Just an interesting related tangent here: My father in law is dying of heart disease (will probably die in < 1 month) and we run into the same thing.
People see me upset and the first thing they say is he will get better, or, it will be ok. When I explain the situation, it's something like, "oh, well, I just KNOW he will get better. Don't worry"
What?
In case you are wondering: He has already had open heart 2 years ago, 4 of 5 arteries are completely blocked again (and those are already bypasses that are blocked again) and the remaining 1 is at 40% blocked. He found all this out when he went to one of the best heart hospitals in the world and they sent him home: "There is nothing we can do." Again, the open heart to bypass all 5 was only 2 years ago, so the math is pretty straightforward on how long the one artery will last.
He has something in his genetics in his family that makes it so this will happen pretty much no matter what he does.
The advice is endless. He has done his research and I believe he has had some real success in delaying this, he has outlived his younger brother by ~20 years (who died in a similar situation at 34). But it's over now.
I am trying to help his family get everything in order. And while it's sobering, it can be a very positive experience. But I wish our friends would stop telling us he'll be fine.
There is also this commonly held notion that if you "live right", with healthy habits, food, and exercise, you will live to 98 in perfect health, and probably die of an instant heart attack while in bed with a young lover. It's of course true that obesity and lack of exercise increase health risks at all ages, but that risk was never going to be 0. The notion that I mentioned basically makes health problems into a morality play. I've even seen people get angry at the fact that statins can reduce heart disease risk in an "unearned" way - they can't accept that. The fact is that blood vessels and everything else lose function with increasing age, at a different rate for different people.
> There is also this commonly held notion that if you "live right"
One of humanity's greatest questions is "Why do bad things happen to good people?"
The inconvenient truth, of course, is that the universe is cold and uncaring, and random chance and statistics means that bad things will happen.
But we humans hate that answer. We crave structure, patterns, cause and effect, order. Why did flooding destroy a city? You must have angered the gods with your sinful ways! There we go. Cause and effect. Peace of mind. Rules have been created. The universe makes sense again.
Why do young people get cancer? They ate the wrong food! They didn't exercise enough! They didn't fight the cancer! They did this, they didn't that. Cause and effect. They broke the rules. And as long as I don't break the rules, bad things will not happen to me. I will never anger the gods, eat the wrong food, or forget to exercise, and those who do, they're immoral and deserve the bad things that happen to them!
I've seen this described as the Just World fallacy. It's pretty engrained in our culture, with supposed religious mechanisms being gradually supplanted by pop scientific theories.
It is a fact that lifestyle affects likelihood and progression of heart disease. Rare cases that end life early for genetic reasons do not change this. It is unfortunate that some people assume all early heart problems are avoidable, but only because sharing an opinion is unnecessary, not because the assumption is likely wrong.
The morality of not taking care of oneself is subjective, of course.
Edit: I should say I lost a sibling to incurable cancer at a young age. I have heard no end of useless advice about her diet, special almonds, clinics, etc. So I strongly believe in not sharing advice that helps a majority when talking to a particular person, even though I know there are ways to live that reduce likelihood of some cancers.
It is a fact that the effect exists, but I think that you are also victim to the popular idea that this effect is extremely powerful or even overwhelming, making "taking care of yourself" a powerful morality tale. Here is a quote from a large study:
"having a BMI between 30 and 35 shortened life by an average of 0–1 years, having a BMI between 35 and 40 shortened life by 1–3 years, and having a BMI above 40 shortened life by 1–7 years"
(This is easily googlable, I don't want to turn this message into a journal article)
Note that the error bars on the effect are quite large (1 to 7 years even for extreme obesity). Now it's true that a lot of things hide in an "average", and there is a lot to discuss here, and I am definitely not discouraging anybody from acquiring healthy habits and lifestyle, but... it's just not a simple story of reward for virtue and punishment for sins. Genetic factors which we have no control over probably have a greater effect. Which is not a story that people want to hear.
Sure, I understand what you are saying. Those are actually significant findings, though. Keep in mind how good we are at keeping people with progressed heart disease alive. The relatively few years' reduction in lifespan masks, in my cases, early onset of heart disease and years of expensive emergency response, frequent hospitalization, transplants, reduced quality of life, and so on. Better is to look at large meta studies about bmi, smoking, diet, and physical activity as they affect rates of disease as well as mortality. I quickly searched and found many results.
Respectfully, I haven't said anything about living until a very old age. I am only talking about a few diseases and I understand there are a lot of ways to die. I have also said the morality of not trying to extend lifespan is subjective.
The same study says that low BMI is also associated with lower lifespan, and the statistically optimum BMI for white people is 23 to 25 (there are racial differences in all the numbers, which I think also challenges the idea of assigning moral qualities to them).
However, I don't know if I would give too much thought to the effect for low BMI - it could just be that people with extremely low BMI tend to have some disease process which causes that; only a small minority of them are rail-thin athletes. For high and extremely high BMI, there are known causal mechanisms for disease, so it's a different story.
We have a huge environment we live in, plus we shape are environment to an extraordinary high degree. Furthermore, we're actually quite sensitive as organisms to those changes, including in ways where it's only now coming out in some cases because our previous equipment wasn't sensitive enough to register what was happening. We also actually know very little about genetics, genomics, and epigenetic despite posturing that we do. That's why the error bars are big
Fundamentally, actually shrinking that error bar for many diseases is one of the biggest hard science and math problems of the future.
i also hate saying and hearing platitudes, but recognize that it's only because people don't know what else to say. by telling them about this unfortunate situation, you're kind of putting them into that position.
these days i only tell my problems to people who have the ability to do something about it, or my closest friends who will commiserate without offering useless responses.
I have to agree with this. People can't be expected to know what every individual would prefer to hear in every conceivable circumstance.
Platitudes are often an oblique way of saying "I empathize and I wish you the best" while not being discouraging.
Actually saying the above might be preferable, but it's unfair to criticize the gesture, I think. If I mention this, it's because I think there are parallels to be drawn with other, more contentious, issues in which people take more serious offense.
It's absolutely fair to criticize the gesture. You know how SJW's tell outsiders to check their privilege when they make the discussion about themselves? Platitudes similarly make the discussion about themselves instead of the cancer patient. "Fight it." Wow, you're so optimistic! "Eat more fruit." You're so knowledgeable! Since you're a certified nutritionist, am I eating enough Quinoa?
> (...) The hyena is caught awkwardly, so he rests his paws on the woman's shoulders, and now the sobbing woman must associate her last chance to be with what is left of her father with the stale breath of a sycophant waiting for his moment to be relevant.
> And while that's going on others are whispering to the quivering back of her coat, "oh, I'm so sorry", "I'm sure he really loved you", "are you ok?"
> Why did any one of them think they had the power, the right, to interfere with another person's mourning? This was between her and her father and God and no one else. Did no one notice that even the husband had given her space? Did they just think he was being a jerk? "I just wanted to comfort her." No, you didn't know what else to do, so you did that. "I didn't want her to be alone." That's because you are a terrible person.
I.e. the woman struggled to spend her last moments with her father while the surrounding mourners (each vying for her attention) entered a pissing-contest to prove who had more empathy.
What a coincidence. Not only is the gesture supportive, it frames the speaker in a positive light! Just like how startups offer perks like catered lunches because the company cares about work/life balance, right? "How convenient, it just so happens that offering cheap-perks allows us to attract top-talent at half the cost". Notice how the CEO never has to consciously register that s/he's fooling anyone. From inside the mind, it all just looks like a convenient coincidence. Narratives are convenient because they can improve public relations without changing behavior.
Plausible Deniability is why these gestures are socially acceptable. "I'm sorry to hear that" or "that sucks" (i.e. acknowledgment) would suffice. But that's not what Pieter Hintjens' associates told him, is it? Instead, they went the extra mile by offering unwarranted advice. Notice that "I'm sorry to hear that" doesn't connote that the speaker holds relevant information, and is therefore important and worth paying attention to. Regardless of how we define gesture, it is not lost on Hintjens that the stock phrases he receives nudge the conversation in a particular direction.
I saw this first hand when my dad was dying. Now I respond to people who tell me about a loved one who is dying with something like "I'm sorry, how's he holding out?" or "I'm sorry. If there is anything I can do to help, let me know." The last one means, essentially, if you need someone to have a beer with so you can release what's been bottled up, I'm here for you.
The first couple of times I received platitudes, it irked me. Later I realized they were just trying to make me feel better and took it for what it was. Not everyone has gone through this, either themselves or with a loved one.
True, but I am usually only telling people because they specifically ask how he is doing.
Of course, if you are referring to here on HN, I only posted it to share in the phenomenon. While I appreciate that many are offering sympathy, I certainly wasn't expecting it here :)
As an immigrant who come to America in my 20's, I never fully understand this. I saw people who asked a person who just experienced extreme difficult situations, "are you ok?". Apparently she was not ok. Her husband just passed away and they had two young children. Nobody would be ok unless she is completely heartless. Other sayings, like "it will be fine", "everything will be ok", etc.
> I saw people who asked a person who just experienced extreme difficult situations, "are you ok?". Apparently she was not ok. Her husband just passed away and they had two young children.
In American culture, this use of "Are you okay?" is not at all literal. It is a polite and well-understood way of opening a dialogue in which the other party can detail the problems stemming from the situation under discussion (implicit from the context of the question) with which they require either emotional support or more concrete assistance, without actually asking for assistance, and without the initiator overtly suggesting that the other party needs assistance in the first place. Its a means of offering support within the context of America's culture of maintaining the illusion of self-reliance. (OTOH, because of that culture of self-reliance, even this elliptical opening is expected to be declined in most cases with, in most cases, an "I'm okay" or, when that is so manifestly not the case as to be ludicrous, "I will be okay".)
The more direct forms which do overtly reference a perceived need for assistance ("Is there anything I can do to help?" or, even moreso, "What can I do to help?") are generally considered less polite and less acceptable, particularly in public and/or from more distant acquaintances.
Hope is the humanities desired result, we all hope for the miracle. Once in a great while it happens.
Good luck. The paper work for these things is the hardest, and making sure the executor of the estate is up to the task. I do hope you've been able to get the family to see an actual accountant to do as much as possible while he lives so the tax burden and hassle will be lower. Its a serious pain in the butt to deal with bureaucrats when you really want to deal with family.
It is a really weird situation (I'm trying to put myself in your friends position). I guess I'd revert into this BS nice talk as a way to help you emotionally (even though I know it's BS).
So -assuming that I do care and that situation makes me sad- what am I supposed to say? How could I really help?
How about you think about what you just said for a minute. How is this a situation of "nothing to lose"? You are talking about an extremely sick person who, based on the fact that he has extremely advanced heart disease, probably has a lot of difficulty just being there for his family, and trying to put his affairs in order. Do you think he has the time and capacity to go on an "extreme diet" on the strength of "why not"? And if I publish some book which says that hitting oneself on the head with a pillow 100 times will cure heart disease, should he then try that? After all, what has he got to lose, right?
True. Similar to cancer, most people don't consider the fact that the severe constant pain he is in (his heart is starved for oxygen) and the weakness and exhaustion is a severe hindrance.
That and at this point facing the reality of his own impending death, suddenly concerns for your family become paramount. His one daughter is still living at home (although she is 19 so that won't be a long-term issue).
He's a tough guy though, so he really is trying to do all of the above anyway. I think that is why so many believe he cannot die. If willpower was the only thing that mattered he would live forever.
I'm sure that if you read Dr. Esselstyn research with advanced heart disease patients, you wouldn't be comparing it with hitting yourself in the head with a pillow.
Also, I don't know where you got the impression that it's a radical diet. Many people eat, and enjoy eating this way regularly.
While he didn't follow this specific diet, what he follows is pretty close and I really do think his diet choices are why he has lived as long as he has, at least for his particular situation.
He has been practically obsessive about eating organic and most of it is home-grown (which is where he gets a lot of his exercise as well). Again he has done his research and takes a boatload of quite effective dietary supplements in addition to a good diet.
However, it's not an infinite cure. There is a hard limit to what diet can do.
This advice can be very helpful for someone just starting to have a heart problem, as it can significantly improve and lengthen life.
But he is way beyond that now. Many of those stories are from people who had a particularly poor diet, and turned the situation around by changing the diet. There isn't much he can change at this point, he's always tweaking, and experimenting (he's been at this for 25+ years!) but it's about as close to optimal as he can get.
I don't know anything about your situation, but eating organic is not really what Dr. Esselstyn's diet is about.
Note: If you already know everything below, I am not talking down to you. I'm just writing it in case you haven't heard all of the information before. You can decide if it's valid information or not, I cannot say either way since I'm not a doctor.
The theory behind the diet is that if you eat a plant based diet, your Endothelial cells in your bloodline will activate and start removing plaque.
I don't think you can be on a diet that is "pretty close" to this diet and still be on this diet. You have to remove all of the banned foods in order for the Endothelial cells to start reversing the damage.
You could also try a Raw Food Diet, but a Raw Food Diet is essentially also a Plant Based Diet.
I'm not a doctor. I have no idea if this actually reverse heart disease or would work for your father-in-law. But it's the only thing I've ever found on the internet that sounds like it might actually reverse heart disease.
I will say thank you for sticking your neck out a bit and sharing; information is powerful and now the choice of what to do with this info is up to the OP rather than probably not hearing about it at all. Of course the most likely response is to ignore it for the father's case but since the condition is genetic I'm certain the poster is reviewing all their options as well.
People see me upset and the first thing they say is he will get better, or, it will be ok. When I explain the situation, it's something like, "oh, well, I just KNOW he will get better. Don't worry"
What?
In case you are wondering: He has already had open heart 2 years ago, 4 of 5 arteries are completely blocked again (and those are already bypasses that are blocked again) and the remaining 1 is at 40% blocked. He found all this out when he went to one of the best heart hospitals in the world and they sent him home: "There is nothing we can do." Again, the open heart to bypass all 5 was only 2 years ago, so the math is pretty straightforward on how long the one artery will last.
He has something in his genetics in his family that makes it so this will happen pretty much no matter what he does.
The advice is endless. He has done his research and I believe he has had some real success in delaying this, he has outlived his younger brother by ~20 years (who died in a similar situation at 34). But it's over now.
I am trying to help his family get everything in order. And while it's sobering, it can be a very positive experience. But I wish our friends would stop telling us he'll be fine.