Control

Both Doug and I have posts brewing for the co-parenting blog about this whole thing, but they’re taking a bit of time to roll around in our heads, I think.

In the meantime, I wanted to talk about control and respectability policing. (The best summary of respectability policing I’ve seen is by Carolyn Edgar in this post on a totally different topic than heart attacks.)

About a month ago, I was on the phone with Doug and he was asking about my parents, who are currently taking care of my 98-year-old grandmother. I was expressing frustration with the amount of time and energy and maintenance my dad has to perform on some of his health problems, and I started ranting to Doug about how we both needed to keep exercising so we didn’t end up with these health problems and yadda yadda. He cut me off with a “You’re preaching to the choir” and I knew he was right.

One of the nice things about being divorced and being able to interact successfully on a limited set of topics is that we are always expanding our topics. One of the things we’ve been interested in lately is exercise and general health. Running, his swimming, my barre, etc. And how to get the kids into lifelong sports. This has been a whole journey for me, understanding my body as a machine that has definite responses to what I do to it, but that still works in ways I’ll never be able to control. 

And I knew that he was worried about his health because he has a genetic risk for heart problems on both sides. So all of his exercising and eating well and not salting his food isn’t any kind of guarantee, and, in fact, may all be a red herring in preventing a Major Health Event. 

And his worries turned out to be correct. What happened was all just from his genetic legacy.  

What has surprised-not-surprised me is how the first question most people asked (after asking if he was ok, of course) was about what he’d done to bring this on. Sometimes it was about whether he exercised, or what he ate. Sometimes it was incredulous (from the people that know him and know that he’s improving his health constantly). But it struck me that we have all been conditioned to think that we have control over our health 100%, and that if we’re exercising and eating well, things won’t happen to us.

It’s respectability policing, and we’re doing it to ourselves.

So many people have been so kind about the heart attack. And I am sure that they would be equally kind if Doug was carrying more weight and never exercised and didn’t do all the other things he was “supposed” to do. But I also think that they’d be a little bit relieved, because that would mean that there is a linear relationship between what you do and what happens to you. It would mean that we do have control over our health.

I was profoundly affected by reading Haruki Murakami’s What I Talk About When I Talk About Running.  In it, he talks about being a writer and a long-distance runner, and how he runs for health. He feels it’s his responsibility to run so he can give his body the exercise it needs, but at the same time he knows that he could die or become sick at any time. Running is no guarantee. He does not have control.

And I don’t have control, either, even when I exerting control by putting on my shoes and going out when I don’t want to, or eating an apple instead of a bagel. 

Here’s the tension: We should exercise and eat well. Exercising and eating well don’t mean we won’t get sick or have a medical event or die.  There is a relationship there, but it’s not linear. And nothing we do, even looking both ways before we cross, can guarantee that we come home every night.

How do we live with that tension?

25 thoughts on “Control”

  1. This reminds me of how control-freaky many of us (well, me anyway) can get around pregnancy health and feeding a baby. We want so badly to believe that by eating and doing exactly the right things, we can guarantee health (and by extension, happiness, long life, a fancy college degree, and all the trimmings) for our children. But it’s one of the hardest first lessons you have to learn as a parent, that you can do everything "right" but you still don’t have absolute control over your child’s health and well-being. You can’t shield them from harm no matter how much organic kale everyone is eating.

  2. Wow, well this was powerful. Here’s my thoughts. I have thyroid disease. I also had multiple miscarriages plus infertility that may have been tied to the thyroid. I can only do so much for this disease. I can’t make it stop. I can’t make it go away. I can exercise, eat better and sleep better, but that doesn’t mean my thyroid will start working again.
    I try to teach my kids to treat their bodies well. Treat your body well, and you may have great rewards, but just like driving well doesn’t mean you’ll never get into an accident, being "healthy" doesn’t mean you will never have health issues.

  3. Perhaps it is not so much fear of death as it is the desire to live, and live well, that is the higher calling. We practice fitness not to fend off an event but because we like the rest of the package.

  4. Reading this brought back the feelings of frustration and anger I feel during conversations about food stamps, social welfare, health insurance, and a safety net. I is a sign of a moral failing in this country to be poor, much as it is a sign of a moral failing to be ill. Perhaps it is a product of thinking that if others are sick and poor because they are morally deficient, then it won’t happen to me. I won’t lose my house because of a cancer diagnosis. I won’t have to go on food stamps or apply for welfare, because I am a good person. The impulse to blame people for their problems is a way to "other" them and insulate ourselves. I try to remember everyday that there but for grace and luck go I. Which is terrifying. But freeing, also. I can only do my little part and hope that everything turns out OK.

  5. I have a few thoughts on this issue.

    First of all, I’d love to hear any suggestions on how to incorporate exercise and physical movement into the lives of kids who aren’t into sports. Our older son, 7 y/o, hates sports and frankly isn’t at all athletically inclined to the point where he has trouble riding a bike and playing on the monkey bars in the way most of his friends do. Genetics at play, unfortunately. Both my husband and I are the same way and have also struggled with weight problems most of our lives. My weight issue is more or less under control (at my insurance biometric screening this year I had a normal BMI for the first time in my adult life – YAY!!!) and we try to stay active in the form of walking as much as possible but unfortunately this often doesn’t involve the kids since my husband walks to and from work and I do mine when the kids are in school. We need to find ways to get our kids to understand that exercise doesn’t equal sports and just because you can’t catch a ball, or have any interest trying to learn, you can still be healthy moving your body.

    Secondly, my ILs are the kind of people who immediately jump to blame whenever someone gets sick or has major health problems. Which is kind of weird because there have been some pretty significant issues in their children’s generation of the family that aren’t attributed to lifestyle. But it’s clearly just that they’re afraid and have to believe they’re somehow immune.

    About the fear, I think you just have to do what you can and live with it. My husband had a brain tumor the year before we met and even though it was benign and no problem to remove he still had to be on anticonvulsants. Early in our relationship I spent a lot of time being freaked out and worried about his health but I quickly realized I just to get over it if I was going to be in a committed relationship with him. When the medication stopped working nine years later, while I was pregnant with our second son, we just had to deal with it. Granted, I flipped out the day he called to tell me he’d had a grand mal seizure in O’Hare waiting for a flight home from a business trip and woke up in an ambulance, but it was what it was. Over the next year and a half he spent 50-plus days in the hospital for observation, epilepsy surgeries, surgery treatment for the life threatening infection he developed after the second surgery, and yet another surgery to have a prosthetic piece of skull implanted. It wasn’t fun and honestly, I spent a good part of that year afraid he was going to die or be disabled by a seizure or stroke. He’s pretty much recovered and we’ve moved on but it is always in the back of our minds.

    Maybe it’s not quite the same thing as Doug’s heart attack but I think you have to approach it the same way. We can’t control life as much as we think we can and parenting should have warmed us all up for that reality. ๐Ÿ˜‰ There is no guarantee my husband will stay seizure free just like there’s no guarantee I won’t have a heart attack tomorrow in spite of losing weight, eating well, and exercising. But I continue to do those things, just like my husband continues to take his medication, because I feel better when I do. Just like I feel better when I get enough sleep. Even though there are always going to be medical possibilities our of my control what I can control is living my life in a way that makes me healthy enough I can enjoy it. Or so I tell myself.

    1. My son, now 10, was a lot like yours at the age of 7. We tried soccer…he truly stank. And hated it, so what was the point? He took forever to learn to ride a bike and manage the monkeybars. He is naturally cautious and was totally uncoordinated. But around that age, we stumbled into taekwondo. There’s a little place within walking distance of our house, and we thought we’d give it a try. Best move we ever made. His teacher is the perfect mix of mom and drill sergeant. Son still kind of stinks at team sports, but dang, he is a completely different person physically. His coordination, strength, balance, and confidence have skyrocketed. He can break boards with his feet and hands in numerous ways; can remember and perform long sequences of blocks, kicks, and so on (it’s like a dance–I love watching him); he has really internalized the lessons of working hard, showing respect, and problem-solving that he learns at TKD. And now that he is an "upper belt" and is often the most skilled person in class, he gets to lead certain portions of the class, which is great for his confidence and self-esteem. If you can find a good TKD school, I’d highly recommend checking it out.

    2. Ditto what Tine said, but my son does boys gymnastics at the Y. He’s not exactly uncoordinated, but he’s not into sports by nature, either. My sense is that any individual (as opposed to team) sport is worth a try — but also that they tend to focus on exercises that build the core strength and balance that children who aren’t by nature into athletics tend to need.

  6. I think the way we live with that tension is to consciously work on taking ourselves out of a place of sitting in judgment on everything. I realize that our brains are meant to look for patterns, and that it’s evolved as a means of enhancing our survival. But when the patterns aren’t there, or as you say aren’t linear, then it’s crazymaking to keep believing that they must be. We need to move towards acceptance, and that includes taking the bad with the good. The genetics that give us so much we call good, can also give us something we call bad. I think we collectively need to Calm The Fuck Down.

  7. @BethB- There are a host of ways of being active that don’t involve sports. I think we’re too sports-oriented in our society; it narrows the field. If bike riding is also out, simple walks. Kids love nature walks. If my kids are in the forest with a stream or pool of water, they are happy as clams. They run, clamber over rocks, throw pebbles into water, try to catch fish, etc. Walks can be intense like a hike or easy like a stroll. We like to look for birds or animals or leaves (they love collecting things to integrate into art projects later) as a way of making it more fun than just a random walk. Canoeing is another relatively gentle way of enjoying being outside/active. We don’t really talk to them much about the importance of being active, or being healthy; mostly we try to do. We walk, we hike, we boat, etc. in the natural course of things.I tend to think exercise and healthy eating are like teaching your kids manners – they do what you do, sometimes with some gentle encouragement.

    @eep – Amen. I agree, and think that the way we think about the sick and the poor are interrelated, and the idea of moral superiority = health and wealth is feeding a shockingly callous attitude towards the poor and the sick. People often treated me as though I had done something ‘wrong’ because I had hyperemesis in my pregnancies (ie, I was ‘weak’ and couldn’t ‘tough it out’) and long difficult births. It was eye opening to me to see how many truly random things we ascribe to virtue. I choose compassion.

  8. This is reminding me of the work I’m doing right now in couples and individual therapy. There are things I need from my wife. In order to get those things, she is going to have to change in XYZ ways. But it’s not my job to change her, indeed, it’s not possible for me to change her. Still, there are things I can do that might have the effect of helping her to change. But it’s not healthy for me if I do them simply to change her, because I can’t change her. But doing those things is probably going to be good for me too, regardless of whether my wife changes and I get what I need. So I try to change myself in ways that are good for me (sort of like exercise and eating well), and I hope that making those changes will have the effect of changing my wife in ways I need (sort of like hoping exercise and eating well will change my life expectancy), but if they don’t have that effect, it’s probably still better for me to change what I can because my life right now will be better.

  9. @BethB – we accepted that our daughter was NOT competitive and hated all competitive sports. Then we started thinking outside the box: ballet (ok, perhaps not that for your son). Gymnastics (in the "learn to tumble/get strong in your body" kind of way, not in the compete on a team kind of way). Rock climbing. Bike riding. Martial arts? Drumming? While genetics might be at play for your son, it also becomes a self-fulfilling prophecy — I’m not strong, so I don’t use my muscles, so I don’t get strong(er).

    Then incorporating more walking as a family (dog walking? stroll after dinner? Race you to the corner! Leaving the car parked & walking to places instead. Of course, the latter requires that you are in/live in a place that is even remotely walkable. It’s how we chose our neighborhood but I recognize that’s not necessarily true in all places.

    Good luck!

  10. Thanks for this post, although I’m sorry about the crappy circumstances that brought it on. I’ve been struggling a lot with this in the last year too since my husband was diagnosed with MDS. He’s going to have to get a bone marrow transplant at some point in the near future, but it’s watch and wait in the meantime. It’s incredibly difficult at times to live with uncertainty that a health crisis like this brings on. It just immediately erases any kind of magical thinking you’ve ever had about having control over your health, and that’s a really scary place to be (especially for a control freak like me!). But you do learn to live with it because you have to, and eventually you become somewhat attenuated to the uncertainty and in some ways it allows you to live life more openly. Of course I often wish I had been able to delay "seeing behind the curtain" a bit longer, mainly because it makes me worry for the future for my 2 and 4 year old, and because it’s hard for friends my age to relate to my situation which can sometimes make me feel lonely. But like I said, it has certainly also offered us certain gifts – I am able to appreciate today a lot more than I ever could back when everything was seemingly fine. I honestly don’t sweat the small stuff like I used to, and that’s liberating!

  11. This is a huge issue to wrap your head around; I hope you are both able to be gentle with yourselves.
    In your previous post, you mentioned survivor stories. My mom’s sister married a man whose father, uncles, and brothers all died from major heart attacks, and all fairly young. To my recollection, in their 40’s and 50’s. At some point in his 20’s or 30’s, my uncle started walking 3-5 miles a day, every day. And he decided to be a vegetarian. He had some scares along the way. He also didn’t give up every pleasure – he liked a shot of half-and-half in his cereal, and my aunt said she bought that because if she didn’t, he’d buy heavy whipping cream. ๐Ÿ™‚ The thing is, he outlived my aunt, who had a bout with liver cancer. And although he did have a major heart attack, it was in his 80’s. 5 or 10 years after that, he passed peacefully in his sleep, having lived a long and full life.

  12. Definitely dealing with this right now. My husband is in the process of being diagnosed with (probably) Crohn’s disease. No genetic history, only risk factor "being between 15 and 35". My MIL’s "helpful" suggestion was to eat more vegetables. For a really fun time, he has all the symptoms except weight loss and reduced appetite. I know he’s reluctant to share the diagnosis with people and I believe part of that is because he doesn’t want to hear the judge-y things people might imply about how if he just got in shape/ate better/etc. it would go away.

  13. I think about this issue a lot. My father has lung cancer. He has never smoked in his life, was never a big drinker and was always very active and careful about what he ate. In some ways if he had smoked 40 a day for 50 years, I would feel like it was fair enough for him to get lung cancer. But when you treat yourself well, it seems more unfair and in some ways much more an act of God. I’m not saying that God causes bad things to happen to good people, but I am saying that the seeming unfairness of it all makes you think.

  14. @BethB: I would also add swimming, archery, roller skating, dance (it’s OK for boys! ballet, tap, jazz, hip hop), playing on the playground, skateboarding,trampolines, bowling, yoga, wrestling, horseback riding, etc. If you’re concerned about his fitness, coordination (gross motor or hand-eye coordination), strength, etc. consider having an evaluation by a physical therapist to determine if there are targeted exercises you could work on to improve his skills, which might help him want to participate more.

  15. So many good comments here. ITA @eep with everything that you said. DH won’t tell a lot of people about his transplant because of too many judgements when he told people in the past. He’s more open now, but it’s still guarded with many.

    Like others have mentioned, my way with living with the tension is that eating well and exercising make me feel good now. And also, if, IF, I manage to live to a ripe old age, I hope to be active mentally and physically, and will happily put in the effort now to try and reap those benefits later. But I know it’s no guarantee. I guess, for me, living with the tension is to not be motivated by fear. Fear is an awful motivator.

    With DH’s life expectancy more up in the air than the average person, I’ve learned to live with a certain amount of uncertainty. It is definitely easier in years where there are less unexpected / unusual health issues. But at some point you just have to hope for the best, plan for the worst and go on living your life. Saying all of this though, I know it is easier for me to put DH’s health on the back burner of my brain. I know he struggles at times, and more deeply than I do, with the thought of leaving ‘too soon’ in our young son’s life. It is ever more present in his life with daily medication and other health related things he must do.

    @MeInNeverland, while DH watches what he eats and overall follows guidelines for his health given by his doctors, he too has some food pleasures that he will not give up entirely. Reduce, yes, but not give up. For him it’s a quality of life issue. It took me a long time to really get that. And to concede that it was his life, not mine, so he got to make the decisions concerning his health.

    1. I’m with The Milliner — do it for how it makes you feel now, not because it’s going to make you live forever. My mother grew most of her own food, never ate a single piece of junk, and still died of colon cancer way too young. An active, healthy friend died last summer of insanely rapid metastatic cancer — one month she was walking her kids to school and living life, and the next month she was dead. And a good friend who spends practically all day in the gym or walking his dogs recently had a devastating stroke. I am sooo not a Zen person, but sometimes you have to just focus on the process and not the imaginary end result, because life can be a real bitch. And cut yourself some slack; a glass of wine or a bowl of ice cream can enhance your life in their own way too.

  16. @ Moxie, so sorry to hear about Doug’s cardiac event, but so glad that he was able to get this wonderful medical care and survive it. Very.

    On the " control" side of things, and life’s uncertainties there is a thing known by various names but I will go with Just World Hypothesis. It’s a natural part of human psychology, and helps us all live productive lives in the face of mortality but it’s a terrible thing to encounter when disaster strikes. Taking care of our health, eating healthy foods, moving our bodies, not smoking, going to the doctor are also part of leading those productive lives in the face of mortality. But they prevent nothing very much. They often postpone very successfully, for decades. They certainly can make you feel much, much better and your body work very well. But one of my friends is a geneticist who points out that there is a percentage of people who do everything wrong and live until they are 100. And the reverse.

    When I was five my mother, because of mental illness, hit me with a shoe with a wooden spiked heel. Fashionable at the time. On the bony chin with great force so blood spurted. I had lived long enough by then to know to leg it until she was more back to normal reality. So I sprinted out the front door down the street. Where I met a friend of my father’s. Who looked at me and said " Oh, what a bad, bad girl you must be! To make mummy punish you! Bad! ". That gentle readers is the Just World Hypothesis.

    Lung cancer? Smoked! Heart attack? Fat! Stroke? All those salty snacks! Homeless? Financially irresponsible. Few people are as blunt now, and will ask with great concern whether you exercise or light up but it’s the same thing.

    It helps them feel safe because it makes you, the victim of fate, " other". They floss etc. They are doing the " right" things. But the world’s not just. Good things happen to bad people. Bad things happen to good people. Some seem to have all the luck, some doomed. My father smoked like a chimney and drank like a fish. He had a fatal coronary while being operated on for lung cancer in his fifties. Fair enough. He had a great friend he used to go drinking with. He too imbibed and lit one cigarette from the other. He is quite frail now, but good for his age. He is 92. As my father would have been, he was an older father. My father wasn’t " worse" and his friend isn’t " better. It’s life.

    Which is precious. And despite the just world hypothesis and other survival mechanisms we all have , it does not mean people don’t care, won’t help or really judge you. Death and terror frightens us and doesn’t always show us in our best light.

    Which hurts when you’re in scary times and get asked questions and the feeling that others think you’ve just had your just comeuppance. Ouch. It will all feel better in time. And a lot of us are in the precarious boat, but still chugging along. Main thing is a life saved.

  17. The only way I can look at it is with statistics. For instance, we all get told the breast feeding statistics – if you breast feed, you reduce baby’s risk of asthma, obesity etc and mom’s risk of breast cancer etc. There are no guaruntees, but if, like me, you have asthma in the family, a reduction in risk is worth going for. The same with statistics for exercise and healthy eating. I have no control over a lot of things, but if I can arm myself with a 20% chance of obesity as opposed to a 40% chance then I will go for it. I may still get hit by the 46A bus but that’s life.

    One statistical report that I did read that really struck me (and I’m afraid I can’t quote the source or accurate percentages) was about exercise in families. In a family if the father exercises, the children are 40% percent more likely to exercise in later life. If the mother exercises, the children are 50% more likely to exercise in later life. But, if the family exercise together, the children are 75% more likely to exercise in later life. I suppose it cements the idea that ‘we are a family who exercise and are fit and healthy’ in the children’s minds.

    Finally, there is a brilliant blogger who writes about running and how to start running even if you cannot run and have never run before – Doctor Mama http://doctormama.blogspot.ie/
    The bar on the right of the page has all the info you will ever need and she is so inspiring she is even making me dig out my trainers, which is no mean feat.

  18. My husband’s father died of cancer when he was in his 30s. My brother-in-law had a heart attack when he was in his 40s (point being, we didn’t have a long-standing health history on that side of the family). That finally prompted my husband to go to a doctor, who sent him to a cardiologist, who told him that physically he looked great and genetically he was in the crapper, with hypertension and high cholesterol. He was at risk for a heart attack and you never would have guessed it to look at him.

    It’s well controlled now, but the tension is that he’s become really hyper-vigilant about it, which is kind of good, but has made our kids become self-conscious about their weights. And they are both tiny. My concern is actually getting/keeping weight ON them.

  19. As I age, my motivation to eat cleaner and exercise is less about vanity and more about longevity. The real life examples that stay with me are not the people who did everything right and got sick anyway but rather the people who got sick and lived – the ones who made healthy choices recovered nicely while the ones who didn’t had a much harder time.

    Re: Doug’s recovery – my medical degree was obtained by watching hospital-based dramas on TV so I know little about heart attacks. However, I would wager that his underlying health has been a big factor in how he’s recovering?

    I hope to increase my chances of living through a heart attack or cancer or autoimmune disease or stroke by giving my body a good foundation of health. When we know ahead of time that our genetic deck is stacked against us, we can plan ahead to combat that. But we also need to plan ahead for the genetic surprises that don’t forewarn us. I’m slowly getting better at this, as is DH, and we hope our kids embrace it for their lives.

  20. On the one hand, this is, of course, the human condition. But generally, when I get freaked out, I remind myself that I’m a whole lot more likely to have to deal with long-term care insurance and sufficient retirement savings than I am with a premature death.

  21. Susan Sontag โ€œIllness 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 the good passport, sooner or later each of use is obliged, at least for a spell, to identify ourselves as citizens of that other place.โ€

    We are all vulnerable. We need to be compassionate.

  22. we do what we can, but I remember my high school gym teacher who practised what he preached about good health and was a whippet-thin muscle machine needing a quadruple bypass in his 40s. sometimes your number is just up. it doesn’t help that the good health message is so confused with a million different pieces of advice which change every five seconds – eg. I started eating a lot more healthy fats (including from meat) and to my surprise didn’t gain any weight at all (and got better skin to boot), so clearly the orthodoxy of the polyunsatured fat brigade of the 1980s is bunk. i hope Doug makes a good recovery.

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