New York Times Personal Health Columnist Jane Brody discusses health behavior.
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GUEST: Jane Brody
AIR DATE: 05/26/2012
I’m Richard Heffner, your host on The Open Mind.
And when this program is over, you may just want to go on your computer to thirteen.org/openmind to see today’s guest again …and/or to see other programs I’ve had the pleasure of doing with her back in the 1980’s and earlier in this century.
For in each you’ll find the same bouncy, enthusiastic, reassuring Jane Brody, the Personal Health columnist for the New York Times now as she was when we first did our Open Minds together more than three decades ago.
Now I use the somewhat unusual descriptive “reassuring” to help define my journalist friend just because she’s always made it so clear that our destiny – from the state of our personal health, to even our exit (in what she titled her wonderful recent book, Jane Brody’s Guide to The Great Beyond) – that our destiny is so very much in our own hands: whether or not we exercise regularly, whether or not we eat the right foods in the right amounts, whether or not we sleep enough, even whether we prepare well enough to finish with no regrets.
Which, of course, leads me to ask my guest – after all of these years of “nudging” her readers so much about our personal health habits, does she think we Americans are finally exercising the right amount, eating properly and not too much, sleeping long enough each night? And are we wisely, rationally enough preparing for “The Great Beyond”? And, of course…if not, WHY not?
BRODY: Good question, Richard. Very good question.
HEFFNER: What’s the answer, though.
BRODY: Unfortunately … I mean if you take the population at large, we are not doing better. We are not doing nearly well enough. There is a segment of the population who has bit the bullet and taken this kind of advice, not just from me, but from many other people like me and from physicians who are in the “know”, the few that do talk to their patients about nutrition and exercise.
Who have, you know, gone the right …down the right path and for the most part, eat sensibly … eat lots of vegetables, don’t over eat, maintain a normal body weight … the way you do, the way I do … and exercise on a daily basis.
Maybe they don’t sleep enough … I think sleep has been a problem … and, and as we get more and more electronic devices available to us, no matter where we are in the house … sleep gets the short end of the stick.
HEFFNER: You’re really finding that … do you find it that way yourself?
BRODY: I find it that way myself. Now I lost my husband two years ago and now I have newspapers and The New Yorker sitting on my bed. And I, I …
HEFFNER: Waiting to be read.
BRODY: Waiting to be read … I never keep up. I never catch up. I try to do … you know The New Yorker comes every week … (laugh) … the newspaper comes every day. It’s really a challenge.
Ah, there’s an awful lot to be read and I don’t even turn on my tele … I have two television sets that just sit there taking up space, for the most part.
HEFFNER: Well, then why complain about the electronic revolution.
BRODY: Well, because it’s not just me and I know how many other people are constantly … I mean I … almost … coming here … I almost hit a woman who was crossing … looking at her little “thingie” whatever she had in her hand …
HEFFNER: Her iPad … yeah …
BRODY: But it was not even an iPad … it was a little phone or something …
HEFFNER: Oh, I see …
BRODY: … and she’s crossing against the light … in Manhattan and there’s a taxi coming on my right that she didn’t see at all … she didn’t even see me … I saw her at least so I honked at her. But, I mean, this is the kind of thing we, we have people … totally … they can’t seem to part for two seconds with their little gadgets.
HEFFNER: Jane, I want to know … did you yell at her as you yell at the reader?
BRODY: I didn’t have an opportunity to yell at her, but I did honk at her. And she did look up and stopped … for the moment … so that the taxi didn’t hit her, at least.
HEFFNER: Well, look, I know that everyone I know reads you, reads you religiously. Are you suggesting perhaps it’s a little way … our way of getting around doing the right thing … by reading Jane Brody?
BRODY: (Laugh) Well, there are some people who I guess who read what I write, and say, “That’s enough, I’ve read it and I know what I’m supposed to be doing and that was good enough for me.”
But, you know, an awful lot of people have followed the advice, the kind of advice that I give … and, and are doing a much better job. But I’m … what I’m saying to you is that it’s not nationwide by any means … all you have to do is look at the obesity statistics to know that we are not taking control of how much we put in our bodies, let alone what it is we’re putting in our bodies.
HEFFNER: I have the feeling, I don’t know whether you share it, that we really don’t believe those statistics about obesity.
BRODY: You don’t believe them?
HEFFNER: No, I’m not saying I don’t …
HEFFNER: … I do because I keep my eyes open when … particularly when I’m in other parts of the country.
BRODY: That’s exactly right. That’s exactly right. New York City is a little bit of a fooler because in, in major metropolitan areas people are thinner. Why? They walk more. They walk more. They have to go up and down stairs to get to the subway and out from the subway.
This, this city is, is, is not a microcosm of the United States, by any means. And you leave … you go out to the countryside and you would be astonished at, at the level of obesity. In, in a parking lot in a, in a mall and they park as close as humanly possible to the store that they want to go to. Because god forbid they might walk.
There was a very, very interesting piece in the New York Times very recently about Texas. Texas, with all their wealthy people, can’t afford to supply school buses for their school children any more who live within two miles of the school. And the article quoted a sixteen year old boy … that’s a high school student … who was complaining that he now had to walk 20 minutes … one mile … to school and one mile … 20 minutes back home. He’s so unaccustomed to using his feet. This is, this is terrible.
HEFFNER: You do feel that his matter of exercise is absolutely key to our problems.
BRODY: It’s, it’s not the only thing, by any means. But it is certainly true that we evolved as a species … moving. We had, we had hunters who, who chased animals, and we had gatherers who went out into the field … we were moving all the time. And we stopped moving.
I mean … we … our jobs are sedentary … our recreation is sedentary … and we use a vehicle to get us from one place to another at all times.
HEFFNER: Then why are we living so much longer?
BRODY: We’re living longer because two … two main reasons. Infant mortality is way down. Why … because of antibiotics and all the interventions that we have. So, we, we used to kill off an awful lot of people shortly after birth. And that counted in life expectancy. You know, all those people who died within the first year of life …
BRODY: … diminished our life expectancy. Also maternal mortality is way, way down … for the same reason … antibiotics and better maternal care. So those two factors have greatly increased life expectancy.
What we haven’t had commensurate with the increase of life expectancy is an increase in health expectancy. There are far too many people living, living those last decade or two decades of their lives, are not living healthfully. They’re sick and, and you look at the cost of our medical care in this country … it’s through the roof.
Why, because we have to take of those people. And we should take care of them. But … why, why should we keep doing this indefinitely if they failed to take care of themselves, when they had a chance.
HEFFNER: So that’s the connection you make, they are failing to take care of themselves …
BRODY: Many of them ….
HEFFNER: … to follow Jane Brody’s advice.
BRODY: Well many of them are … many of them are failing to take care of themselves.
HEFFNER: And at the end of life, then … now, you did a piece the other day … I guess it was earlier this week … that scared me …
HEFFNER: … because I was thinking of my poor wife … you wrote a piece called “Care giving as a roller coaster ride from hell”.
BRODY: Well …
HEFFNER: Get a lot of response to that?
BRODY: … I, I haven’t seen all the letters yet … I’m … the emails, but in fact we have portrayed care giving as a wonderful thing that people do for the people they love. And we have …. we’ve glossed over the difficulties that, that ensue with the caregiver. And especially … let’ say in this … this particular article focused on care giving wives. So if their, if their marriage was not so great to begin with … when that husband gets sick … the wife is expected to take care of him. And you think he’s … his personality doesn’t improve when he gets sick and he knows he’s terminally ill … it gets much worst. I mean for anybody … even the sweetest person on earth, when you’re not feeling good, you’ve not exactly the most cordial individual. You’re not inclined to say “please” and “thank you” at every turn. You’re more likely to act out and to, and to be rash with the people who you are closest to … because you can get away with it.
I mean you can’t do it to a, to a … somebody you hire. You can’t do it to a nurse in a hospital. But you can do it to your spouse. And that’s what’s happening.
HEFFNER: Jane have you thought about the larger social consequences of this phenomenon … we are living longer …
HEFFNER: … we are getting sicker at the end of life …
HEFFNER: … we do need care. Now what happens to us …
BRODY: What do we do next? What do we do? I mean most … I, I’m facing the situation right now with an aunt of mine who is 92 years old … who now needs 24/7 care and can’t afford it. Cannot afford it. She has long term care insurance that will run out in October … and her children don’t have that kind of money … to pay for this kind of care … and we … I’m sure they’re going to ask me for help. Which, which I will give them. But, you know, what if I wasn’t there? What if I didn’t have the resources to help out? It’s, it’s a real dilemma … it’s, it’s a very serious problem and I don’t know what the answer is except that we … all of us … all of us should have … as you mentioned in the introduction … a plan for the end of life.
So that you … you’ve already assigned somebody to speak for you when you can’t speak for yourself. You already have established conditions under which you do not want to be “rescued” when, when a crisis … a medical crisis occurs. This aunt of mine did not have that available … and when she … stopped breathing and her heart stopped …
HEFFNER: They resuscitated her.
BRODY: They resuscitated her. They resuscitated her and miraculously she came back. She came back miraculously, but now there is a “Do Not Resuscitate” thing on her chart. But that only applies if you’re in a hospital. And if you’re not in a hospital, in only 21 states can you have that kind of “Do Not Resuscitate” dictum established outside a hospital.
HEFFNER: You wrote about emergency … ah, emergencies and when you call, there’s an emergency, send an ambulance …
HEFFNER: … but that’s a problem in terms of what we’re just talking about.
BRODY: Well, because paramedics, are, by law, obliged to attempt to resuscitate somebody. And if you don’t have this dictum that says … it’s got to be signed by a doctor, it’s … this is a serious kind of thing. It’s not just like your Living Will like you go to the hospital with or the Health Care Proxy where you don’t … you don’t’ need anything except somebody to witness your signature. But in the case of outside the hospital without this, this law which exists in New York State and in 20 other states … my aunt lives in Florida … doesn’t exist there.
HEFFNER: It’s interesting you had a piece recently about this business of doctors being upset by a New York State law …
HEFFNER: … that … does it require them to offer advice?
BRODY: What they were attempting … it was to … right … exactly … to … to say “Are you prepared to … would you like to talk to me about your end of life preparations?’
HEFFNER: Doctor must ask that question?
BRODY: Yeah. What’s the big deal. The patient can say “No, I don’t want to.” And that’s the end of it.
HEFFNER: You’re not sympathetic at all to the doctors who say, “Don’t tell us how to practice?”
BRODY: No, I’m not at all sympathetic to that. Because I see what happens at the other end. And the doctor … you know, the doctor’s not paying for the cost of this care. The doctor is actually being paid to keep his patient alive indefinitely. Of course none of us live indefinitely.
But, you know, they’ve got a vested interest in not letting that patient go. But all, all that’s … all that’s being … broached is put the bug … the bee in your bonnet. You know, do you want, do you want to talk about this? Think about not just yourself … but think about the people you love and who love you and what kind of spot you’re putting them in when you haven’t told anybody how you want to be treated.
HEFFNER: Well, you certainly made me think about that in this week’s piece.
HEFFNER: About what a hell it is for the caregiver so frequently.
HEFFNER: And gets more and more hellish …
BRODY: Right. I mean that person’s life is on hold and sometimes for years … years … because many people … you know, let’s say you have emphysema and what is … what causes emphysema … 90% of emphysema is caused by cigarette smoking. So, you know, there’s the resentment that, that, that guy brought it on himself.
HEFFNER: You smoked. Right.
BRODY: You brought it on … and now look what you’re turning my life into … my life is on hold for the next five years because you smoked. So that’s, that’s a very difficult situation to put a loved on in. So I, I hope that all your listeners have already given up cigarettes.
HEFFNER: And we hope that all of the listeners have written out what they want done.
BRODY: Yes. And that would be …
HEFFNER: The Living Will.
BRODY: That would be wonderful. But Living Wills are not a document … a legal document. The doctor can ignore a Living Will and you have to have somebody who is assigned to speak for you when you can’t say …
HEFFNER: A proxy …
BRODY: … what, what it is that you want.
HEFFNER: Jane, what happened when a few years ago … not so long ago … there was all the fuss about Death Panels …
HEFFNER: … when the Obama healthcare program was being attacked … inappropriately.
BRODY: Absolutely inappropriately.
HEFFNER: What happened to … with, with your readers … did they express …
BRODY: My, my readers were very upset that this wasn’t … that it was being misinterpreted and that this … there was never a Death Panel … they were never going to put grandma out to sea on an ice floe …
HEFFNER: The Eskimos have the right idea …
BRODY: Yes, they, they did (laugh). There was a wonderful cartoon in The New Yorker years ago and I have it in, in my Great Beyond book. An Eskimo father and, and, and his sons standing at the shore and this woman is sitting on the ice floe and the father tells the kids, “Grandma’s going to Florida”.
HEFFNER: Not California, but Florida.
BRODY: Florida … right.
HEFFNER: Well, what, what … did you help interpret the … what was called the Death Panel?
BRODY: Oh, absolutely. Absolutely … I mean … you know, many times and at any opportunity that I could get, I spoke to the fact that … and I wrote to the fact that there … there was never a so-called Death Panel. All it was, was offering the options … offering the options … let’s have this conversation. And we really all need to have this conversation. So that we’re not … we don’t leave our loved ones … high and dry when, when push comes to shove and they have no idea what to do.
My, my little cousin didn’t have any idea what to do when, when her mother stopped breathing and she was in the hospital …as she was being wheeled out of the hospital, she was on the way to being discharged … and she needed to be resuscitated. And had my cousin known that … what to do … she would have said “Don’t do this”.
HEFFNER: About those conversations that you approve of and you approve of the law in New York State … what would you have be the conversation between doctor and patient?
BRODY: Well, the, the doctor first has to just gently approach the subject … “Do you want to talk about how you would like to be treated if you cannot speak for yourself, if something happens to you medically and you cannot speak for yourself?”
So that’s, that’s really what it’s all about. Do you want … and, and you can set any series of conditions. You can say, “I want everything … I want you to do everything humanly possible to keep me alive as long as possible”. And then they’re obliged to do that.
But you also, like my husband, did not want anything done. He would have been happy to die two weeks before he actually died if, if I hadn’t been there as his health care proxy to say, “No, we’re not going there … we’re not going there yet”. He’s dying on his own and he’s dying on his own terms, but we’re not going to speed up this process at the moment.
We, we, we just didn’t know … it didn’t take very long, he was only sick for six weeks. So it’s not a prolonged agony.
HEFFNER: Don’t talk to my wife, please, because I sort of want her to …
HEFFNER: … nudge me along.
HEFFNER: But, so I think now.
BRODY: Yeah. Well, that’s it. And, and … when … once you’ve become ill, if you still can speak … or express yourself even in writing … because let’s say, god forbid you had a stroke and you can’t talk … you might still be able to communicate in some fashion.
HEFFNER: Jane, you’ve thought a lot about this. What, what do you think about the response to that point of view that people so frequently toward the end of life are in depression and even if they are articulate … they’re not able, because of the disease … the depression …
BRODY: Well, one of the conditions of the … physician assisted deaths is that you have to pass a psychiatric examination. You have to … it has to first be determined that depression is not what’s causing your desire to end your life.
So, but I’m not … I’m not even talking about physician-assisted deaths, I’m not going there at all.
HEFFNER: You’re talking about the reverse …
HEFFNER: Just stopping the …
BRODY: But, but …
HEFFNER: … process.
BRODY: … you know … it’s, it’s interesting what you say about depression because it’s certainly true. My stepmother who was married to my father for 30 years … my father died eight years before she did … and, and, in retrospect we realized that she had been depressed those whole eight years after my father died. And when she developed a symptom that was potentially fatal … she didn’t tell anybody. She didn’t tell anybody. And it wasn’t until a neighbor said “I haven’t seen Sophie for several days” … went to the house to see if she was all right and found that she was lying in bed bleeding. But she did not want to be helped. She did not want to go to the hospital, she did not want anything done, she was ready to die.
But, you know, had she been treated for depression all those eight years … she may not have gotten there.
HEFFNER: Jane … not …
BRODY: It’s important to recognize that. It’s important to recognize when people are depressed and, and do something about it, if something can be done.
HEFFNER: There’s another point that I, I want to raise. We don’t have much time left. But you wrote a piece October 2011 … navigating the net wisely in a health crisis … and I, I wondered about that. I know that I respond in a health crisis by going to the computer.
BRODY: So does … millions of other people do it as well. It’s fine to educate yourself if you know what it is that’s wrong with you or if the doctors can’t figure out what’s wrong with you … and then the net can be very useful.
I mean I … many of the columns that I’ve written through the years … people have suffered with these conditions … for years … and not known what was wrong with them, until they read my column and they said, “Oh my god, that’s what I have”. And they go into the doctor’s office waving the paper … the newspaper saying, you know, “Check me out for this … cause this is what I … I have exactly these symptoms that are described here.”
HEFFNER: That makes you very popular in doctor’s offices …
HEFFNER: … doesn’t it?
BRODY: You know what … for the most part, you know, when I first started writing this column, I thought doctors were going to hate me, they don’t hate me at all. They use my articles to help educate their patients.
HEFFNER: I would imagine so … because I read them so regularly. But the question is … how many people do wisely use the net?
BRODY: I have no idea how many wisely use the net … but it can be used wisely, it just it should not be used in exclusion of, of seeking proper medical care.
HEFFNER: You wrote about one particular patient who found a physician through a group of people on the net who shared comments about this disease and in common there seemed to be one name … one physician …
HEFFNER: Do you think that happens very often?
BRODY: I don’t think it happens very often, but it certainly can happen. And, and how do … when I decide to write about a topic, how do I find the experts …
HEFFNER: How do you?
BRODY: I go on the net, too. I go on, on the Internet and, and I look to see who’s written scholarly articles on the subject. And I call those people up and say, you know, “I’d like to talk to you about it”. And I can tell in, in five minutes of a, of an interview whether this person really knows what he or she is talking about. But I’ve, I’ve found wonderful people that way.
I mean one of the classic ones was hernias in women. And I wrote a column about these mysterious symptoms … women don’t have hernias the way men do. They don’t have a protruding hernia …
BRODY: … and they’re internal and the doctors send them to psychiatrists because they can’t figure out what’s wrong with them. They think that it’s just all just psychosomatic, when, in fact, the doctor that I wrote about has now been contacted by 200 women who turned out to have this, this condition … 85 of whom she operated on and corrected it. And many of them had been suffering for years … as long as a decade with this, this hernia that wasn’t diagnosed.
HEFFNER: Now, Jane, I have one, one question … what are you going to do when you grow up?
HEFFNER: Are you going to continue the personal health …
BRODY: You know I have been writing this column since 1976 and when I started writing it … my fellow science writers thought I’d run out of ideas in six months.
HEFFNER: That’s very funny.
BRODY: Isn’t that funny? It is funny because right now I have 4 huge file drawers of unwritten column ideas.
HEFFNER: Well, I can imagine so, because every Tuesday I rush to the paper to look and see “Well, what is she going to say now?” …
HEFFNER: … that relates to my life. And I’m sure that many people do …
BRODY: Well, I have … I have an upcoming column that you should absolutely pay attention to, it’s about over medicating the elderly.
HEFFNER: Because I’m so old and I need medication and that’s the point …
HEFFNER: … thankfully because of the subject that I have to say to you thank you so much for joining me again …
BRODY: You’re welcome …
HEFFNER: …and let’s not wait quite so long before we do it again.
HEFFNER: And thanks, too, to you in the audience. Meanwhile, as another old friend used to say, “Good night and good luck.”
And do visit the Open Mind Website at thirteen.org/openmind to reprise this program online right now or to draw upon our Archive of 1,500 or so other Open Mind and related programs. That’s thirteen.org/openmind.