Looking back on my social media activity over the past few months, it is clear that something has shifted. It's gotten away from the interesting advances in alternative medicine and groovy bicycle stuff that I usually discuss, and has plunged heavily into politics. A savvy marketing consultant would probably slap me upside the head while telling me how off-message I've gotten. And they probably would be right. What's a doctor doing talking about politics? It's really not in my wheelhouse, and the topic stands a better than average chance of driving away patients.
On the other hand, maybe politics is a doctor's business. But before we get into that, a personal mea culpa: Like so many other people in this country, I'm feeling a certain amount of concern over our collective potential futures. I'm not really fearful -- a man who has twice gambled everything he has on slim chances of success is unlikely to respond to fear -- but I am worried. It seems that we're at a pivoting point, and the pivot extends through about seven dimensions. None of us can see clearly what's ahead. As a result of my own concerns, I've been more than usually willing to participate in discussions I would normally steer clear of. What may have gotten masked in the verbiage is that I'm personally pretty accepting of a wide range of opinions. Sure, the world would be darn near perfect if everyone believed like me. It would also be incredibly boring.
Transgender people have bad backs, too.
But, professionally speaking, should I even be mentioning politics? It's something I rarely discuss with patients in person. For the most part, within the confines of the treatment room, politics wouldn't seem to affect outcomes. But the fact of the matter is, politics often plays a huge role in affecting patient care, and can have a dramatic influence on outcomes. Let me give you an example or two.
For several years, I made it a point to reach out to the community of transgender people. Not that I have any specific skills for helping transgender people transition or become comfortable with being beyond binary gender classification, though I have sought to educate myself above the general level of knowledge. Nevertheless, those tasks are best suited to endocrinologists, surgeons and therapists. But, you know, transgender people have bad backs, too. And headaches, and allergies, and tummy problems -- all the things I treat on a daily basis. I wanted my clinic to be a place where transgender people could just come and get their health issues dealt with in an environment where their gender identity doesn't really matter. In doctors' offices that's all too rare.
During that time, I got a glimpse of just how powerfully our political system affects individual health. A large part of what causes some of the dysfunction associated with transgender people's functioning has nothing to do with the individual, but is more due to society's rather dismal response to those who don't fit into our narrow categories of normal. While the gay and lesbian rights movement made tremendous strides during this time, transgender people were largely left behind. The mantle of shame and fear impressed upon them by our society hobbled many of our efforts to improve health. I treated transgender women who refused to exercise, fearing they would bulk up, lose their femininity and no longer "pass" as a woman. I had transgender men as patients whose use of the local gyms was hobbled by their inability to use the appropriate locker rooms.
Perhaps the greatest inhibitor, however, was poverty. Because of their status as outcasts, transgender people often find it difficult to get or hold a job. State insurance in Connecticut doesn't cover chiropractic care for anyone over the age of 18 (I have yet to make any sense out of that particular regulation), and when it does offer coverage, it provides benefits only for a chiropractic adjustment, but none of the other services I provide and that are within my scope of practice.
It is not an exaggeration to say that almost all of my services to transgender patients were, as a result of politics, public policy, and the vast bigotry inspired by social conservatives, provided free of charge. I didn't mind; part of my individual social contract is to care for the sick regardless of the ability to pay.
So the detrimental influence of politics here is two-fold: First, and most important, is how social policy and attitudes impedes the ability of transgender people to navigate a healthy path in society. Second is the social net so full of holes that I couldn't receive payment whatsoever for treatment of a transgender person's headache, if that particular treatment required nutritional or acupuncture intervention rather than a chiropractic adjustment.
An absurdly loose definition of "safe."
Politics is my business in other ways as well. Take, for example, the push to hide GMO produce from the consumer. A lot of my practice is based around nutritional intervention, and very often I am providing care for people who are very sick, and have been so for years. In these cases, the quality of the food in their diet is absolutely critical, and for at least some period of time, must be tightly managed in order to acheive the results we want. How on earth can I do that when I don't know what is even *in* their food?
I know the argument is that GMO plants have been tested as foods and found "safe."
It's an absurdly loose definition of safe. Food safety testing for genetically modified plants has consisted of exactly this: The GMO food is inserted into a livestock's feed for a period of time, not exceeding 6 weeks, while it's effect on output (eg, milk for dairy cows) and "health" (in this case, soley measured by weight loss (bad) or weight gain (good)) is measured. If the cow keeps making milk and the pig keeps making bacon, the GMO is determined safe.
There has been no legitimate long-term testing of GMOs and their role in chronic diseases such as arthritis, cancer or heart disease, not to mention how genetic modification affects the levels of macro and micro nutrients. How can I tell a patient to increase their levels of certain foods in their diet, foods that were once known to have certain levels of a nutrient, if genetic modification has changed it in unknown ways? Worse yet, what if my advice floods them with previously unconcerning levels of chemicals that worsen their condition?
That is tantamount to an MD telling a patient to take the pills in that brown bottle without a label on it. They don't know what's in it, and neither do you. Food is my patients' medicine, and through the political expediency of not requiring appropriate labeling, my ability to prescribe the kind of medicine my patients need is being stolen.
A catalyst for change.
Finally, I must address one other reason why I have felt so strongly to speak out in this political season. It is because, over the past two decades, I have come to realize that my role in patients lives is not just the dispenser of adjustments, advice, exercise and supplements; I am, sometimes by choice, and sometimes by default, a change agent. By the time people get to me, their lives are often so contorted, so distressed by malaise and malfunction, that nothing short of a grand step into the unknown will help them. I'm the guy who holds their hand and helps them make the jump.
A case in point: Many years ago, a patient came to me for nutritional advice. They wanted me to help them fix their diet. And, after consultation and examination, I found that a single change would eradicate a large piece of their health problem.
I told this patient that they needed to stop drinking. That the alcohol was taking their health and would eventually kill them.
That wasn't the first time I discussed alcoholism with a patient, nor would it be the last. It's never an easy discussion, and it is rarely something that the patient wants to hear. I try to be honest, caring and non-judgemental; alcoholism isn't a failure of morals after all. But it is a diagnosis that is loaded with massive societal overlays of blame and self-loathing.
In this particular case, the patient stormed out of my office in a rage. I felt bad, like I had failed them. My failure stuck with me for years.
Several years later, I was interviewing a new patient. I asked them how they had heard about me, and they told me that this former, one-time patient of mine, the one who had stormed out of my office in anger, had referred the new patient to me from a sober facility. That was nice to hear, but it was the way they worded the referral that clutched my heart.
"Go see Dr. Jenkins," this patient had said. "I'm alive today because of him."
It was then that I realized that, at the core of what I do, I am a catalyst for my patients, enabling them to do things they couldn't do before. That is my most fundamental, and most important, role.
So it is in this election. I can't see much in the murk, but what I do see in this time in our country is the potential for change. The change can be good or bad, but in my very small, very limited way, I will fight for the change that I think will make this country healthier. We are sick right now, sick with anger, sick with bigotry and sick with unnecessary poverty. If I am to be true to my role as a healer, and true to myself, I feel that I need to fight for the changes that will make us all a little bit healthier.
You may not agree with my opinions, my message, or my candidates. That's fine, civil disagreement is what makes the world turn 'round, and I've emerged from political tussles with more knowledge and sometimes a fresh perspective that changes my opinion.
But just know this: I am working as hard as I can for what I believe is the healthiest outcome for us all. And I also choose to believe that you are too.