I just watched an episode of Modern Family that starts with the characters answering the question, “What’s your biggest fear?” I was thinking about their answers and how self-interested they sound. This led to a moment of panic — how will humanity survive if our biggest fears are immediate harm to ourselves or our children, rather than long-term environmental destruction or overpopulation and drought? Then I realized a huge wad of emotion hit my eyes and throat when I watched the poignant ending scenes: parents watch teen daughter drive away alone for the first time (side note: I actually identified with the parents — I must be a grown-up!), gay dads realize their baby daughter only said “Mommy” because her new doll says it, and fathers and sons overcome fears, have fun, and bond. The reason I want the planet to survive (and humanity along with it) is because I selfishly enjoy these personal moments. I love being alive, and I love my friends and family members, and I love all of our pets. And I do want other people and animals to have lives worth living, too, and that would make me feel good.

One of my patients yesterday was making some difficult changes in her life. She had committed to quitting smoking and had been avoiding things she grew up eating because she was cooking for a family member with diabetes, and she made an effort to walk every day. This made me happy, but also scared she will fail. It’s all dependent on the strength of her will, because poverty will fight her, her health insurance might not cover nicotine patches, she didn’t want to face her own signs and symptoms of diabetes, and her social influences might discourage her. The government and the food industry will fight her by not telling her how she REALLY needs to change her diet — by eating real foods rather than a bunch of artificial salt and sugar substitutes. By cutting back on meat and dairy. Other industries will fight her by polluting her neighborhood, advertising smoking, and promoting sedentary activities, and people who watch Fox news will fight to keep the government from doing anything about it. Maybe no one will ever show her the bigger picture (as I see it, anyway!).

Then I think, why do I care so much about these people whose politics and lifestyles I probably disapprove of anyway living longer lives? They’re just going to support animal torture and murder by eating more hamburgers, as my husband wryly pointed out to me when for some reason he decided to come up with reasons NOT to be an organ donor. (And now he wants to be an EMT!)

But I also want people to live healthier lives. I kind of hate feeling like I need to just repeat standard medical lines. Of course it’s also hard for me to give unpalatable advice (if I have a hard time telling people they really need to quit smoking or they really need to exercise, it would be really hard to say they really needed to eat less meat and dairy). But I really do want to encourage more diet and lifestyle changes and less use of pharmaceuticals. That’s what makes me think I might want to be an N.D., or naturopathic physician, someday. And maybe now I should work part-time at the cardiac rehab place because it’s encouraging to interact with the people go there — patients who actually want to make changes and want advice and will try to follow it. But then I’m afraid I’ll give them bad advice and they’ll work so hard and will still have medical problems. Or I’ll give them good advice but it still won’t work and they’ll give up.

Maybe it would be easier for me if I didn’t give up on myself all the time, if I could actually envision the possibility of a person making real changes and not giving up. I did the vegetarian thing but keep letting up on the vegan thing. I ignore my own signs and symptoms of pre-diabetes. I embrace denial and drink another soda. I don’t want to give up cinnamon rolls or chocolate candies. And I fantasize about walking dogs at the animal shelter but I often don’t even walk my own dog on my days off. How am I supposed to believe in anyone else?

It’s time for some lists! (My favorite way of dumping all the crap swirling around in my brain!)

Things that discourage me:

  • Predictions that there will be over 9 billion people on Earth by 2050.
  • Well-intentioned people who worry about well-educated people not having large families anymore
  • People who are opposed to gay marriage because they think humans have a duty to make MORE babies
  • Young people who should be savvy about pet overpopulation but buy dogs from breeders and pet stores

Things that give me hope and make me happy:

This list is sort of limited by the things I’m thinking about right now. I’ll try to come back to it later and make it better!


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