Letter from GOD: obesity and death are unacceptable

Our resident Grumpy Old Doctor (GOD, for short) explains to his urban daughter how things really are in that other world out there

---

Dear Julia,

There are a lot of geriatrics in this town and it’s a well-known fact that old people die in threes, which can make things awkward if they all happen to go in the first week of your locum. People talk, word gets around.

It was busy in the newsagency at lunchtime. The proprietor was under the pump and happy to explain why to the customer in front of me. “We’re short staffed today, Dave’s gone to a funeral,” he said, before glancing meaningfully in my direction and adding, “Been a lot of them lately. Just The Australian, doc? Three dollars thanks.”

Like a chastened child I shuffled out with my head down to read in peace and catch up with life in the outside world. A tennis player had been “shattered” (lost a match) and a footballer “completely gutted” (missed a goal). A leadership “crisis” was creating a political “scandal”. It was all “totally unacceptable” but will be sorted out next week by a man in a nice suit who is prepared to “call out” bad behaviour and knows “what real Australians want”.  Apparently, no one else has a clue because none of their ideas have passed “the pub test”.

Up here, the only things called out are the meat raffle and members’ draw numbers at the club on a Friday night, and no one goes to the pub to test things – but it is a good place to see how people live in the real world, a world in which utility always trumps fashion.  A look at the shoes confirms that, like Aldi customers, country pub patrons go for comfort and practicality over fashion in their footwear – thongs are popular even in mid-winter.

The street is lined with four-wheel drive utes equipped with large dog cages and combat strength roo bars. Functionality determines what a young working man will drive. You can’t exist without a car in the country and for the unemployed the choice of vehicle can be tricky. An agitated gent outside the op shop strongly advised me to: ”Never buy a Ford Territory. They want $800 for a new tail shaft.”

Inside Vinnies, his family were making further pragmatic choices. They had come not in search of oddities and vintage wear, just clothes that fitted both their bodies and their budget.

Here it appears the relationship between budgets and bodies is an inverse one – the smaller the budget the larger the body – so obesity is common and dietary habits are hard to break. In my first week I told a grader driver with a big beer belly that he was too fat.

“I know I am, doc. Can’t do much about it though. The missus left me and I’m batchin’.”  Another patient, Cindy is in a stable relationship, dresses nicely, has a well-paid office job and is overweight. She smiles, calls me by first name and promises the consultation will be brief, as she just wants “another script for diet pills”. When told that I don’t prescribe diet pills because they don’t work and sometimes cause psychosis she turns the charm off and disengages. The consultation was indeed brief.

John is morbidly obese, schizophrenic and looking forward to pension day on Thursday. “I’m hungry and I’m gonna get two plain hamburgers, two steak sandwiches and a strawberry milkshake.” For John, the price of sanity is an insatiable appetite for take-away food. Antipsychotics do that.

Cindy won’t be coming back but I met John again, down the street on Thursday night, and was greeted with a cheerful “Hello doc. How are you going? I like your shoes, are you going to the gym?  Are you havin’ a good day?” I hadn’t had a good day, but John made it better.

There was no obesity or talk of diets in the gym. There was no talk at all. Young and lean, the gym junkies engage only with their images on the wall-to-ceiling mirrors and the closed world of the mobile phone screen.

In the nursing home next morning I found the residents disabled, demented and happy to talk about their lives. Bill told me how to catch and kill a wild pig. “Hide in a tree above a stock trough at dusk and jump on the pig when he comes to drink. Put one arm under his neck and stab him with the other. Had a few busters, doesn’t always go well.” And then there was Mary who recalled meeting her husband on a blind date 50 years ago “and by God he was blind; he’d had a few”.

A scoreline reading “Undertaker three, doctor nil” was not a good start in a place where non-performing dogs are shot and infertile ewes culled. Fortunately, the second week has been fatality free and my standing in the community has picked up. The newsagent’s attitude has softened and we’ve been invited to a “Do” at the golf club on the weekend. No-one has asked if we have any special dietary requirements and there is no dress code. I’ll let you know how it goes.

Eat less if you want to lose weight.

Love, Dad.

Dr Max Higgs is a former country GP, a current rural and remote locum and a collector of stories