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Guilting the Sick

“What will your last ten years look like?”

You may have seen the Heart and Stroke Foundation’s new TV ad. A split screen juxtaposes a series of images: an athletic shoe against a bedroom slipper, a bicycle wheel against the spokes of a wheelchair, the steps of Manchu Pichu against a powered chairlift, a box of fishing tackle against a box of medications. The voiceover man wants to know: “Will you be quick enough for a game of tag with your grandchild? Strong enough to embrace every moment? Will you grow old with vitality…or get old with disease? It’s time to decide.”

Ads like this won’t fix anything by scaring the vulnerable

I watched this with my wife Caroline, herself at genetic risk of heart disease. She also has multiple sclerosis (MS). We exclaimed at the same time, “So health is a matter of choice?” The sight of a wheelchair triggers special feelings for her. She’s been fighting it for two decades, as she has all her MS symptoms. She works hard to accept a condition she can’t change.

The message we were getting at that moment was that it’s her own fault if she ends up in a wheelchair. That’s not a rational response to the ad, of course. It’s a visceral one. It’s surely not what the Heart and Stroke Foundation intended, but it is what happened. They were presumably motivated by compassion, but their impotence is thinly veiled.

Painting reality in black and white as if it’s a simple choice is patronizing and counter-productive. It makes you feel guilty. It makes you wish to God you could change your lifestyle, but there’s more to changing habits than a decision. Ads like this won’t fix anything by scaring the vulnerable. It takes special skill and support to help people change, especially when it comes to the bad habits of a lifetime. Smooth and polished as it is, this ad says more about the frustrations of the Heart and Stroke foundation than about the people it purports to serve.

As medical science has advanced, self-reliance has retreated

We live longer than our ancestors mainly due to clean water and public sanitation. Still, we give most of the credit to medical technology. It can be dazzling, though it’s got nothing for the two and a half million people with MS. When it succeeds at anything we hear of a ‘cure,’ but of course there’s no such thing. Science merely extends life. On the whole, cancer survivors eventually succumb to cancer and stroke victims to cardiovascular disease. When this TV ad asks what your last ten years will be like, the implication is that if you play it right you’ll live life to the full, right up to the last moment. Then, you’ll abruptly and happily drop dead.

So dazzled are we by medical advances that we’ve become druggily dependent on them, so vulnerable to TV advertizing that we’ll fall for anything that’s slick enough.

As medical science has advanced, self-reliance has retreated. The Heart and Stroke Foundation is part of the reason we find it so hard to change. We don’t have to reject medical science, but we do need to take back our power. That sounds like a political decision but it’s really a personal one.

We can change habits, but not in a vacuum. We need to deeply understand ourselves. What we call our ‘self’ is mostly a collection of judgements hatched in different circumstances, a clutch of habitual responses and jumped-to conclusions. Managing change takes skill, support and effort. If you want the last decade of your life to be ten good years, you’d better look to the ten years before that, and the ten years before that. How are you doing now? Are you working systematically on your own mental strength and self-reliance…or are you putting it off for another day?

Caroline doesn’t manage her disease but her attitude. She can’t stop it any more than medicine can ‘cure’ anything, but she can make her life worth living. She’s thoughtful and funny, an inspiration to others. That won’t change if she’s in a wheelchair rather than on a mountain bike. Let’s get real. Death will get us all. What counts is how you live. The Heart and Stoke Foundation knows that, but they’re sending the wrong message nonetheless.

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18 responses to “Guilting the Sick”

  1. Rob Stolzy

    Bravo! I completely agree. Except maybe for the final sentence. I really am not sure at all that the Heart and Stroke Foundation ‘knows’.

    We’ve been surrendering our potential for initiative to doctors and the health profession, while they in turn have been surrendering it to Big Pharma. Result is a twofold kind of ignorance. First, as compared to less technical societies, we lack a basic common sense about what is healthy in terms of food, lifestyle, activity, ambitions, and social norms (like conversation). Second, as compared to 50-100 years ago, our doctors have become unable to understand the full picture about a human being standing before him. They’ve become atrocious listeners (as a whole), unable or unwilling to grasp relations between physical and meta-physical symptoms, and totally dependent upon statistical testing for both their diagnoses and treatment suggestions.

    Just about the healthiest thing a person can do for themselves is to observe how their inner being works, and strive to make it more conscious and less automatic. For feelings and for thoughts.

  2. Anne

    Thank you so much for this article. I live with chronic illness and it’s hurtful when others assume there’s nothing that can’t be cured with medicine or willpower
    My Buddhist friends seem to be the only ones willing to see the way life really is.

  3. Andrea

    I agree with you for the most part. It seems hard to imagine that they don’t know how their ad could offend a lot of people who get sick through no obvious fault of their own. And and on another left of laying blame, if we are not in charge of ourselves as buddhism teaches us – which is the case with not-self, are we really able to do anything different than what we do anyway. Society is what it is because of actions of people who’ve come before us. The way society is now allows and encourages people to indulge their weaker sides and lead the lifestyles that lead to sickness. A belief in the not-self idea means that we can’t actually do anything differently than what we do, however hard we may try. So when people are trying to change society, it would be a good idea if those who can change things, do so bearing in mind human weakness. So as i think you are suggesting, the heart and stroke foundation could help people not by guilt tripping the population (which won’t make too many people change their ways) but actually make it easier for people to do the right things , the things that may lead to a healthier final 10 years supposing that genetics or some random virus don’t get to us/them first.

  4. Paul in Canada

    Thanks for the article. The first time I saw this, and subsequently, I was left with a big “say what?!?”. Death is inescapable. So is failing health. But I was left with, oh, so if I change my lifestyle, I will just drop dead some day from being healthy………… really?

  5. David

    I don’t agree. i think the ad sends a good message. On their website, it says 69.4% of Canadian men have a weight issue (most are over weight I think). A person’s health mainly depends on his/her right attitude and activities. Never too late to get active! One may not improve dramatically but any right workout will improve one’s health.

    Health and living value are different concept. I agree that inspiration should be the ultimate goal of a person’s life. The value of one’s life depends on how much inspiration he/she gives in his/her life time.

  6. Caroline

    I ‘got’ the positive message and it made sense, but my gut reaction was too strong to ignore. There are more sensitive ways to promote a healthier lifestyle than that.

    1. David

      It is not easy to change any habit. When one is open minded and a lot of STRONG messages keep stimulating his brain, one day he will change. The ad sends out a great strong message. What I interpret is that most people can choose to live the last 10 year life like the one on the left ad. Only watching the ad is not enough to change your mind and make the decision. Lots of other inspirations are needed.

      From my own experience, I now regularly run 5 days a week. However, it took me about 5 years to get to the current habit. Initially I watch those marathon events on TV. I admire how amazing they are. They could just keep running hours. I wish I had the ability to run one. Then a few colleagues run marathons. They are so close and so real. That impacts my thinking more. Then I watched Team Hoyt. I thought if they could do it, there is no reason I couldn’t. Then one day I received an email at work asking people to join a running team for the Run for the Cure for the Breast Cancer research foundation. After all the inspirations registered into my brain, it is enough to trigger my decision to stop just thinking but act. So I joined the team and started training. To be honest, it was hard at the beginning to keep training as planned, but gradually I formed the habit to run as schedule.

      Here is another example. Fauja Singh, 101 years old, the world oldest marathon runner, started running in his 80s. At age 101, he doesn’t take any medication. Take a look at this video from BBC.

      1. Caroline

        I totally respect what you are saying, and admire how you changed. If I was healthier I’d be in that marathon too. But I have MS with limits beyond my control. I know the ad wasn’t addressing people like me, but it pushed a button and I daresay it pushed other people’s too.
        Brought to mind the scary pictures on cigarette packs. Ask a smoker, doesn’t change a thing.

  7. Alexandra Maheux

    Dear Stephen,

    I’d firstly like to say how terribly sorry we are to hear about your wife’s diagnosis.
    We understand there are illnesses, chronic conditions and accidents, like MS, that are simply unavoidable in our lives at any age. This is unfair and undoubtedly frustrating. However, our campaign is not aimed at people in this situation.

    By way of background, nine out of ten Canadians have at least one risk factor for heart disease and stroke. They are the leading causes of hospitalization in Canada, resulting in nearly 1,000 hospital visits each day. They also represent the first and third leading causes of death in Canada.

    At the same time, 80 per cent of early onset heart disease and stroke is preventable. There is an established link between improving lifestyle behaviours and better heart health. The campaign specifically addresses five controllable behaviours that can affect heart disease and stroke risk. These are physical inactivity, smoking, poor diet, stress and excessive alcohol consumption. It is precisely those people who can change their controllable risks that the Heart and Stroke Foundation wants to reach with our current campaign.

    In this way, we hope to improve awareness and have many Canadians take steps to improve their health on this matter of vital importance. Our Make Health Last campaign aims to provide a powerful message to Canadians and encourage them to understand the facts about heart disease and stroke, as well as take an online health assessment at MakeHealthLast.ca.

    We appreciate your comments about the campaign and have circulated it internally. Caroline sounds like an incredibly strong person with a positive attitude everyone could learn from.

    Again, our apologies for having upset you and we wish you and your family strength.


    Associate Manager, Public Relations, Heart and Stroke Foundation

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