DOCTORS' LOUNGE
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I
BECAUSE I SAID SO AUTHOR Mary Barry, MD
’ve been thinking a lot about discipline
lately. There is a clear line between the be-
haviors you require for yourself, and those
you set for other people (at least in your
own mind). The other people, those I only
know socially, mostly will not know that
this behavior is desired. If I know them as
patients, however, I endeavor to teach them.
Every parent - I think of my mother and the uncountable times
she must’ve said this - will be queried by a child, “Why do I have to
do this?” and the instant answer is, “Because I said so.”
This is also the daily refrain (silently in our hearts) of the office
physician. Sometimes we just wish we could lay down the law and
require the patient to pick up every twig in the yard the next time
they violate a principle. They arrive 18 minutes late for the first ap-
pointment of the day because of - “Traffic?!” - that word inflames the
doctor heart. That can be planned for, we think; steps can be taken,
alternate routes can be tried. I want to say, “I got up at 4:30, but you
failed to get here?” Yet I refrain, because blaming is not teaching.
God only knows what all had to happen, at home, for them to get
here on time. God only knows what barriers stand in their way.
The best course is to cut to the teaching chase: “What are you
doing for yourself that is healthy?” is the question that I choose.
Asking people to think about how to be healthy, as opposed to
how they are getting unhappily worse, involves the consideration
of discipline.
We have to plan to be healthy. There are so many billion temp-
tations, many of them very cheap, that make us sit more and weigh
more. It takes money and effort to have fresh meals from scratch.
It takes chunks of time to exercise. It’s much more work to plan,
then cook, then use the leftovers, and that’s just when there are only
grown-ups. Add three kids, two grandkids, one elderly relative and
a career, and you have a working parent who eats peanut butter out
of the jar and bourbon out of the bottle, after collapsing on the sofa
at last. My patients eat energy bars for breakfast, fake cheese crackers
out of the machine for lunch, fast food on the way home with the
kids, or pizza that’s – thank God - delivered. Mostly, they eat store
bought food in the car, and junk everywhere else.
It’s hard to figure out a good way to help. I think of the example
of Sir Jack Drummond, who was knighted after World War II by
Winston Churchill for taking total control of England’s wartime
food supply, then designing the national diet. (I first read of him in
a novel, and more recently in the Daily Beast.) He was a biochemist
who did groundbreaking work in describing and naming Vitamins
A, B and C. His word was law. No food was imported or processed
without his permission. He wrote the daily menus for a nation, after
deciding what could be imported and what could be grown. Food
could legally be obtained only with ration coupons, gardening or
hunting (as opposed to poaching). He outlawed many foods, for
instance bananas; too much trouble to import for the nutrition re-
ceived. He gave pregnant women and small children extra vitamin
D, orange juice and calcium, and gave all children a daily bottle
of milk. He allowed men 3,000 calories and women 2,000. Sugar
was banned: not native to England, so it disappeared. Bread was
whole-grain only, one kind only. He got dried eggs on Lend-Lease
from America. He forced the rich to do without fancy foods and
added more protein and vitamins for the masses. Infant mortality
rates during the war were the lowest ever. The fatter got fitter, and
diabetes rates plummeted.
Regimentation, thus, is often useful. I ask working parents to
start a disciplined way of feeding their families with one weekend
day: figure out a breakfast protein, fruit or vegetable, and a dairy or
grain. This requires experimentation. This requires telling children
this is what they will be having for breakfast. This requires buying
real food and not Pop Tarts. This requires knowing what most people
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