Communion Of Dreams


Spread your wings and … walk?

No, this is not about the ongoing fiasco which is the TSA. But it certainly could be.

Rather, it’s a chuckle I thought I would share about my cardiac rehab sessions. Remember those? I started them about a month ago, with all the expected advice about diet and exercise. Since then, except for a trip to California to visit family early this month, I’ve been a good boy about going to my sessions and putting in the time and effort to meet the goals they have for people who had a couple of stents installed like I had.

Actually, let me amend that: I met all the goals they have set with my first workout session. As in, for where they want you to be at the end of 36 rehab sessions. Today, at my tenth such session I hit twice those goals. That isn’t to say that I am some perfect physical example of athletic prowess; rather, it’s that typically when people have the procedure I had done, it’s usually because they have systemic atherosclerosis with all the problems that entails. I had a genetic defect. And while I am overweight and out of shape, I’ve managed to avoid the real damage of cardiovascular disease.

Anyway, I’ve been going to rehab 2 – 3 times a week, in addition to my regular morning walks and other yard/garden work. Frankly, I mostly hate it. I hate the TVs which are always on, tuned to some inane morning show. I hate the cheery encouragement of the nurses, particularly when they want to go over yet another handout they have about reading food labels and strategies for managing portion control when eating out. And I hate the pap of “motivational posters” featuring lovely outdoor images (which are fine) with mostly trite inspirational phrases in a very distinct typographical style. There are about a dozen of these things on the walls, mixed in with yet more posters about diet strategies and charts showing exertion and pain levels.

But …

… I noticed this one, lost in among all the others:

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It’s a little hard to read, with all the reflection/distortions, but it says: “Limitations. Until you spread your wings, you’ll have no idea how far you can walk.”

Er, what?

Turns out (as one of my friends noted on Facebook) that this is actually a DEmotivational poster. Yeah, one mocking the usual trite inspirational phrases ones.

I think that this is absolutely hilarious.

I don’t know whether it was slipped in there by someone as a joke which no one else has ever caught, or it was seeded among the others to give cynical bastards like me a chuckle, but it works. I get a laugh out of it every time I go to rehab. It makes the grim process of exercising slightly less annoying. And I think that is wonderful.

 

Jim Downey

 

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The virtuous heart.

I got an object lesson in privilege yesterday. My privilege.

I went in for my first session/assessment for cardiac rehab, following the stent procedure I had two weeks ago. The RN who did my assessment had been a cardiac surgery nurse, and knew her stuff. She also had all of my medical records pertaining to my procedure, and was completely familiar with my overall health and particularly my cardiac health (which, as I have mentioned previously, is actually really good).

We went through what is the normal procedure for such things: I got hooked up to a heart monitor, she checked my blood oxygenation, my blood pressure, my pulse. All were excellent. Then we went through my exercise and dietary habits in pretty thorough detail, discussing the few points where my eating habits deviate from ‘accepted medical recommendations’ (which are actually just ‘outdated medical recommendations’ such as limiting how many eggs you eat in a week to just one or two) according to the forms she had to fill out. All that was routine, and the same material I had been over with at least half a dozen other medical professionals in the last month.

Then we got into discussing just exactly what the condition of my heart now was, and what was recommended to help me improve it, post-procedure. She started out with the model heart on the desk, relating it to how my own chart compared, and complimented me again on the fact that I basically have no other evidence of atherosclerosis or plaque build-up anywhere in my heart other than the one problem section of my RCA that they stented. She said something to the effect of “genetics plays a role, but undoubtedly your regular walking every morning for the last decade has made a huge difference.”

“I’m lucky. I’ve been able to arrange my life so that I could take the time out to do that, for the last dozen years or so,” I said.

She nodded. “A wise choice.”

“Well, not one a lot of people can make. Most people can’t just schedule an hour for daily exercise. Like I said, I’m lucky. Very lucky. ”

“True,” she said. “But I always tell people that whether or not to exercise is a choice they make.”

I paused, considered, then nodded. We went on with the rest of the assessment.

Why did I hesitate? Because in that moment — in her statement of my ‘choice’ — lies a perfect summation of my privilege.

I’m a ‘virtuous patient’, in the eyes of most of the medical community. I’m a nice guy, who is well educated, professional. I exercise regularly, eat (relatively) healthily, don’t smoke at all, and rarely drink to excess. I maintain good social integration, and work to have a happy marriage and a good support network of friends. I even floss more than is probably average.

So, since I do all those things, in their eyes the quirk of a fault that is my kinked coronary artery isn’t really my fault. It’s just a small bit of bad luck. A small bit which can be forgiven, because I make a lot of ‘good’ choices about how I go through life.

But while I have indeed made a number of choices which can be considered to be virtuous, my privilege lies in having been able to make those choices.  Realistically, how many people who are earning minimum wage are able to plan to go walking through their neighborhood (or at the local YMCA or city activity center or mall) every morning? How many people living in a food desert have access to plenty of fresh fruit and vegetables? How many people who are actually obese (I need to lose a good 50 – 60 pounds to be at my ideal weight), would be perceived as being lazy rather than working to maintain good health? How many people have the formal education and time to stay on top of modern medical research and discussion of best practices such that they can discuss the nuances of diet and exercise and the role it plays in cardiac rehabilitation?

I could go on and on. But I’ll refrain. For those who are already concerned with such matters, it isn’t necessary. And for those who seldom or ever consider how privilege affects health, it won’t be sufficient. However, perhaps a few people — you? — will take the opportunity that my privilege has presented to realize that how we judge the choices of others comes mostly from how we perceive them as people.

 

Jim Downey

 



Scraping by.

I’ve been entirely preoccupied with a big book conservation project which landed in my lap unexpectedly and needed attention right away (and trying to keep work going on St. Cybi’s Well), but a news item I saw the other day has been kicking around in my head. Er, so to speak. It’s the notion that the quality of dental hygiene & health in the modern era is *much* worse than it was before the advent of civilization. Here’s a good passage from one of the better articles which sums this up:

Our mouths are now a gentrified shadow of their former selves. And as Carl Zimmer described earlier this week, ecosystems with an impoverished web of species are more vulnerable to parasites. He was writing about frogs and lakes, but the same is true of bacteria and mouths. The narrow range of microbes in industrialised gobs are more vulnerable to invasions by species that cause disease, cavities, and other dental problems.  “As an ecosystem, it has lost resilience,” says Cooper. “It basically became a permanent disease state.”

Of course, current thinking is that this is due to a fairly radical change in diet between the two time periods, with our reliance now on domesticated grain crops.

But I know the real reason:

“He had a nutty theory that early man had been shortlived, but impervious to disease. Something about being able to trace back mutation clues to some proto-genes that suggested a powerful ability to heal.” Jackie frowned.

Yeah, that’s from almost the end of Communion of Dreams. And is a topic we’ll revisit in the prequel.

Hehehehehehehe.

 

Jim Downey