What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Monday, September 11, 2006

Appeasement, Short Term Gain for Long Term Pain

Every once in a while I venture out of my comfort zone of experience (medicine) and wonder into adjacent, but at the same time, distant, areas. Over the last few years, and I suppose, because today is Sept/11th and the fifth anniversary of one of mankind’s greatest acts of inhumanity, the word “appeasement” has come up as a strategy for dealing with terrorism, terrorist groups, and rogue nations. So in my usual obsessive-compulsive way, I began ruminating about the situation, and in my overly simplistic way, I applied my experiences in family medicine to the world stage, and the premise that “appeasement” is the solution and approach, that should be taken to the aggressors in this world (My dictionary defines “appease” as “to make calm or quiet, esp. conciliate (potential aggressor) by making concessions). My first reaction to the discussion point was ‘When does living in harmony with conflicting views, deteriorate to negotiating peace, then to appeasement, then to enabling, then to aiding and abetting, and then to abdicating all the things that we believe in? Is the slippery slope the negotiating? Or even before that---simply talking about our different opinions (many friendships have been destroyed by talking politics and/or religion)? After mulling over these imponderables, I got a headache, and decided I would leave those hefty intellectual exercises to men, er----persons, wiser than I.
Now, back to the topic, my medical practice experience with “appeasement”; could I think of instances in medicine and human behavior, where this was a useful and beneficial approach to aggression?
Of course! The well known and respected “baby soother”. Whenever the baby is unhappy and invades our peace and solitude with piercing screams and cries, stop what you are doing immediately, and plunk that wonderful little nipple facsimile into her/his mouth. What’s the worse that can happen? Sucking a soother at school at age ten when unhappy? Big deal, kids have to learn to be tolerant. Come to think of it, there may be a time when the soother doesn’t work and the infant wants the real thing plus warmth, reassurance, company, visiting, singing, entertainment. So what if it is in the middle of the night and the child is two years old, surely a little appeasement, say a cookie, in response to the discontent this once, er—twice, er---five times won’t do harm? Anyway if this starts to fail, you can always appease them by taking them into your bed with you; that usually is very soothing and comforting to children. Besides, it acts as a fairly good method of birth control. Mind you, when they reach puberty (well, actually even maybe before) you had best find some alternative appeasement method. Child services are suspicious of aging children sleeping with their parents. O.K., maybe the soother wasn’t the best example.
How about a cookie to appease children who scream, cry, yell, turn blue, etc when you are trying to visit. That can’t be so bad. Oatmeal cookies are healthy, and you will only do it when you have company, ----- and I guess when you’re shopping, er, and in a restaurant, and, well, I guess in public. Well, maybe at home too, but only if he does it for more than five, or maybe two minutes when we are at home. And of course, if I want to sleep; but that is actually a negotiated compromise, right? But I’ll be tougher on him when he gets older and he understands more and I can reason with him. I won’t try to appease him then-----unless he threatens to burn down the house, of course. Well, what else could I do? O.K., I guess I could have bought him the car he wanted even though he was only fourteen. So, O.K., maybe the appeasement cookie wasn’t that good an idea.
I know. Appeasement works in situations of marital dysfunction. Say the husband likes to have his meals exactly on time and gets yelling and aggressive if they are ten minutes late, just make sure his meals are always on time, and show him his shiny shoes, he always settles down when you show him his shoes that you shined. And when he starts yelling and shouting, just say “yes sir”. That usually appeases him. Except, of course last time, when he hit you because he thought you were being a smart ass (were you?) Maybe the doctor was right when you saw him about that black eye. The aggression and abuse does seem to be getting worse in spite of your best efforts at appeasement. I guess that wasn’t a very good example.
Of course, here is a good one. My daughter had a very aggressive and hyperactive six month old dog that she needed help with. Being a kind soul, she took the dog to an obedience school that believed in the carrot and not the stick. During the first class the dog was uncontrollable in the new exciting environment and barked continuously. At first the instructor reassured my daughter that under the circumstances (new environment, other dogs, etc.), her dogs behavior was normal. After thirty minutes of ongoing chaos (I think the chewing on people and furniture may have had some impact as well), the instructor gave her dog a “doggy” biscuit. The dog lay down quietly and ate the biscuit. Peace at last! Everyone cheered. A great example of appeasement. Unfortunately, bad behavior returned two minuets later and the remainder of the session was spent feeding the dog various treats. The next session was worse, and, after being satiated with treats in the first twenty minutes, the dog proceeded to destroy the environment around him. The instructor deemed the poor dog as incorrigible, and my daughter and her dog were expelled from the class. Perhaps the instructor was right, the dog is incorrigible (although he behaves perfectly with me in all circumstances), but as I write this blog entry I am starting to have some doubts as to the benefits of the “appeasement” process and philosophy. In fact, I have a suspicion that it may be a process where short term gain leads to long term pain. Perhaps I just need more time to think about it.


Blogger Money Bags4Me said...

Some good points to think about.

I've got an alligator in the back yard and sent the cat out to tell it to leave. The cat never came back.

So I sent the dog out to try and negotiate terms, you know, have the alligator recognize our right to exist. The dog never came back.

I think next up I'll try sending my toddler out there with some raw steaks, maybe that will make him happy.

My wife thinks I should just shoot it and be done with the problem, but that sounds a little to extreme. I just have to find the right angle so that the alligator will adopt western liberal values. Hey if leopards can change their spots so can alligators. The poor guy probably had a bad childhood and all the rich alligators picked on him.

I just have to think,think,think.

12/9/06 8:41 AM  
Blogger Al said...

Send Jack Layton

22/9/06 9:49 PM  

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