Please Don’t Pressure Me To Consume Health by Miriam Sagan

In some discussions about Barbara Ehrenrich’s views in her new book “Natural Causes” I feel that I have stumbled upon beliefs that are more dogmatic than practical, particularly as regards health. I’ve loved reading Ehrenreich since I discovered her first book, many years ago. “For Her Own Good.” chronicles women’s healthcare, and its relationship to the subjugation of women.
Her new book really lines up with the way my thinking has been developing. It basically points to the reality that all of us will die, that much of health advice on diet and screenings (and even, I’ll add, the target numbers for metabolic diseases) don’t necessarily lead to either increased longevity or improved health, and that we should make our own decisions.
It is this last point, I think, which sets off those folks I’m conversing with. Let’s say I decide to stop testing my PSA. (I figure that’s a gender neutral example, as I don’t actually have a prostate!). Many people react as if I’d decided to ignore malaria, a broken leg, and a psychotic break all at the same time. How…irresponsible! How unscientific!
This is where the religious approach kicks in. Forget that the jury really is out on many screenings in terms of public health. Forget that screenings carry risk. Apparently I’m also supposed to forget that I’m more in charge of my own decisions than, let’s say, the health care industry or my average friend. I don’t like to be bossed around, and I doubt if that is going to change. Actually, as regards my life and death and fashion decisions, “ain’t nobody’s business but my own.” There is no reason for anyone to make me conform.
I don’t like it when other people monitor what I eat or drink. I don’t appreciate comments or implications that my choices are unhealthy—or healthy. Frankly, I wish folks paid a lot more attention to my creative pursuits or attempts at social responsibility and a lot less attention to my health decisions.
It’s not like I’m refusing a vaccine against polio, and therefor putting a child and the group at risk. I’m guessing it is the fact that I’m hesitating to consume that upsets some other people. And this is because I’m also often lectured for not having a cell phone, a dryer, a micro-wave, or an unshared car. Why on earth should this bother anyone else? They aren’t washing my dishes.
There is no moral or ethical imperative that I’ve ever heard of that requires us to buy things or comply with the health fads of the day, and much of health advice is indeed momentary. I’m all for self care, but I’d like to be involved in defining that for myself.
Now this may be the point in the discussion where someone tells me how X. did Y.—and X’s life was saved! Is X. to be my role model? Is X. charitable, bold, creative, compassionate, adventurous? I probably would not do as X. did in terms of finances, romance, aesthetics, or child-rearing. And, honestly, not in terms of life and death.
Another book I recently enjoyed was “Thinking in Bets” by Annie Dukes. It’s about poker, and how life is much more like poker than chess. The author emphasizes that we are always making decisions based on incomplete information, and that adjusting to that is a necessity. The answer isn’t to try and get more information, but to realize you have to take a chance. She also looks at outcome biases—thinking a decision was good or bad based on the upshot. I wish someone would develop this as regards health care decisions.
One last thought—making our own decisions also affects end of life—i.e. deaths. Again, I don’t owe it to anyone to do a certain kind of treatment. But I’ve been thinking that it would help if we applied the notion of quality of life to life itself, rather than to just its end stages. How does the accepted capitalist paradigm of earning to consume affect our quality of life, year after year? Personally, I like to practice saying no to consumption. Not in some huge morally superior way, just in small ways that allow me to explore my own autonomy.