with special needs. It also made sense to split the childhood demographic into two distinct groups with children living with their parents for longer, entering the workforce later, marrying later and life expectancy increasing proportionally. Edgar says it’s time to recognise that middle age, like childhood, is now lived in two stages. We’ve evolved to a point where the first stage involves work and the second, activity before old age. We don’t simply stop work, and then die as we did in the early 1900s. Retirement is from the paid work force but it doesn’t mean you also retire from life. Edgar says it’s a time of maturity, broadened by experience. A time for giving something back and finding satisfaction in a range of activities, like volunteering, childcare and mentoring. Contributions, that should be recognised and valued. It’s a generation that might not figure in measuring a country’s GDP, but strong communities can’t exist without them. Patricia Edgar claims the media doesn’t help by frequently getting it wrong in promoting the concept of some kind of intergenerational war. It is a rare for a family not to view the interests of the young as the over-riding concern of parents and grandparents. Income flows from the old to the young more so than the other way around, a fact that is often conveniently ignored. Edgar says it isn’t difficult to see that the attributes of the very old are being dismissed way too early. And given our increased life expectancy, the term “old” should mean someone over 85, not 65 and certainly not 55.
According to Edgar, social, medical and cultural policy needs to catch up with this dramatic change in our life cycle. We should stop talking about retirement and “having a well-deserved rest”. Working until the age of 70, if the jobs are there, and there’s no discrimination in the workforce, makes perfect sense. And the reason for continuing to work doesn’t have to only be as a way of earning an income. It can prevent decline. For too many people, retirement leads to cognitive, emotional and physical obliteration.
Edgar says people living an active life after 55 have much to give. As a society we need to think about redesigning our long life journey. There is a growing body of research suggesting that health and satisfaction post 50 plus, is an opportunity to re-invent ourselves. We have become used to thinking that education is solely for the young. Instead we need to think about education as a life-long process.
According to Edgar, the choice is ours to make. We are experiencing a longevity revolution. And if we have enough will and imagination, it has exciting potential. Yes even for you Ezekiel Emmanuel. And, you should tell your boss in the White House.