Here’s a sobering story in the NYT about a man who almost missed the signs of a heart attack until he remembered reading about the suddenness of the late Tim Russert’s death. Fortunately, the author made it to the hospital in time to get effective medical attention — and he found that he’s not the only middle-aged guy paying extra attention to his heart these days. It’s a poignant article — but I’m sure Shapelings will notice the rhetorical patterns I did: the many references to weight in the article (and, implicitly, the dangerous effects of assuming heart attacks only happen to fat, sedentary people); and the nickname for the author’s cycling club: the Cheat Death group.
This article, which is written from a personal perspective and is (I think) an effective use of anecdata, reminded me of two other things I’ve read recently. The first is Kate’s post on Broadsheet about the fact that heart attack symptoms are different for women than they are for men. If you haven’t read it yet, please do — it serves as a stark reminder that the “default” body of Western medicine is male. And while you’re at it, take a refresher course in the signs and symptoms of a heart attack. A key quote:
As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.
Not to be morbid, but please, if you even begin to suspect that you might be having a heart attack, call 911 (or your country’s equivalent) immediately. Don’t try to talk yourself out of it: time is crucial when it comes to treating heart attacks. In the meantime, it’s not a bad idea to get certified in CPR and first aid, which you may be able to do at your place of employment (that’s what I did when I worked for a big corporation). If you work in a big office building, there might be an AED in your building somewhere, which should come with instructions and is surprisingly easy to use. Find out where it is, and make sure your coworkers know too.
Now onto more abstract musings. I read Susan Sontag’s classic essay Illness as Metaphor last week, because I’m cheerful like that, and the “Cheat Death” club reminded me of a passage I wanted to share with you all. Sontag, who had cancer herself, examines the ways in which grave, incurable illnesses (particularly cancer in the 20th century and TB in the 19th) get appropriated as metaphors for moral conditions, political events, and the like — and then the negative connotations associated with those metaphors are extended back onto the people who actually suffer from the disease. Cancer becomes a sign of moral weakness, of the wrong kind of personality, instead of a physical ailment that could happen to anyone. Sound familiar, anyone? Physical illness is psychologized to shift “blame” — from environmental hazards, the inadequacies of medical knowledge, and just plain chance — onto the individual. Here’s the passage that really struck me:
Moreover, there is a peculiarly modern predilection for psychological explanations of disease, as of everything else. Psychologizing seems to provide control over the experiences and events (like grave illnesses) over which people have in fact little or no control. Psychological understanding undermines the “reality” of a disease. That reality has to be explained. (It really means; or is a symbol of; or must be interpreted so.) For those who live neither with religious consolations about death nor with a sense of death (or of anything else) as natural, death is the obscene mystery, the ultimate affront, the thing that cannot be controlled. It can only be denied. A large part of the popularity and persuasiveness of psychology comes from its being a sublimated spiritualism: a secular, ostensibly scientific way of affirming the primacy of “spirit” over matter. That ineluctably material reality, disease, can be given a psychological explanation. Death itself can be considered, ultimately, a psychological phenomenon…
At the least, there is the promise of a triumph over illness. A “physical” illness becomes in a way less real — but, in compensation, more interesting — so far as it can be considered a “mental” one. Speculation throughout the modern period has tended steadily to enlarge the category of mental illness. Indeed, part of the denial of death in this culture is a vast expansion of the category of illness as such.
Illness expands by means of two hypotheses. The first is that every form of social deviation can be considered an illness… The second is that every illness can be considered psychologically… These two hypotheses are complementary. As the first seems to relieve guilt, the second reinstates it. Psychological theories of illness are a powerful means of placing the blame on the ill. Patients who are instructed that they have, unwittingly, caused their disease are also being made to feel that they have deserved it.
The impetus for Sontag’s discussion here is the idea of the “cancer-prone personality” that was gaining traction when she wrote the essay, but I think her analysis can shed light on the OBESITY EPIDEMIC OOGA BOOGA, too. The medicalization of fat bodies is clearly an example of her first hypothesis (every form of social deviation can be considered an illness), and the relentless attempt to use shame as a weight loss motivator is a clear example of the second. First, we’re told that our fat bodies are a danger; then we’re told that your body is the legible sign of the inner you, some secret personality that’s just not disciplined enough to lose weight. This double blaming leads not just to personal fat shame, but the tragic instances of fat prejudice in medicine, which often arise from the idea that fat people cannot be trusted to describe the reality of their bodies, and that they don’t deserve adequate medical care anyway. They deserve illness, because they are fat — and if you’re fat, you’re ill by default.
Sontag begins her essay with a stunning metaphor:
Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.
Illness is a fact, not a manifestation of your morality. Fat is a fact. Mortality is a fact. You cannot cheat death by joining an exercise club any more than you can cheat hunger by eating only carrot sticks. What you can do is try to listen to your body, both its pleasures and its pains, and live a life that is healthy for the body and the mind that you are.