Với một loạt các thông điệp và ẩn dụ trái ngược nhau, làm thế nào bạn biết?
Rõ ràng, tôi không được khỏe mạnh. Tôi thừa cân, và mặc dù A1C của tôi chưa bao giờ vượt qua ngưỡng tiền tiểu đường, nhưng nó chắc chắn đã tán tỉnh ý tưởng này. Cholesterol của tôi đôi khi ổn, đôi khi không. Tôi bị cao huyết áp (có thể do di truyền) và suy giáp (chắc chắn là do di truyền, cảm ơn mẹ). Tôi bị ngưng thở khi ngủ, và những gì dường như là khởi đầu của bệnh Meniere, mặc dù nó có thể là một cái gì đó hoàn toàn khác. Các bác sĩ đã từ bỏ việc tìm ra kết quả cuối cùng.
Mặt khác, tôi không quá béo, chỉ có một mức độ độn thêm vừa phải. Tôi dắt chó đi dạo rất nhiều, tôi bơi lội, tôi chơi boogie, tôi đi bộ đường dài, tôi đi tập yoga (nhưng phải thừa nhận là không thường xuyên), và khi người hướng dẫn Pilates của tôi trở về từ Châu Phi, tôi cũng sẽ bắt đầu lại. Tôi không thường xuyên ăn đồ ăn vặt (nhưng tôi có ăn) và về cơ bản tôi đã ngừng uống rượu. Tôi chưa bao giờ nhận được COVID, mặc dù đã rất liều lĩnh trong hai năm qua. Tôi đã đi nội soi vào năm ngoái và được thông báo rằng tôi có một “ruột kết đặc biệt khỏe mạnh”, bất kể điều đó có nghĩa là gì. Ngoại trừ một đợt bệnh zona cách đây 4 năm sau một cuộc chia tay ngu ngốc, và học đại học, tôi chưa bao giờ thực sự bị ốm gì cả, ngoài những loại virus theo mùa mà tất cả chúng ta đều mắc phải.
Vậy tôi có khỏe không? Tôi nghĩ rằng cộng đồng y tế có thể sẽ nói rằng tôi không, vì họ tuân theo các con số (cân nặng, A1C, cholesterol). Và những người mà cộng đồng y tế chắc chắn sẽ đề cao như những bức tranh về sức khỏe đang giảm dần hoặc gần chết. Cách đây vài tuần, một vận động viên đua xe đạp leo núi người Scotland 37 tuổi đột ngột qua đời trong tình trạng ngừng tim trong giấc ngủ. Bob Harper, huấn luyện viên thể hình nổi tiếng, đã lên cơn đau tim ở tuổi 52. Cộng đồng y tế có thể coi họ là người cực kỳ khỏe mạnh, bởi vì họ đã làm những điều lành mạnh. Nhưng Harper có một tình trạng di truyền làm tăng “lipoprotein (a) trong máu của cậu ấy” nên theo số liệu đó, cậu ấy thực sự không khỏe mạnh chút nào.
Nhưng chúng tôi coi Harper là người khỏe mạnh, bởi vì tình trạng di truyền đó không phải là “lỗi” của cậu ấy. Mặt khác, nếu anh ta là một củ khoai lang không có bệnh di truyền, thì bất kỳ vấn đề sức khỏe nào cũng là “lỗi” của anh ta. Những thất bại về đạo đức và cái gọi là thất bại về kỷ luật gắn bó chặt chẽ với những ý tưởng về sức khỏe hiện tại của chúng ta, đến nỗi – ít nhất là đối với tôi – câu hỏi về điều gì là lành mạnh đã trở nên tê liệt. Tôi cũng ngày càng trở nên thất vọng khi phát hiện ra rằng dường như không ai biết họ đang nói về cái gì.
Khi tôi viết bài này, tôi đang nấu công thức của Alison Roman cho món đậu lăng chiên với chanh và tỏi , và bắp cải đỏ của Đan Mạch. Tôi dự định ăn đậu lăng với trứng để có protein, món mà tôi cảm thấy tốt, nhưng cũng với cơm, món mà tôi cảm thấy không tốt. Mặc dù là một loại ngũ cốc cổ xưa đã được ăn trong nhiều thế kỷ, nhưng giờ đây chúng ta cảm thấy xấu hổ về carbs như gạo, mặc dù phụ nữ ở Okinawa ăn nó và sống đến hơn 100 tuổi. (Nhưng công bằng mà nói, nó chỉ chiếm khoảng 12% trong chế độ ăn của họ , trong khi 67% là khoai lang).
Tôi định ăn bắp cải đỏ với một miếng thịt lợn, và tôi thậm chí không biết cảm giác của nó như thế nào. Một nhóm người khẳng định rằng ăn thịt là điều tồi tệ đối với bạn, nhóm khác khẳng định chìa khóa trung tâm của sức khỏe là protein động vật. Và sau đó là tôi, người thực sự không muốn ăn động vật chút nào, ngoại trừ thịt xông khói một lúc. Và sushi, tôi gần như quên mất sushi.
In an effort to figure it all out, I recently starting working with a Fancy Nutritionist. (I was also in a fit of pique about my inability to lose weight). She insists that animal protein is the key to health, and likes to say that we are “ancient bodies in a modern world” and should therefore prioritize protein, vegetables and maybe a little fruit. But if you point out that “ancient” people did not get to eat meat multiple times a day, or even multiple times a week, she waves that concern away.
And if you follow Dan Buettner and his Blue Zone research, you know that he would vehemently disagree with the Fancy Nutritionist about animal protein. (I’ve been fascinated by the Blue Zones ever since I read this New York Times article about the man who forgot to die.) But when I mentioned Buettner and his Blue Zones to the Fancy Nutritionist, she just rolled her eyes and doubled down on the animal protein. The next day, as an orthopedic surgeon was examining my mother to see if she could get a hip replacement given her agonizing arthritis, I asked him how to avoid the same fate.
“Anti-inflammatory diet” he said without looking up. “And that means…?” I asked, genuinely confused at this point. “Plant-based, all the scientific evidence says plant based” he said, again not looking up, adding another layer of confusion and again contradicting the Fancy Nutritionist. Unsurprisingly, Fancy Nutritionist also happens to say that “all the evidence” supports her theories about animal protein. And Buettner says the same about the plant-based diets of the Blue Zones. Just like the orthopedic surgeon said.
So, as a good girl trying to follow the rules, which rules do I follow? I’m the daughter of a scientist, who told me all science is theory. Nothing is ever proven definitively, so I’m open to the notion that reasonable minds can have different hypotheses. But the division between these two camps is too great to chalk up to emerging theories. Both sides insist — with absolutely no humility whatsoever — that “all the science” (all of it!) backs up whatever their brand of health is. Since both theories can’t possibly be true at once, someone is lying. Or perhaps incompetence abounds, and no one actually knows what the hell is going on at all.
I’m inclined to think it’s a combination of the two. Until recently, it was taken as gospel that plaque buildup caused Alzheimer’s disease. Then we discovered that theory was based on possibly falsified images. The animal-protein-is-key to health camp then seized on this, and in a I-told-you-so kinda way doubled down on protein, protein, protein. I’m not saying they’re wrong, but I am saying I’m confused, because no one is acknowledging the chasm between the two camps.
Confusion is everywhere. I don’t wear sunblock (except on my face, because I’m vain) because I always had a gut instinct that something was off about slathering your skin with chemical goop. And cosmetic companies make a lot of money pushing the narrative that we will all drop dead from skin cancer if we don’t add layer after layer of their products. My refusal to do this was seen as nuts by a few of my friends, but now we know there are cancer causing elements in sunblock anyway. So are we just trading one problem for another? Isn’t that confusing? It is to me.
When MAGA Man and I went to Vegas, and hung out by the pool he was stunned that I didn’t put sunblock on. And I was stunned that he wouldn’t get the COVID vaccine. I pointed out that our objections were ultimately the same: “You think that the vaccine is being pushed by Big Pharma, and I think that sunblock is being pushed by Big Sunblock.” And even though we had Tài xỉu online the same objection, just with different villains, we simply could not see the other’s side. And this nicely sums up what it’s like to navigate what is healthy and what isn’t these days: two warring camps, insisting that the other side is crazy to ignore “all the science,” which everyone insists happens to be on their side.
When I wrote a piece about giving up on my CPAP machine, I got comments from readers warning me that I was making a grave mistake. One person simply noted that “Carrie Fisher died of sleep apnea,” I guess trying to scare me straight, conveniently ignoring that Fisher also happened to do a mountain of drugs. But I wasn’t sleeping well with the CPAP machine, and woke up exhausted every day.
So what is the healthy choice? The medical community would likely agree with the Carrie-Fisher-Died-And-So-Will-You lady, but is it healthy to shove sugar in your face at 4 p.m. because you only got four hours of sleep? Sugar is also the enemy. Like so many health-related conundrums, would using the CPAP machine just be trading one problem for another?
In addition to the confusion, the mixed profit-driven messaging, the failure to address the question of problem swapping, there is the unavoidable intersection between privilege and health. Whenever a friend gets seriously ill — and there have been more than one at my age who have dropped dead months after a cancer diagnosis — I think of Susan Sontag’s essay “Illness as Metaphor” and her brutal insight that there is a “kingdom of the well” and a “kingdom of the sick.” She writes “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.”
She goes on to discuss the metaphorical implications of two diseases that have taken up residence in our collective consciousness over the years: tuberculosis and cancer. Tuberculosis was considered cool, its sufferers artistic and ethereal, passionate even. Women wanted to look tubercular, kind of like the heroin-chic days of the 1990s. In contrast, cancer sufferers were (and still are, in my view) regarded as repressed, frustrated, bringing their diagnosis onto themselves by some failure to maintain good-vibes, and are therefore shameful.
The shame around cancer is now so entrenched we barely notice it. When people are diagnosed there seems to be a flurry of ritualized statements demonstrating shock and surprise at the news, because they “never smoked” or “always ate right and exercised,” as if their disease was the result of a moral failing or a failure of discipline. But the truth is that a cancer diagnosis is just a cruel turn of a roulette wheel, as all the “healthy” people who suffer from it will tell you, and all the two-pack a day smokers who avoided it will also tell you.
But we ignore this fact, and in our permanently health influencer saturated culture, the shame around cancer remains inextricably linked to what one is willing to do to obtain optimal health. The more you’re willing to do, the less shameful you are. The less you are willing to do, the more it’s all your fault. Shame on you.
When I first started working with the Fancy Nutritionist — who is also a minor influencer on Instagram — the idea was to “heal my gut” before we did anything else. I did a GI test (gross) and a blood test (fine, easy) to find out my gut health (low bacteria, some h.pylori) and the foods I’m “sensitive” to (wheat, corn, olives, cucumbers, cumin, cheddar cheese). Then she put me on a protocol to heal my gut, which required me to avoid the foods I’m allegedly sensitive to, and to take various supplements to increase my gut health.
Sounds easy, right? But the supplements included four different pills at meal time, three different pills in between meals, a special tea three times a day, and then another weird tea thing twice a day. And because I’m sensitive to olives, I needed to cook everything at home because I also couldn’t have olive oil.
Reader, I tried. And to be fair to the Fancy Nutritionist, I did start to feel better in surprising ways. A pair of shorts that I thought would never fit actually did. Somehow my hair is now growing like gangbusters. My skin is better.
But with a full-time job and aging parents I couldn’t actually take all these pills, drink all these teas and cook for myself every day. When I tried to explain this to her — that sometimes lunch is eating a microwaved burrito over the kitchen sink, that after an ten-hour work day there is absolutely no way I could cook for myself, and that there is not enough time in the day to drink tea three separate times — I got shamed. “You need to prioritize your health,” she said simply and sternly, over FaceTime, her face a glowed up cue ball. I could see her pool in the background, and it occured to me that maybe she had never held a 9-to-5 job. She probably never had a commute.
I was at a loss for a way to explain to her that I am trying, I really am, but that I also have other unavoidable priorities — like my job. But in the rarefied world of health-influencers, these other priorities simply do not exist. In their world, spending an hour each day concocting a matcha smoothie with ten hard-to-find ingredients is normal, and if you can’t do the same, you’re that future shameful cancer patient. You are a willing resident of the kingdom of the sick. You deserve what’s coming to you.
I suppose this sort of shaming would be less traumatic if there were clear rules to follow, but there aren’t, evidenced by the chasm between the animal protein believers and the plant-based crowd. Jordan Peterson’s daughter, Mikhaela Peterson, claims that she cured her various ailments by by eating only beef, salt and water. And I believe her, because I believe she understands her own experience.
But I also believe the scientists who say this is an exceptionally bad idea. I know that when you look at the perfect little pearls of a raspberry or the tiny teardrops of pulp in an orange section, or the perfect little trees that are broccoli, it’s clear we are supposed to eat these things. The Bible even seems to be on the side of the plant-based folks. Genesis 1:29 reads, [a]nd God said, Behold, I have given you every herb bearing seed, which is upon the face of all the earth, and every tree, in the which is the fruit of a tree yielding seed; to you it shall be for meat.
If it were up to me (and of course my own health decisions are up to me, the idea that they aren’t comes from…a weird place) I would have coffee with heavy cream for breakfast, sushi for lunch, and a garbanzo bean stew for dinner. I’d eat peaches in the summer and oranges in the winter. I’d have a steak about twice a month, and a BLT once in a while, maybe some French toast a few times a year. I’d also get to have three mini peanut butter and chocolate cups a night. (I said the mini ones, okay?) For exercise I’d swim, garden, walk the dog, do yoga, and hike — but not every day. Maybe three times a week. The rest of my free time would be spent cuddling the dog, painting, staring into space. Oh, and I would have pasta. Sometimes.
So am I healthy? Is this even in my control? I don’t know. My friend Laura, who was a yoga instructor and a fitness model, was definitely considered healthy. Then she dropped dead of leukemia at 43 — so clearly, she was not healthy at all. Her blood stream was lying in wait, locked and loaded, ready to kill her no matter how many green juices she guzzled.
I thought about Laura the other day when I was cleaning out my drawers and found our family tree. As I started to look at great-grandparents and great-great grandparents I noticed they all died at age 98, 101, even 105. Were they healthy? Or just lucky? Or are luck and health the same, and we just won’t face that fact? My grandfather used to drink a dubonnet with dinner every night and eat handfuls of jelly beans. He lived to 95, but had Alzheimer’s. Is that healthy?
Vậy tôi có khỏe không? Tôi không biết. Nhưng tôi gần như chắc chắn rằng các bình luận cho phần này chắc chắn sẽ bao gồm một số lượng lớn các tuyên bố tự tin về những gì được và không có lợi cho sức khỏe. Tôi ghen tị với sự chắc chắn của những người bình luận trong tương lai. Nhưng đối với họ, câu hỏi thực sự của tôi là: Làm sao bạn biết?