Sunday, December 14, 2008

"Let them eat cake"



Since I am unable to watch House during the week, I like to watch the reruns on the weekends. Some of the cases are quite fascinating. The one I watched last night was from a few weeks ago, titled "Let them eat cake."

In this episode, a personal trainer comes in after she has collapsed from a fitness infomercial shoot. As usual, House and his assistants go through a battery of tests to figure out the right diagnosis. They wound up scanning her for a tumor and realized that she had gastric bypass surgery since her stomach was stapled. Some of the assistants ask her about the ethics of her career choice as a fitness trainer yet having medical intervention. She replies with that she is helping her clients to get healthy as she did once she had the surgery.

Anyway, this post isn't geared towards the contradiction of her career choice and previous lifestyle. This post is about what happens at the end of the show. After many tests, House finally makes a diagnosis of
hereditary coproporphyia, a condition in which the liver lacks an enzyme that interrupts heme production. There is no cure for the condition, however, the treatment protocol is to reverse the gastric bypass surgery and implement a diet high in carbohydrate and sugar.

When House tells the patient, there is a look of mortification with her pleading for another way. The only other thing was medications for pain control. In the end, she chose the medication, and refused the surgery. House's final statement is,
"
Most people don't have the guts to admit they'd rather be pretty than healthy."

Now, I think that statement is slightly shallow, but I do get the point he is making. For this patient, having the bypass surgery helped transform her life so that she wound up living a healthier lifestyle. Therefore, I'm sure she felt like if she reversed the surgery, it would all be for nothing, or there was a fear she would regain all the weight lost, or simply unsure she could trust herself.

If I was in that position, I'm not sure what I would have done. I'd like to think that the "healthy" rationale would win out, but would it really? If you were placed in a medical situation of being thin or healthy (excluding weight restoration), which would you choose? What if your diet had to drastically change to all your fear foods, how would you react?

Transcript for episode

12 comments:

Gaining Back My Life said...

I'd love to answer our question, but as suspected, it's not the right answer I want to give.

Healthy, yeah, that's what I want to be.

Kara said...

I've totally seen that episode! I think it's sad that society is in a state where beauty and thinness are valued higher than health. But the fact of the matter is that I have bought into that and am struggling with that myself.

Charlynn said...

I know the correct answer to this question, but the truth is, I don't really know what I would do in a situation like this. The severity of the situation might be a factor.

Cammy said...

I saw that episode also, and found it pretty thought-provoking. I think ultimately I would choose healthy, but I *know know know* I would agonize over it. In the end I would like to think I would pick whatever will allow me to stay the most active and involved in things I care about, the same things that have been the big motivators in my recovery efforts this far...but yes, it's a sad statement about society that such a decision would be so difficult, but I won't deny that I would struggle with it.

MelissaS said...

i didn't see the episode, and i know what the "right" answer COULD be, but looking at it from a different perspective - wait, i want to stop and say i'm a recovering anorexic, bulimic, compulsive eater, drug addict, alcoholic- is one option better than the other? reversing surgery and stuffing carbs and sugar doesnt sound great either. so you may end up with diabetes, high blood pressure, cholestrol problems? taking meds SUCKS but is it worse than surgery and force-feeding? i'm now a healthy 5'6 and 135 pounds. i've weighed 95 and 200. i've been this way for seven years and i'm happy and comfortable. is there anything wrong with feeling healthy and easy in your body? i'm just trying to give another perspective.

Tiptoe said...

Thanks for everyone sharing your opinions. It looks like the majority of us would have a difficult time making this type of decision. And it is sad that society is geared to a physical appearance than health.

MelissaS, you make an interesting point, and I can see where you are coming from. Sure, there could be problems from reversing the surgery and eating a diet rich in carbs and sugar. However, from what I gathered in the show, the surgery would have been the best option for her health. The meds may alleviate pain, but the disease would continue to manifest and cause worse symptoms on her overall body. So in essence, she wasn't choosing the best option for her health, but more what appeared to be her looks. And that of course was an underlying issue of fear and uncertainty.

Kudos to you for being healthy for so long and feeling comfortable with yourself. It really is a great accomplishment.

Sarah said...

Sad to say I would say answer to stay thin, depending on the severity of the illness, maybe not. This is my honesty. To physically see my pain on the outside (excess fat) versus the pain inside thats "hidden" would be my choice. I also think when it came down to her, I think it goes back to the trust with her body when it comes to eating. Her gastric bypass surgery seems to be her clutch, her main motivator to still remain thin. (Black & White thinking maybe? Either I'm this, or completely obese)

Lola Snow said...

I'm with the majority, I'm afraid. I can cheer loudly for health, but when push comes to shove....

Lola x

MelissaS said...

tiptoe: if you have a chance to check out my blog you'll see i don't have that together, but eating really is coming along, in it's own way. i'm glad i found your blog. you raise great points. thank you

Tiptoe said...

Sarah, I agree with you that there probably was a "trust" issue in regards to her food habits and body.

Lola, it's really a hard thing to consider, and so many of us would be right with you.

MelissaS, yes, I will check out your blog. I'm glad to hear that recovery is coming along for you.

gutsinarut said...

Since I actually had a gastric bypass, I know I should be all "I would choose healthy! Because that's why I had surgery in the first place!" but I mean, really, honestly, I can't say that's what I'd choose. It depends on what "being healthy" means; that is, if I had my surgery reversed, it seems like all the problems I had *before* would come back. I guess it's like choosing one health problem over the other one. I hope I never have to make such a decision!

Tiptoe said...

Gutsinarut, I was curious what your decision would be since I knew you had gastric bypass surgery. I think it makes sense that you would be worried about the problems prior to your surgery re-emerging. I think a lot of people who were in a similar situation and had to face reversing the surgery would feel that way.