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booooored
I am over paediatrics and it's been a week. This is probably because none of the lecturers have been much good except the guy who went on about fractures for ages, and it's fucking cold outside and really warm in the tiny videoconferencing room and I am seriously this close to just falling asleep against the wall and answering all questions directed at me with a snore or a light stream of drool.
I'm drinking mocha, but part of me is trying to feel guilty about it, because yesterday we had the chronic diseases lecture about the skyrocketing rates of juvenile diabetes and the way our society increasingly makes healthy food/healthy amounts of activity really difficult to obtain and how much more awesome lifestyle interventions would be if the social environment in which the changes should be made were even slightly interested in facilitating those changes...
and I'm like, MAN I COULD DO WITH SOME MCNUGGETS RIGHT NOW.
Relatedly: I am trying so hard to be on guard against the fatphobia that medical school instills in a person, and I'm coming to the conclusion it's all about separating personhood from medical fact. It's about being honest with people about the increased complication rates following surgery, but refusing to participate in conversations that involve the word 'disgusting' as applied to fat people. It's about knowing that obesity is a risk factor for insulin resistance and hypertension and high cholesterol, and being conscientious about monitoring these things, but not getting hung up on weight if a fat person is actually pretty damn healthy. It's about trying not to kick my colleagues in the teeth when they reduce the problem to 'well, if they just ate less crap and got off their asses once in a while...' It's about the fine line between doing and saying things out of genuine desire to improve someone's health, and doing and saying them because you just don't think they should be FAT, because EW.
In this as in many other things, I think it comes down to a test of basic human decency, ie. does this thing you're about to say make you sound like a dickhead, Y/N? If Y -> DON'T SAY IT. You can teach students about the increased difficulty of operating on people with a large body habitus without making it into a game of GUESS THEIR BMI complete with horrified noises upon being given the answer.
Anyway.
BORED. BORED BORED. Save me from drooling indignity: say hi if you're around. Tell me something fun.
I'm drinking mocha, but part of me is trying to feel guilty about it, because yesterday we had the chronic diseases lecture about the skyrocketing rates of juvenile diabetes and the way our society increasingly makes healthy food/healthy amounts of activity really difficult to obtain and how much more awesome lifestyle interventions would be if the social environment in which the changes should be made were even slightly interested in facilitating those changes...
and I'm like, MAN I COULD DO WITH SOME MCNUGGETS RIGHT NOW.
Relatedly: I am trying so hard to be on guard against the fatphobia that medical school instills in a person, and I'm coming to the conclusion it's all about separating personhood from medical fact. It's about being honest with people about the increased complication rates following surgery, but refusing to participate in conversations that involve the word 'disgusting' as applied to fat people. It's about knowing that obesity is a risk factor for insulin resistance and hypertension and high cholesterol, and being conscientious about monitoring these things, but not getting hung up on weight if a fat person is actually pretty damn healthy. It's about trying not to kick my colleagues in the teeth when they reduce the problem to 'well, if they just ate less crap and got off their asses once in a while...' It's about the fine line between doing and saying things out of genuine desire to improve someone's health, and doing and saying them because you just don't think they should be FAT, because EW.
In this as in many other things, I think it comes down to a test of basic human decency, ie. does this thing you're about to say make you sound like a dickhead, Y/N? If Y -> DON'T SAY IT. You can teach students about the increased difficulty of operating on people with a large body habitus without making it into a game of GUESS THEIR BMI complete with horrified noises upon being given the answer.
Anyway.
BORED. BORED BORED. Save me from drooling indignity: say hi if you're around. Tell me something fun.
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But I can't do fun, I don't think. Stayed up until 4:30am, and graaaaaaaaah, Frar, I want my writing muse to SHUT. UP. and stop...coming up with ideas. It's ridiculous. Particularly as Avatar (aliens, not airbenders) doesn't have a very large reading/writing fandom ANYWAY, and I go and do things like 'um, guys, this is kinda racist and unfortunate implications, why can't we fix' and they are all 'IT'S ALL GENIUS NO RACISM AT ALL THE NA'VI ARE PURE' and it makes me sad. And I'm rambling, so I'll stop now.
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I think the single most important factor is socioeconomic, though; most medical students come from very affluent backgrounds, and also live in the cities instead of rurally, both of which mean much better overall access to fresh nutritious food.
Plus we have the health messages drilled into us from day 1 of medical school, and most of us are pretty good at keeping to them. Apart from the binge drinking. That still goes on.
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And the economic disparity plays a role here too: the average income tends to be lower in remote areas, so people spend the money that they have on whatever will get them enough calories, and that's sadly the cheap, calorie-dense, unhealthy stuff. Fresh fruit and veg are expensive, and even MORE expensive if they have to be trucked in from a long way away, and the subsequent lack of demand for the produce means that less is likely to be delivered...etc.
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So... you know the urban gardening projects people get going in cities? Everyone grows carrots in their footpath verges, co-op gardens and whatnot. Perhaps there's a need for such things in smaller rural centres, too? Which sounds counter-intuitive because people expect *rural* to be *full of food*. But, hmm, growing vegetable gardens is a completely different skill to growing wheat or farming sheep, and maybe not everyone has those skills or the time to put into raising a whole range of vegetables on their own property.
To be effective there'd need to be a balance for the socio-economic disadvantages - start-up money and training resources and so on. And you'd need to tie it in with existing community networks (schools? Pre-schools? churches?) but not rest it solely on any one of them, in case that organisation collapsed.
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Education, while not nearly as big a contributer to the problem as many other things, DOES play a role here, especially in early childhood. We've been hearing about lots of young mothers who maybe didn't finish high school, and live remotely so coming in for paediatric checkups is logistically difficult, and maybe you have four kids to look after and if one of them refuses to eat anything except cow's milk flavoured with chocolate syrup in a bottle, that's what you give her. And then eventually the kid presents with a haemoglobin level that's scraping the floor, and vitamin deficiencies.
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Possibly subsidies the *production* (rather than, or as well as, consumer purchase) of fresh food? Well, further subsidise - primary producers are already subsidised. Because in addition to expense there's the problem of supply - there isn't enough of it or it's in the wrong places, and that's something small-scale local production can help with.
And education, yis! Which is another hard one to do without wandering into *something*-ist territory. Classist, probably.
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We had a teaching session on new diabetic treatments yesterday, and the incretin based therapies. Really fascinating stuff, about gut released hormones that modulate the pancreatic insulin response, as well as satiety centres, which are known to be deficient in T2DM (both their release and the response to them). New therapies are bringing HbA1c back to target *and* reducing weight in diabetic people. The prof giving session talks about side effects - 'the major side effect is nausea, and you need to counsel patients to stop eating when they no longer feel hungry, which is new to many of them'. Cue guffaws from the crowd.
And I'm sitting there fuming, because we've just been hearing about how people with T2DM have been missing a major satiety hormone for maybe a decade, and we think it's hilarious that restoring it might lead people to need to learn new habits? Fuck off.
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And now I will practice cello in the 20 minutes remaining before 10pm when the crazy downstairs neighbor will come bang on my door saying that the sound of me sitting on the couch typing is so noisy it's keeping her awake. Ah, apartment life.
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Oh, there was a crackpot theory about my next-door neighbor dumping a body out his window in the middle of the night! But that's not fun, either. Interesting, maybe.
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Something fun? Um, why do ghosts make such bad liars?
*drum roll*
Because you can see right through them!
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That reminds me of my favourite joke! What's red and invisible?
...
NO TOMATOES.
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Funthings! Are you on tumblr? Tumblr is good for fun things.
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Hi!
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I feel awkward approaching the topic because there's a lot of stuff out there about Healthy At Any Size (which is awesome) but also some places that are like ALL THE MEDICAL EVIDENCE ABOUT BEING FAT = BEING UNHEALTHY IS WRONG, which, well, no, it's not. There are still associated risks. But I agree that the medical profession as a whole still has an unhelpfully fatphobic approach to the whole matter, and a tendency to go FAT PERSON -> DING DING MUST INTERVENE, which sort of wipes out the person's identity.
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But it took me years to find this good collection of zebra doctors, and I guard them JEALOUSLY.
You could be a zebra doctor. You'd be good at it because you'd like the challenge. Just saying.