The Upstream Life.
My cousin once told me a story,
"There once was a river where people were jumping in, and as the river went downstream, people began to drown. Bystanders began to watch in horror, and started to help each victim one by one, until there were so many people that the rescuers became frustrated. How could they possibly save everyone? No matter how many times they tried, they could manage only to save a few at a time, leaving many others to die downstream.
Though some rescuers thought, ‘Why are these people jumping in the river in the first place?’ So these few curious folks walked upstream and discovered why people were jumping in the river. All over were signs posted ‘JUMP IN! THE WATER IS REFRESHING AND THE RIVER IS SAFE!’ There were no warnings of the dangers that lurked ahead.
There’s a saying we have in public health, are you more of a downstream person? Or an upstream person?”
I work in a very fast-paced, crazy, organized chaos type of environment. The team I work with cares for people in all walks of life. Sometimes people come into the emergency department because they are in a life or limb threatening situation— heart attack, stroke, severe anaphylactic reaction, or worse— they are dead and are in cardiac arrest and we have to work hard to bring them back.
Others come into the E.R. because they are uncomfortably sick, and have no access, means, or motivation to seek primary health care, because they know that if they come to the emergency room, they will be seen by the physician to what they think is immediately— but in actuality it may take a couple of hours because of the people previously mentioned.
And believe it or not, we get people who are completely healthy, but accidentally came across something in WebMD and believe that they are experiencing a life threatening condition.
Granted, this does not explain every patient that comes into the ER, there are your typical drunkards, drug users, abusers, and seekers, broken bones, and such, though it puts the team in a very unique position.
Although we are mainly downstream rescuers, we also have the opportunity to be upstream at the same time.
There are many times where people come into the emergency department severely ill and their symptoms virtually irreversible, and we cannot help but think if only they visited the doctor or if only they took care of themselves.. they didn’t drink so much, eat so much junk, smoke so much, etc and yes, these are contributing factors to why people become sick. Though what we oftentimes forget is that sometimes it is the environment of the individual.
If you take someone who lives in a lower-class neighborhood, add in terrible family dynamics, maybe even some sort of traumatic experience or abuse, lack of proper education, lack of support systems, cheap, delicious food with low nutritional value, and a low income— you have the perfect recipe for an unhealthy life.
It also does not help that Miller, Coke, Pepsi, and McDonalds have the coolest commercials, and if you consume their products, you obviously will have a better life. I swear all diet coke commercials involve beautiful people playing in sunshine with streamer on their beach cruisers, or coming out of stretch limos.
example of diet coke ad, notice hot shirtless guy on cut off picture of a beach cruiser
I’m sorry but I find it hard to believe that the people who consume McDonalds the most are as skinny as they are in their commercials.
omg you guys should totally have a big mac.. and then throw it up later
The media skews our perception of what is healthy, and it doesn’t help that they are so affordable. So it shouldn’t be a surprise that even though most of these people know that these are unhealthy foods, everyone around them is eating them, it is within their income, and there isn’t any real motivation to change your lifestyle of eating fried salty sweet deliciousness, and walking less than 1 mile a day
..until you’re in the emergency room with excruciating abdominal pain because you have so many stones inside of your gallbladder that they have become infected and now you have to go to surgery.
The emergency room is very downstream in a sense, where we see people at their worst, when their disease process has progressed so far, and often insidiously, to where there is irreparable damage.
We have reached a point of history where we have such amazing technological advances, and people should be living longer and healthier lives, yet preventable diseases are still our number one causes of death.
Yes, there are genetics involved, but genetics are usually involved because there is a long line of a family’s history of not taking care of themselves to the point where it has attached to our DNA and become a trait passed on to future generations.
There is an upstream to my profession, however. Every patient discharged, every patient who gets to go home, after a grueling 8 hours of waiting in a fluorescent-lit, linoleum tiled, only slightly less tortuous version of hell, gets discharge instructions. Sometimes these instructions are concise, to the point, streamline, and straight forward.
And sometimes, most times, we literally have no idea what is wrong. Think about it, if you’ve spent an entire lifetime of eating, drinking, acting, exercising (or lack thereof) a certain way, how could we possibly reverse the effects in one visit? Sometimes, how could we possibly find out what is wrong in one visit? 2? 3? Multiple hospital visits? Our job, our training, is to make sure that there is no imminent life or limb threatening situation. It is our job, it is the law.
So what I tell my patients sometimes are the simple things, eat more veggies, wash your hands, take the medications your doctor prescribed to you as written on the label, and ask questions. But nobody needs a doctor’s visit to live an upstream life.
1. More vegetables than fruits, more water than juice.
There’s a higher nutritional value in green leafy vegetables, and fruits, though have nutritional value, also can be high in sugar, which a lot of people don’t realize. Consuming high amounts of sugar over an amount of time can make you insulin resistant (a chemical known to regulate your blood sugar levels)
2. Wash your hands, and if you’re sick, take advantage of rest days.
A 2013 study from Michigan State University found that 95% of people do not wash their hands properly. #nasty ..Also, when hell freezes over and you do get sick, please do yourself a favor and have at least day of rest where you can sleep for more than 8 hours. Sleep is one of the most important healing mechanisms our body has. And take advantage of netflix, all seasons of Breaking Bad are on there. You’re welcome.
3. Get Immunized.
I understand the propaganda behind flu shots, but our hospital alone has seen 4 deaths of influenza type A strains in healthy people. And there’s a reason why we haven’t seen polio and pertussis in a long time. Please do your research, because we have recently gotten a pertussis outbreak at work. WHOOP(cough) there it is..
4. Get a health check-up, at least once a year.
Ok, I am guilty of not doing this, we live busy lives in this modern world, and taking time to schedule a doctor’s visit can be worse than going to the DMV. Though, health professionals like doctors, nurse practitioners, and physician assistants can just check you out and make sure everything is up to speed. You wouldn’t keep an iPhone without upgrading its IOS, right? And if you’re stubborn about taking medications like me, you can ask your primary care professional if there’s anything you can do to prevent taking medication, because believe it or not, a lot of medicines out there can be prevented.
5. Do your own research of your health insurance.
Find out who your network accepts in terms of specialists, primary care physicians, dentists, optometrists, etc. If you try to schedule an appointment with a primary care doctor and they can’t accept you until 2020, see if you can get referred to another one. Also, there are plenty of urgent cares who offer primary care for a flat fee if not covered by your insurance.
6. Take charge of your health.
Ask questions, research your medications. Ask about alternatives. My absolute pet peeve is whenever I get a patient who says they just came from another ER, said the other ER didn’t do anything for them. “All they did was start an IV, draw blood, and give me some medicine.” Did you know what the medicine is? “No.” The ER is a busy place, the doctors office is a busy place, you have to take charge of what is happening to your body, be aware of your symptoms, have a vague idea of how the body works (Sore throats don’t cause finger pains). Healthcare professionals are there to help you, but how can they if you’re hopeless?
Just because the healthcare profession is a mainly downstream world, doesn’t mean that we can’t have an upstream attitude.