by Carl V Phillips
I just got done talking to two reporters about e-cigarettes and THR. In one of those I had the nice rare opportunity to be able to reply to the comments of the apparently mandatory interviewee for these stories: a medic who seems to understand neither the products nor humanity, but insists on opining on them anyway. Re the lack of understanding of humanity, I pointed out to the reporter that — contrary to the views of that physician — people care about things other than just minimizing health risks (something I almost always have to do, in spite of the fact that most people I talk to are people, and so should already know this).
Of course, the entire “public health” iron triangle[*] (not to be confused with real public health) is premised on the notion that the only thing people care about is maximizing their longevity. Or perhaps their view is that people owe their lives to The State or to The Community (dare I say, to The Collective), and thus only productivity and costs-savings — not pesky little matters of happiness — matter. Either way, they never defend their position. They just take it as a premise and run with it, perhaps knowing that it is indefensible but trying to make people forget that they have no foundation by creating a huge edifice without one.
[*For those who do not know, "iron triangle" is the generalization of Eisenhower's "military-industrial complex", as applied to self-perpetuating, self-enriching special-interest industry/government/academia institutions other than the military.]
But having gone through that thought process, I came out the other side thinking about where “public health” people, along with those medics who think of patients as their serfs rather than their customers, recognize that maximizing longevity is the only thing that matters. I do not recall — in all my years of hanging out with people who engaged in these activities –ever hearing about a physician or “public health” type advising them to give up mountain climbing or commuting by bicycle. Each of these activities is far more dangerous than using low-risk tobacco products. The former (among those who do it seriously) is more dangerous than smoking. And yet not a peep from those who would ban large sodas or whose attitude toward THR is that (even if they acknowledge that is healthier than smoking) it is a poor substitute for the always-better choice of avoiding the behavior entirely.
Of course, I can hear the inevitable response to that, “but they are good exercise”. Trust me, you only hear that from people who have not done those activities. They are certainly exercise, and as such better than no exercise at all. But they are fairly lousy as exercise (which is clearly not the main motivation to do them), with a lot of fitness-inefficient starting and stopping, brutalization of tendons and other body parts that you might discover that you need later, and furious inhalation of bad air (either not enough of it or far too high a concentration particulate matter and toxic gasses from burned gasoline and diesel). That is to say nothing of the trauma risk. But can you even imagine a medic advising someone, “instead of commuting by bike, you would be better off driving to the gym, riding the stationary bike there for half an hour (during which you can get some reading done for the good of The Collective, something you cannot due while commuting), and then continuing on to work.” By “better off”, they of course mean healthier — what else matters after all?
If you actually had this discussion with a “public health” type special interest activist, you could count on them also responding that just commuting by bike, rather than switching to that reduced-harm version, is better for the environment. To which I say: Aha! So even if you do not care about people’s pleasures, health concerns do not trump all other human wants, do they!?
To head off some of my experience from my last post, of comments and nasty notes from people who know nothing of my work, I will point out that I am aware that “public health” types and activist physicians are generally authoritarian elitists who think of the plebs (and the environment) as helpless kittens who need to be protected. That is the charitable interpretation; the less charitable version being that they think of the plebs as savages who need to be civilized into proper moral behavior so they can be good members of The Collective. The people who they encounter who commute by bike and climb tend to be fellow elites, who can be trusted to make their own decisions, while the peasants who use tobacco need to be civilized. (What about the people who commute by bike — sans carbon fiber, lycra, and helmet — because they cannot afford to drive to their jobs, often on particularly unsafe roads? The “public health” types do not really care because that highly unhealthy activity is not “immoral”, and the physicians who are willing to see them understand that they probably have bigger health concerns.)
Still, we can ignore all that subtext and perhaps find a vein of good rhetorical fodder. When responding to an authoritarian who takes the “you would be better off not doing it” attitude, whether in an interview or personally, perhaps it would be useful to ask “so, do you recommend that people give up hobbies/sports that are just as hazardous in favor of just riding a stationary bike? Why not?”