NOT GOOD FOR BLOKES:
I mean you go to a lot of doctors rooms - how many fishing magazines are there? Often the room is pink, with flowers on the walls! An Apache helicopter would be alright, wouldn't it? Or the odd tank ... or a deer ... or something?
The Kiwi male is an endangered species! Well, maybe endangered is the wrong word, but he's certainly in trouble! Our uncomplimentary statistics declare that 'real blokes' are dying much earlier than everyone else ... and it's not because we don't have good medical facilities, or that our men are off fighting wars. It's because of our lifestyles.
An epidemic has broken out amongst Godzone's men. According to doctor and author, Dave Baldwin, we've become a nation of ginormous fatsos ...
Dave is a general practitioner, ex-Air Force, and founder of the unique Bulls Flying Doctors - a mobile aviation medical service for pilots located in the remote regions of New Zealand. He's a passionate Kiwi bloke, keen hunter and family man, who's also working incredibly hard to drill important health messages into the scones of Kiwi men.
The release of his best-selling book 'Healthy Bastards' caused quite a stir, with its tell-it-like-it-is honesty and anecdotal humour. So we decided to track down this Crump-like author and find out what the fuss is all about ...
GRAPEVINE: Firstly, let's get this one out of the way - why on earth did you call your book 'Healthy Bastards'? Didn't you realise you'd offend my mum?
DR DAVE: Well, my mother wouldn't talk to me for six months after seeing the title! But here's the thing: Kiwi blokes are dying too early - much earlier than everyone else, and a lot of it is preventable! So I'm passionate about reaching the one-third of our population that just don't care. Can you tell me what health promotion is directed at that group - that's working? There's no point sending them brochures - because they won't read them. And it's no good counselling them - because they probably won't listen! We've got to approach these men in a way that makes it rock for them!
Now, one of the icons of the Kiwi bloke is Barry Crump. And virtually every home (well ... lots!) has one of Barry Crump's books - like 'Good Keen Man' or 'Bastards I Have Met'. So I figured if my book was going to catch the eye of the Kiwi bloke, it would need that in the title!
When my publisher accepted the book, there was lots of debate about the title, but for me it was a line in the sand: I had to have it in.
So, look, like I say - my mother didn't talk to me for six months. And for six months after that, she referred to the book as 'Barstaards' - she wouldn't say it! But now that it's been a big hit, she doesn't care!
GRAPEVINE: At least you won her over! But seriously, why a book about men's health? And what's this thing about one third of our population?
DR DAVE: The statistics on health in our country are not good. My understanding is that a third of our population are overweight. Immediately that means that a third of our population are unhealthy - because overweight is bad!
Okay, we've got all these overweight people. But what do we do now? And, really, not a lot is being done. Unfortunately, the Health Department has let us down - there's not much focus on the issues, and they haven't been promoted well.
So I'm one of many who're trying a different approach. For me, it was writing a book that would appeal to Kiwi blokes - which it seems to have! We got on the bestseller list, which is great - and now I'm working hard at getting the Government on board. The reality is: these issues have to be promoted more effectively - and made more 'man-friendly'.
GRAPEVINE: So what do men need to hear?
DR DAVE: Well, I simply want men to appreciate their bodies - and be grateful. The human body is a beautifully-designed machine. It's a gift, for goodness sake. So take care of it!
GRAPEVINE: Beautifully-designed machine? Lots of people would have us think we're just meat and bones! What's so great about these bodies of ours?
DR DAVE: One of the most popular movie series ever is 'Terminator' with Arnold Schwarzenegger - the real man on the street just loved that! And there was a part in the movie where you could actually see this incredible robot underneath the flesh covering.
The thing is, we are much, much more amazing than that!
When you move your hand, you can see the muscles contracting in the forearm. All you have to do is cut the wire that supplies those muscles and they don't work anymore. The brain, which is the most incredible computer ever devised, sits inside this hard bony skull. We don't need Mr Microsoft - it works beautifully!
I mean, how do you get across to people that this wonderful computer sits behind your eyes? And you've got to take care of it. So if you're riding a bike - put a helmet on!
GRAPEVINE: You've been a doctor for a number of years now. When did you begin to realise that the state of the nation's men wasn't too flash?
DR DAVE: I think it was a progression, once I started in General Practice. You see, medicine is a very hard road. In the early years, you're just working your butt off trying to get your ticket (mine's Family Medicine). Then you spend the next few years trying to establish yourself ... and to be quite honest, you don't really see the big picture. But after a period of time, once the practice is sorted and you're developing relationships with people, an element of futility starts to creep in. You see young people dying of accidents and suicide; you see middle-aged men dropping off the perch from heart attacks and strokes - and, the thing is, they don't need to!
One of the most sobering experiences is to go to the morgue, as a doctor, and sign the death papers of someone you've known for 10 or 15, maybe even 20 years! They've sat inside your surgery and you've counselled them; you've given them medication; you've laughed with them and sometimes you've cried with them!
You've developed a great relationship - and now, here they are, like a dead sheep on this hard slab. Next to them are maybe two or three others - it's what I call the Grim Reaper's taking for the night. And you look at them and think, ""They don't need to be there!""
It goes back to a choice. As a doctor, do I just accept it and say ""That's my job - tough cheese!"" or do I think ""I'll just put a bit of effort in myself and see if I can turn a few lives around.""
GRAPEVINE: Describe your average Kiwi bloke, in terms of health ...
DR DAVE: Well, I work in a rural community, right next to Ohakea Air Force Base. And, demographically, we're fairly lucky - there are lots of pretty health-conscious people around. So I think we're a little bit spoilt compared to a lot of General Practices.
But, I think, broadly speaking, there are three categories:
1. There are people who really take pride in their bodies, and you can tell - it's shown in the way they carry themselves and in their confidence.
2. There are people who've been gifted with really beautiful bodies - but you can see them deteriorating in front of your eyes with the smoke, the booze and the neglect.
3. And then there are people who're just munted - fullstop! But they could turn it around and make it better if they wanted.
There's a stark contrast, for me, between the patients in my general practice who don't take care of their health - versus the people I work with in the Flying Doctor Service. These guys, in order to keep their pilot's license current, have to be a lot more health conscious. For example, I have a number of commercial pilots who are 75.
Now a good percentage of people in their 70's are in a rest home!
One of these guys, Russell, from Twizel, is a case-in-point. I was down at his hangar a couple of months ago, and I couldn't find him. In the end I located him out the back, chopping wood! He had his top off and he looked like Arnold Schwarzenegger! He had a young man's look in his eyes that was wonderful to see. And just around the corner was the big twin-engined 'Squirrel' that he flies around Mt Cook.
But he's only one of a number ...
GRAPEVINE: So what exactly are the biggest issues for the typical Kiwi bloke?
DR DAVE: Well, somehow, we really need to get them to make some lifestyle changes. We have to get across, as simply as possible, that you are what you eat. You eat crap, you are crap. If you eat well, you are well. It's as simple as that!
Now, there are so many things that can be done to promote that. I think the Government has done a good thing raising the price of cigarettes and making it uncool to smoke. But they've got to put all that effort into obesity, as well ... like maybe even a fat tax!
Seriously, obesity could drive our health system broke. Take America for example: it's one of the fattest countries in the world, and they spend 17% of GDP on health. They reckon in about 15 years, it'll be 30% - which is incredible - and much of it is due to complications of obesity: diabetes, heart disease, joint replacements.
But there was one statistic from the NZ Medical Journal that's equally frightening. They wrote that ""Diabetes and its complications are potentially preventable, yet diabetes is taking an increasing slice of the health dollar, with a recent estimate of around $1.77 billion by 2021 for Type 2 diabetes alone, reducing the resources available to other areas ..."" like vaccinations and stuff like that!
GRAPEVINE: But isn't diabetes something you're born with - something you can't help?
DR DAVE: A lot of the early diabetes you would've heard about can't be helped - it's a genetic thing that's still not fully understood ... and it's terrible. But a huge percentage of diabetes today is what they call 'Type 2 diabetes'. It's where the poor old pancreas just runs out of insulin - it's over-strained because people are just too fat!
One of the top gastric-bypass surgeons in Wellington reckons that this type of non-insulin dependant diabetes is almost curable if people would just lose weight.
EASIER SAID THAN DONE
But how do you get them to lose weight? I guess you could put them in a cage and feed them a lettuce leaf each day - but that's not ethical! Somehow, we've got to promote a lifestyle change - and the lead has got to come from the Health Department.
GRAPEVINE: Okay, we've talked about obesity, but not everyone who's unhealthy is overweight! What are the other big health issues for Kiwi men?
DR DAVE: Well, apart from diet, there's smoking and alcohol and drugs. Alcohol by far is the worst abused - and it's a major, major issue. I've seen so many families destroyed by it. And one of the problems is that the alcohol-producing companies have a real hold on the Government.
Interestingly, Sir Geoffrey Palmer has just completed a great review on alcohol - and, as a country, we have to seriously look at his recommendations about cutting back the supply chain and the advertising. The thing with men is, they often participate in risky behaviour. Especially young men! And, somehow, we need to promote the cutting down of that risk-taking behaviour - and to do it without getting all PC, otherwise men won't respond.
Blokes see themselves as bulletproof. That's why we won the Battle of Britain, wasn't it? You put all the young guys in Spitfires and they had a great time!
So, anyway, we need to cut down the risky behaviour, promote exercise, and, somehow or other, promote healthy relationships. Because, when the chips are down, it's your friends and family that get you through.
GRAPEVINE: Why are Kiwi blokes so reluctant to visit their local doc?
DR DAVE: I think it's a combination of things. A lot of men aren't motivated enough. And the typical Kiwi male is quite a stoic beggar: ""Oh, it's only a pain. She'll be right!"" But quite a few of them also lack knowledge - which is why I put so much effort into the book.
I partly blame the health clinics themselves - because they could actually do a lot more to make their services more 'man-friendly'.
NOT GOOD FOR BLOKES:
I mean you go to a lot of doctors rooms - how many fishing magazines are there? Often ithe room is pink, with flowers on the walls! An Apache helicopter would be alright, wouldn't it? Or the odd tank ... or a deer ... or something?
Another big problem is that blokes are often late-presenters with illness - in other words, they don't get to their doctors early enough. So the challenge is getting them there in the first place - then encouraging them to get regular checkups so, if we do find a problem, at least we can deal with it in its early stages.
GRAPEVINE: Are there as many local GPs as there used to be - especially those family doctors who've been around for years?
DR DAVE: Unfortunately there's a real man-power issue with general practice in NZ. Governments over the last 10 or 15 years have neglected people-training, and as a result there are less and less of them. Which is a real concern - because men should have easy access to GPs!
Evening clinics are a great idea, so blokes can fit in an appointment around their lifestyle and job. Like, it's pretty hard for a forestry worker to get a health check! They've got to come in all the way from the backblocks, wait an hour in the surgery, and then head back out again!
GRAPEVINE: These health issues you're highlighting: are they relatively recent arrivals? Or are they things we've been battling for generations?
DR DAVE: You've got to remember that 100 years ago, the average person died at about 50! So we're doing pretty well in this millennia with the average age of death now in the mid-70s. I guess health has always been an issue, but in the old days it was more tied up with a lack of hygiene and poor nutrition. We've got most of that sorted today, so now it's a matter of almost too much nutrition - and all these self-destructive behaviours.
The leading cause of death in New Zealand is cancer - one of the biggies being lung cancer. And obviously there's heart disease, which is the other major killer - particularly of men. And not just heart attacks from smoking and poor diet: it can be heart failure from alcohol - it just wears your heart out.
When I talk to men about taking care of their machine, I remind them: you've gotta die - but you don't want to be disabled unnecessarily!
GRAPEVINE: What symptoms or signs should we look out for that mean: ""Get to the doctor, pronto!""?
DR DAVE: In a nutshell ... any sudden, significant change in health should get you to the doctor. Like, for example, sudden and unexplained tiredness. Sudden bleeding from an orifice that's never happened before. Pain - obviously! A change in bowel habits, unexplained nausea, intermittent vomiting. They'd be the most common symptoms ...
Say, if you were a person who never suffered headaches, and suddenly you get a series of quite severe ones - now that's a change from what you're used to. If you've always had headaches, and they've been checked out before, there's probably not a lot that can be done, if you know what I mean. But a significant change has to be sorted.
GRAPEVINE: Aside from responding to these warning signs, how often should we visit our GP?
DR DAVE: I think a once-a-year check is a good thing. For the younger guys, maybe every second year. But at least every couple of years - at least! Just to get the basics checked ... you know: your blood pressure, your heart rhythms, your urine - and if you're over 50, your prostate!
It's also important to review risk factors.
If a 42-year-old came in and saw me, and he hadn't seen a doctor in years, I'd ask if anything runs in the family. He might say ""Yeah, Dad died of prostate cancer when he was 48."" So I'd remind him that there's a genetic component to it, and that we really should have a yearly check-up from now on.
There might, for example, be a family history of bowel cancer - and the 42-year-old might come in and say, ""My dad did die at 45, but I feel fine!"" My response would be to try and twist his arm and say, ""You know, with your dad dying like that, you're at a much greater risk. Let's just get a colonoscopy ...""
GRAPEVINE: Okay, we've talked about unhealthy men. Now describe the ideal Kiwi bloke - in terms of his lifestyle, not his looks! Give us something to attain to ...
DR DAVE: Well, I think it's someone who recognises that they are what they eat. They eat a well-balanced, healthy diet. They don't smoke, and they drink to enjoy the pleasure - I mean, there are some beautiful wines and beers out there! They have friends and family that they love, and that love them. And they exercise - doing something they enjoy, so that their machine becomes well-oiled!
On top of that, they get a regular health-check, with a doctor they feel comfortable with. There's a huge variety of personalities amongst doctors - and I can imagine that my style wouldn't suit everyone! I respect patients who say, ""Look doc, you're too rough for me!"" and they go somewhere else! But, I know I appeal to others.
So it's finding a doctor they trust, one who will do regular checks on them. And if ever there's a symptom they're not sure about, they'll go and see him.
So that's the ultimate bloke. And also, he needs to be able to sing!
GRAPEVINE: Given that this seems all the rage ... should we be eating organic, popping pills and getting our colon cleansed in an effort to stay healthy?
DR DAVE: Nah - that's bull$*@#! In my book I quote a wonderful 91 year-old lady -who incidentally looks 55! I'd asked her how come she got to live so long, and her response was priceless. She said, ""I don't know why I've lived so long, but what I can tell you is that all my friends who ate organic food are dead!"" What a beauty, eh!
The thing is; you don't need all that rubbish. I've got friends who take 20 tablets a day! A lot of that mega-vitamin therapy is just quackery at its worst! Take the Chinese herb called ginkgo, for example. The Neurological Foundation were involved in a big study on it, and they found it was absolutely no use at all! Yet all these people have been taking it ...
The problem is not so much whether something's going to do you any good, but whether it's going to do you any harm. A few years ago, I got an article published in the NZ Medical Journal on a Chinese herbal preparation called 'Shen Loon'. There was a young girl who came in. I hadn't seen her for a while, and I noticed that her eczema had cleared up and that she hadn't needed her asthma inhalers. Her parents then told me, ""We don't need you anymore - we're taking Shen Loon tablets!""
Anyway, I asked if I could borrow one of the tablets and got it tested by a top laboratory. It turns out, it contained the same levels of anti-inflammatory shields that you treat cancer patients with. So yes, this tablet had queer Chinese herbs, but it also had a poison as well. It'll get rid of your eczema and asthma - but within 20 years, your bones would've whittled away and you'd have incurable diabetes! So what I'm saying is, you don't actually know what's in a lot of these herbal preparations.
Funnily enough, this was illustrated recently by a number of manufacturers of St Johns wort who'd been had up. These guys were making the wort stuff, but they started running out - so they put grass clippings in it! Seriously!
Listen: all you need is a good all-round diet - with lots of blueberries! You don't need a whole lot of ginkgo tablets that cost a fortune ... and might just be grass clippings!
GRAPEVINE: I know that family plays a big role in your life. Do our roles as dads and husbands have a big effect on our health?
DR DAVE: Oh yeah, absolutely! As Freud, the great psychotherapist, said: ""You need to love, and you need to work."" You need to feel worthwhile about yourself in some sort of job - it doesn't matter what it is! But you also need to love people - and have people who love you. That's one of the cornerstones of everything, really.
GRAPEVINE: Any last words of wisdom you'd like to leave us?
DR DAVE: I guess I can sum it up best by quoting the last paragraph on page 12 of my book: ""I've enjoyed writing this book, and hope that all the medical tips will help you understand the amazing machine that you walk around in - called the human body. If you take care of your body, it will become the ultimate hot-rod for your spirit to ride around in while you're on this earth. And I hope the book will help you do the one thing in life that matters: to have a laugh!""
And in the words of the famous Dr Seuss: ""Be who you are and what you feel, because those who mind don't matter ... and those who matter don't mind!""
So for me, that really sums it up. You see, I'm passionate about the beautiful machine - and that's what we are, an incredible robotic device! And I'm equally passionate about my belief that within that machine is a force, an entity - you can call it a spirit, you can call it a soul, you can call it what you like! But there's an entity there, and you've got to take care of it ...
TO FIND OUT MORE AND GET YOUR OWN COPY OF DR DAVE'S BOOK, CHECK OUT WWW.FLYINGDOCTOR.CO.NZ
Issue 3 2010 Cover Story (843 KB)