The sun poked through my bedroom window for nearly two hours by this point, filling the room with light, and supplying my reading light. I was enjoying my favorite single batch, shade-grown coffee from the Dominican Republic. As usual, it was gently lightened to a chocolatey undertone by the addition of heavy cream from grass-fed cows. My favorite part of the day, I have been engaging in this morning routine for nearly a decade. The only thing capable of elevating this daily enlightening experience were those days when my reading material was above and beyond in entertainment value while providing me some new and interesting knowledge. As I sprinted through nearly a quarter of the book Lesser Beasts during my coffee routine, today was certainly panning out as one of those rare mornings.
Mark Essig’s book Lesser Beasts: A Snout-to-Tail History of the Humble Pig reads as both an educational lesson of the history of the pig, and a thorough (snout-to-tail) explanation as to why these fan favorite multidimensional food sources are praised in some cultures and chastised in others. If you don’t believe this statement, simple perform an online search for the word “bacon” – few words can elicit such admiration and detestation at the same time. Perhaps most importantly, Essig presents his case in an entertaining and interesting page-turner. One underlying theme was omnipresent as the book scaled through tens of thousands of years of the pig and followed them throughout the globe: pigs and humans are eerily similar.
This similarity may provide some rationale as to why some cultures condemned dining on the flesh of pigs – it was as if we were eating our own kind. While I was reading Lesser Beasts to learn the history of pigs and adopt it to my practice, as a physician, food and wine fanatic, and semiprofessional chef (well, at least in my kitchen when I’m the only one eating), I found myself contemplating much more than the culinary pursuits of pigs and the controversial health benefits or issues. Our treatment of pigs, formidable beasts they may be, is signaling to us loud and clear.
We need to take a long and hard assessment of how we treat ourselves and others, and the massive health and social implications as this treatment slowly but surely approaches the likeness of these lesser beasts in Essig’s anthology.
Lesser Beasts are Made the Least at Work
As I sat there approaching the final three pages, I was quickly inching closer to the start of my work day. Like most days, I was confident I would arrive late, though only by a minute or two. Parking in the back corner of the lot to increase my daily walking distance and activity levels often compounded my lateness (doctors may be on their feet a lot at work, but do not always travel so far throughout the hospital, especially in my field where we often sit or stand at computers and sign notes – the bane of my existence). This lateness would never, of course, affect patient care. I always arrive with ample time before my patient encounters as I would never want my planned tardiness to affect them (granted, it is only a minute or two).
I work for a giant multi-billion dollar corporation, known nowadays as a healthcare system. With revenues toppling the GDP of several small Caribbean countries combined, management of this company requires a government-like system with innumerable layers of rules, regulations, and constantly served administrative sandwiches with so many rows of lettuce and condiments, that it is often difficult to remember what meat was being squished it its center (hopefully some delicious, but formidable bacon). This massive overhaul of medicine, like the old medical systems and hospitals, has its fair share of issues and criticisms – there is no perfect system – but it has aimed at improving medical errors and patient safety through a mechanistic approach to many hospital processes. These range from simple things like a time out before a surgery, to specific forms that must be filled out for each and every procedure (yes, I spend an incredible amount of my day checking boxes and signing hundreds of copies of the exact same form, and yes this often makes me want to bang my head off the wall, and sometimes I do). Flow charts are a plenty throughout the hospital, and frequent PowerPoint presentations explain new procedures that have been updated or added, and yes, with each PowerPoint presentation another small portion of me dies. Overall, while many of these forms and processes are necessary, they are eerily similar to Peter’s repetitive and headbanging encounters over TPS reports in Office Space.
Office Space may have come out 20 years ago, but it was decades ahead of its time
Such robotic repetition is required, but such robotic repetition also leads to mindless robotic repetition, an unwanted side effect when it comes to both patient health and safety and employee health and safety. I often find myself “herded” throughout the workday, much like a wild boar culled from the wild and led down a series of narrow pathways until the final slaughter – maybe we aren’t so different from those lesser beasts, especially the way we treat ourselves. Start the day, be at work at a specific time, see a specific number of patients (15 minutes for follow-ups and an hour for consults, and I always run over), fit in treatment contouring and unexpected emergencies in the middle, eat lunch – if, and only if you’re on pace to deserve it, repeat, dictate, leave, and repeat – but make sure not to bring any of it home and make sure not to let the emotion of it ruin your night. Oh, and meetings, my arch-nemesis, are scattered in throughout the week. I have had many final conversations with dying patients before going home on hospice, knowing I would never see them again, only to have to run to a meeting afterwards and explain myself if I am a minute late (and yes, each encounter, like the PowerPoint presentations, is beginning to slowly wear away at my soul).
Nearly every time I get scolded for showing up late to these meetings, I make sure to explain where I was, just to further reiterate that we are not robots, but sentient beings dealing with families and patients during their final moments of life. Thankfully, these reminders are successful at knocking these other lesser beasts out of work mode with their nudging reminder that we are humans and not fattened pigs corralled to solely produce income for the hand that feeds us. However, few things bother me more than when these efforts fail to provide humanity in the modern mechanized state of medicine. Furthermore, these refusals to let humanity enter into the equation of healthcare further illustrate the helplessness that is often forced upon us in the hospital front-line, from office workers to nurses, doctors and technicians. That realization provides a pitting feeling in the depths of my stomach. This feeling, a combination of dread, anxiety, and helplessness is difficult to describe or quantify. In fact, I was not sure it existed for years, and quantifying it seemed impossible.
Then I noticed that I was not the only person who experienced this poisonous mixture of anxiety and helplessness. As I was deep in another thoroughly enlightening book, Lost Connections by Johann Hari, I realized that this feeling is far from uncommon in present society, and that the pitting feeling deep in my stomach seems to be commonplace in corporate America. This infrequent, but uncomfortable, pitting feeling during episodes of helplessness at work sounds eerily similar to that described by those struggling with anxiety and depression. Now do not misunderstand me – I do not struggle with anxiety or depression, but I certainly am sensitive to those who struggle with these paralyzing diseases.
Helplessness is Unhealthy – Lesser Beasts
Back to the pigs – that deep pitted feeling of helplessness that often occurs during the workday has some scientific backing. Returning to Lesser Beasts, pigs that are herded together in small places, or kept free from their own actions, begin to gradually lose their minds as they become bored, anxious, and restless, culminating in biting each other’s tails, gnawing at ears, and scratching their heads off fences. When pigs experience a loss of control, they become exceedingly frustrated and experience significant stress. If stress and frustration continue over time, it can become so intense that it results in death. Pig handlers are well aware of this potential situation and therefore try to minimize their stress level as much as possible. Like humans, pigs form social groups and hierarchies. So how do humans, whom are, for better or worse, more cerebral pigs, fare under similar conditions?
Not much differently apparently.
Pigs and other animals stuffed in crowded cages are not only more stressed, anxious, and depressed, but they have worse health in entirely unexpected places. Animals raised in isolation, on the other hand, experience breast cancer rates at a whopping 84 times higher than those able to communicate in groups.1 In other words, less cerebral animals require both control and social interaction, and we humans require the same (and probably more).
Not surprisingly, Native American tribes, when treated like lesser beasts and corralled into reservations, experience a slew of health issues ranging from diabetes to some of the highest rates of depression and suicide. In fact, suicide rates are so high within these groups that the Canadian government has spent considerable time, money, and effort to address and study the problem. What did they find? The tribes with the most control, social structure, and cultural traditions have the lowest rates of suicide, while those with the least control have the highest.2 Furthermore, those communities that have continued cultural traditions and activities experience lower rates of suicide.3
Or we can turn directly to the workplace, where studies confirm that less than 15% of all workers are actively engaged in their jobs.4 By actively engaged, researchers are referring to all those things that make a good employee: positive contribution to their company/organization, enthusiasm, and commitment. Adding insult to injury, a quarter of employees are so exasperated and irritated by their current work situation that they are actively attempting to impair progress at the workplace. You read that right, a large fraction of employees are actively trying to jeopardize their company. Perhaps worst of all, the majority of employees, or 63% according to the study, are unengaged in their work, and basically counting down to the end of the day from the moment they arrive at work. In other words, as described by Johann Hari in Lost Connections, they are sleepwalking through their day of work.
We require social collectiveness, empathy and genuine relationships instead of hierarchical dictates, not only at work, but in our communities.
The Importance of Balance
In other words, it seems more prudent to balance the mechanistic aspects of our day – those that can improve safety, etc. – with those that make us human. If we sway too far to the side, we become mechanized robots plagued with stress and anxiety, metaphorically ready to nip at the tails of our nonporcine neighbors. Humans may be different beasts than pigs, but these delicious creatures may provide us some lessons on health and happiness.
In other words, we are not lesser beasts, but human beings. Yet, much like these porcine lesser beasts, we still require social interaction and a level of control in both our own lives and work environment to provide us mental and physical health and an enjoyment for life.
Furthermore, when humans, like pigs, are forced to follow strict orders day in and day out, eliciting a massive feeling of helplessness, we are left with two options:
- Succumb to the anxiety and depression that accompanies helplessness
- Fully acknowledge we are not robots, and break some rules and carve our own path when it makes sense
Strangely enough, something as silly as arriving to work late provides me some level of ownership of my life, revealing to me daily that I am more than a herded pig being culled from one place to another against my will. An intentional lifestyle should not end at our life outside of work. When I started almost five years ago, I was told standing desks were not allowed. After I built my own standing desk – a monstrosity of wood and textbooks piled upon each other, one of the layers in the many agreed to provide me with a real one. I now have kettle-bells, a basketball hoop, blue lights (my office is in the basement), lacrosse balls to roll out my plantar fascia, and a battle rope in my office (oh, and of course, an Archer poster). Furthermore, several other colleagues who had been plagued for years with back and shoulder pain now have standing desks, alleviating them from their desk and its seated solitary confinement. Humans, like pigs, need to roam and confining them to one place can hurt their joints.
We are not animals that are herded and corralled from meeting to meeting to meet quotas and balance the budget. We are human beings whose health, connectiveness, and control matter. We are not lesser beasts.
Lesser Beasts References:
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- Hermes GL, Delgado B, Tretiakova M, et al. Social isolation dysregulates endocrine and behavioral stress while increasing malignant burden of spontaneous mammary tumors. Proc Natl Acad Sci U S A. 2009;106(52):22393-22398.
- Kral M j, Wiebe PK, Nisbet K, et al. Canadian Inuit community engagement in suicide prevention. Int J Circumpolar Health. 2009;68(3):292-308. http://www.ncbi.nlm.nih.gov/pubmed/19705660
- Chandler MJ, Lalonde CE. Cultural Continuity as a Moderator of Suicide Risk among Canada’s First Nations. http://web.uvic.ca/~lalonde/manuscripts/2008HealingTraditions.pdf.
- Fleming P (Peter). Mythology of Work : How Capitalism Persists despite Itself. Pluto Press; 2015.
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