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.

Author: Stephen Schettini

Host of The Naked Monk

18 thoughts on “Guilting the Sick”

  1. 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. 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.

    1. Anne: I’ve noticed that ‘spiritual’ and new-age types often get caught up in extreme positive thinking, and the assumption that there’s a fix for everything. Buddhism allows for havoc. In fact, it expects it.

      1. I’ve had Type 1 (insulin-dependent) diabetes for nearly 20 years, so various bits of medical paraphernalia keep my company each day. From time to time someone will tell me that I’m being foolish, and that if I just tried this particular herb/juice/meditation/other, I’d be cured in a flash. Almost invariably they’re either sangha members or new agers.

        I consider it a sign of my spiritual development that I’ve not strangled one of them (so far!). Actually, joking apart, I think they often don’t realize how dangerous their advice could be.

        I’ve been reading your blog postings about your wife’s illness, and your efforts in facing that together. And I think of my husband, and how deeply loving he’s been in the face of the realities of imperfect health. Of course one would like never-ending perfect health, but I doubt that would do so much to reveal the great hearts.

        1. Thanks for this intelligent, funny, lovely comment, Kirsty. One of the good things about humans is the way we face stuff together … sooner or later, there’s always stuff.

          Good luck to you and your husband.

  3. 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.

      1. Hi Stephen

        Yes i get it that my take might be seen as being unconventional. I think i’ve taken this view because if there is no self, i’m not sure what is it that makes the choices we do. We know that we think we are making them ourselves. But if there is no self, then it would make sense to think its a combination of our genetics and our circumstances that leads to these choices. I think this is consisstent with Sam Harris’s view. It may not be the buddhist view which seemed to hold with an idea of freewill but i can’t see how we could have free will and not-self at the same time.

        Also when i was at a monastery recently, the nun said “we have no control” which seems to me that we have no free will. If we have no free will, then we have to ask where are the decisions we make coming from.

        And if you look right down to basics like whether you choose a cake with pink icing or a cake with chocolate icing what could be the difference but genetic preference.

        That’s where i’m coming from. And then it is the people who come before us that set the circumstances that interact with our genetics. That’s why no one can predict what anyone will do but why there is still no free will.

  4. 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. 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. 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. 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. 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.

      2. Hi David: The issue here is not what sort of change various people are capable of but how effective this ad is at motivating them. For people whose bodies do not obey their brain this ad is not simply ineffective, it is a cruel reminder of their disability.

        The strong and capable often have trouble relating to the weak and helpless, just as the rich and successful cannot understand those who struggle to survive. Neurologists think that new research findings should make MS patients clap with relief, but there is no relief in sight. Their wonder drug, Tysabri, has just killed its eightieth victim, while the drug establishment pours scorn on drug-free procedures that bring them no profit. There is no compassion in here.

        It’s great that you’ve developed good exercise habits and turned your life around. Like Caroline, I admire you. Now, what advice do you have for those who cannot put one foot in front of the other without falling down?

  7. 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.

    Sincerely,

    Alexandra
    Associate Manager, Public Relations, Heart and Stroke Foundation

    1. Alexandra: I appreciate you taking the time respond to my post.

      Still, I would ask you to read it more closely. I know your new TV campaign isn’t aimed at people whose ill-health is unavoidable, but I can see why you might feel defensive. I also understand the logic of preventing cardiovascular disease.

      However, my post did not attack your logic. It was about how people feel. Your ad makes people like Caroline and Ann feel bad, though I’m sure you don’t mean it to. My complaint is that I see nothing in it to enable those at risk of CV disease to actually take the steps they know they should. To put it another way, your trust in the power of mere logic to change lifestyles is idealistic, if not misguided. Plus of course there’s the collateral damage of hurting other viewers and bringing disdain on your own organization.

      The loftier goal would be to emotionally empower people to manage their lifestyles. My students and Caroline’s clients come to us because they want to change and can’t. We know this isn’t just a common problem; it’s a universal one. It takes effort and strategy to understand habits, why they’re stubborn and how to let them go. Logic alone is inadequate. Motivation is built with insight and feelings—especially empathy.

      By helping all viewers understand this you’ll help them all prevent what’s preventable and accept what is not. Caroline’s ability to accept her condition, to let go of regret, sadness and frustration is the source of what you call her incredible strength. She is not just a passive example to others. She is a powerful force, not defined by her disability; someone who helps others turn their lives around.

      You should engage her as a consultant. You don’t yet know what you and your organization are capable of.

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