Tuesday, October 11, 2011

Just a little MORE controversy?

In a recent blog entry, Gary Schwitzer complains about the choice of Elizabeth Banks in Just a Little Heart Attack.  He goes through a whole process of determining Banks' 10-year risk of heart disease (though he completely misses the fact that Banks has a strong family history of heart disease) to say that a different actress should have been cast - an older one at the least.

I was quite confused.  Why is a health blogger complaining that a role was miscast?  I assume there is more to it than a thought that a film doesn't represent a reality of statistics.  And, in reality, women just like Banks do suffer heart attacks.  No, they're not the most common group, but does that mean we shouldn't try to get their attention?  We teach high school students - including boys - how to find a lump in a breast (or was I the only one who had a lumpy fake breast passed around in health class?).  What harm does any of this information do?

The only other aspect mentioned in the blog entry was the involvement of Macy's and Merck and the fact that they stand to benefit.  Personally, I hate the mixed interests.  I don't like the involvement of powerful commercial interests in issues of public health.  I don't like it in heart disease any more than I like it elsewhere.  I understand why it is done now - for all the parties involved - but I find it bothersome.  But what does that have to do with this video?  Is he trying to say it's just an ad for Merck and Macy's?

I was really stumped as to what Schwitzer was taking issue with.  He says it is problematically framing the noble message to "make it your mission to fight heart disease in women." I'm unclear as to how the casting of someone who is an outlier - but I would say not even an extreme one - for a heart attack is causing problems with this message.

Then I read the comments.  When Schwitzer, in the comments on his own blog, quoted Larry Husten's comments from here, it seemed a little clearer. 
It’s easy to imagine young, healthy women, after seeing a video like this, returning from the gym after a hard workout and mistaking their sore muscles for a heart attack. That strikes me as a step backward rather than a step forward in women’s health.
Yes, Larry and Gary, it is easy to imagine.  But it is not (in my experience of talking about this and telling the story of witnessing such a thing in the flesh) what actually happens!   I do not tell the story of my mother's death and experience a barrage of friends making trips to the ER or dialling 9-1-1 after tough workouts!

I do not think it scares women to discuss the possibility of heart disease.  And if it does - so what?  So they are concerned for their health and they strive to learn more?  Perhaps they schedule a long-overdue physical, or mentally file away the symptoms of a heart attack in women?
Nine times out of ten, I am immediately asked "so what can I do so this doesn't happen to me?"  Acknowledgement of the outside possibility that even a young and healthy woman can have a heart attack - or that an even younger and healthier woman could be developing heart disease already - gets women asking questions and becoming informed. 

At least that has been my experience when I have talked to women about my mother's story.  I have seen women take their symptoms more seriously and make an appointment with their doctor.  I have seen young women (college-aged women) talk to their parents about family history.  I have seen those same young women (and some young men) encourage their mothers to take symptoms seriously.

I'd like to think that Schwitzer and Husten are not worrying about hysteria.  I'd really like to think that this is not a case of the very same sexism that makes heart disease so deadly for women. 

Again I am happy to see discussion of this anywhere, but this one does make me a little nervous.  Will doctors hear that this film (or any other aspect of awareness-raising campaigns) was an impetus for an office visit and not take them seriously?

What say you, readers?  Am I missing the point of Schwitzer's article?

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