A Canadian Military Physician Offers Insight On Our Culture: Diseases Of Affluence

The coming days will be extraordinarily busy, so for that loyal handful that check in on OS's scribblings, rest assured he's ok, just up to his ears in his professional life.

A Canadian military physician, Kevin Patterson, offers up a long (sometimes wandering) but insightful article about our North American/Northern European culture. While serving in Afghanistan, the contrast between the physical condition of the Canadians who arrived for treatment of wounds and their Afghan counterparts was striking.

For someone used to the life and the pathologies of the rich and settled, much about practicing medicine in Afghanistan felt unfamiliar. One of the striking differences was the way gunshot victims’ abdomens looked in CT scans. Back home, I was used to seeing organs stand out with some prominence from the abdominal fat. In fact, in Canadians, the state of the kidneys can be partly assessed by the degree of inflammation in the perinephric fat that envelops them. It’s the same with the pancreas, and the liver often looks like it belonged to a French goose fattened for foie gras. Indeed, the idea of “normal” in a Canadian body proceeds from the assumption that it might be normal to spend one’s days tied to a grain spout, beak pried open, being filled with cracked corn.

Not the Afghans. The surgeons, in fact, often commented on how the abdominal contents spilled out once the abdominal wall was opened; every loop of bowel immediately visible, unobscured by mesenteric fat, which, in Canadians, would cling to every organ like yellow oily cake. Excessive fattiness is precisely why, when caring for the critically ill in North America, glucose levels are tightly controlled with insulin—a procedure necessary even for those not thought to be diabetic. Stressed by the infection, or the operation that has brought us to the intensive care unit, our sugar levels rise, paralyzing our white blood cells and nourishing the bacteria chewing upon them. But it was never necessary to give the Afghans insulin, no matter how shattered they were.

...and, later...

Afghans die through causes that are widely considered avoidable—war being chief among those, but also tuberculosis, complications of childbirth, measles, meningococcus and polio. This fact is revealed conclusively by the life expectancy in Afghanistan, the lowest in the world: thirty-nine. Westerners are made ill by diseases the Afghans avoid—even among the very elderly, traditional peoples do not suffer cardiovascular disease—while the Afghans perish from diseases we are too rich to tolerate.

This is sobering--and the article goes on to discuss other parallel situations around the world. We've accomplished so much, and have created this fabulous free and prosperous life. We're in danger of self-destructing from our own self-indulgence. It need not be this way, really. We need not immediately don hair shirts and cover ourselves in ashes, but we need to take heed, and repent while there is yet time.

The old theological term repent is much misused and disrespected. At bottom, it means 'turn around and walk the other direction', back toward what is right, even if it feels uncomfortable. Because the path we're on leads straight over the cliff onto the rocks below.

It's well worth a read, and a ponder. The quote of the article is:

Every generation sees itself as a decadent, diminished version of its predecessors. What is different is the extent to which we actually are.