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Book Reviews

Health Talk: How to Communicate with Your Doctor

by Mary F. Hawkins

Living the Good Life: Your Guide to Health and Success

by David Patchell-Evans

Fat Wars: 45 Days to Transform Your Body

by Brad King

Many of us approaching 40 (or 50) are acutely aware of how we need to pay attention to diet, exercise, and general health. We may find we can no longer eat like teenagers without gaining weight. Or perhaps we eat reasonably well but are gaining weight anyway. For many, regular exercise is a challenge to which we rise only irregularly. As we age, our relationships with our doctors become more important, too. We may be comfortable with them for annual checkups, but what if we develop serious health problems? Will communicating with our doctors become a problem in itself?

The mark of a good health book may be the degree to which it influences us to change our behaviour in the direction of better health, whether that means changing our eating and exercise habits or finding ways to make doctor visits more satisfying. Of course, the better written and researched a book is, the more likely it is to make us change. But all that may be required is that it contain some startlingly persuasive information, and the information needn’t be new.

Living the Good Life: Your Guide to Health and Success by David Patchell-Evans, founder of the Good Life chain of fitness clubs, is very persuasive. It’s less a guide than a tract urging the sedentary to take up regular exercise to improve their health and quality of life, and as such it succeeds very well. Reading it has the effect of making one want to change into a T-shirt and shorts and run a few kilometres. Unfortunately, it’s padded with testimonials from members of Good Life clubs that may be seen as little more than advertisements for the chain. Luckily, the author is convincing without them.

In fact, he’s a walking testimonial to the myriad benefits of regular exercise. After suffering a serious motorcycle accident at age 19 and going through rehabilitation, Patchell-Evans became interested in fitness both for its health benefits and as a business. He also became a competitive rower. At 32 he contracted rheumatoid arthritis, which made exercising challenging but even more important to his well-being.

In the book, Patchell-Evans concentrates on the very basics of fitness: how someone who has never been fit can get fit in six months simply by doing 20 to 30 minutes of aerobic exercise three times a week. He urges people not to expect immediate and dramatic weight loss, explaining that muscle weighs more than fat, that muscle helps burn fat, and that while your weight might not change dramatically on an exercise regimen that combines cardiovascular fitness with some strength training, you will look and feel trimmer because you will have converted some fat to muscle. It’s a common-sense approach to fitness. The tone is encouraging, straightforward, and never condescending, despite the cheesy testimonials.

Fat Wars is a much more ambitious book, and, judged by the same criteria, it’s somewhat less successful. It aims to help the chronically fat to lose weight, quickly and permanently. Author Brad King explains, in great detail, the body’s various processes regulating fat burning and fat storage; he then prescribes a 45-day regimen of weight training and limited aerobic exercise and a diet of 40% protein, 30% carbohydrate, and 30% fat. He also explains, in much more detail than Patchell-Evans, why increased muscle mass means more efficient fat burning. He claims we are adapted through evolution to eat more protein than most of us consume at present, and that this contributes to a leaner physique because protein raises the metabolism.

King is a bodybuilder, and what he is really saying (although never explicitly) is that to lose weight you should become a bodybuilder, or at least do many of the things that bodybuilders do. This includes using commercial protein and hormone supplements of all kinds, something that won’t appeal to many readers, despite King’s explanations of how the various substances aid in fat burning. Moreover, King is employed by a company that produces protein supplements for bodybuilders – a somewhat compromising bias that he should have disclosed in the introduction, rather than an appendix.

It’s hard to imagine many readers using King’s 45-day plan successfully, given the complex calorie counting and time-consuming workouts involved, and the fact that bread, rice, and pasta are all forbidden. Wading through the arcane biological material will daunt all but the most dedicated readers, and the use of jargon associated with the bodybuilding industry (“cell energetics,” “build quality muscle” etc.) renders the material suspect from a scientific point of view.

After reading Fat Wars I thought about the amount of sugar, fat, and carbohydrate I consume and started to cut down. I also thought about ways to incorporate some resistance exercises into my fitness routine. But I don’t believe this book will find a large audience, even if its extravagant claims seduce a few into buying it.

The premise of Mary Hawkins’ Health Talk: How to Communicate with Your Doctor is excellent: with cutbacks to health care, doctor shortages, and increasing consumer knowledge about health issues, Canadians could benefit from a well-researched, thoughtful book on this subject. However, Health Talk is not that book.

Hawkins, who teaches interpersonal communications at the post-secondary level, provides a mind-numbingly simplistic take on today’s health-care needs and the complex dynamics of the doctor-patient relationship. Her advice on most subjects is to “[have] a sense of what is best for you” or to “decide what is your preference,” which is so wishy-washy as to be useless. She defends the tendency to put the doctor on a pedestal, instead of pointing out why this approach might be dangerous to one’s health. And here’s a sample of her insight into the problems plaguing Canadian health care: “Sometimes it seems as though the changes made to the health care system have put limitations on the delivery of health care in Canada.” (How’s that for understatement?)

Many of the stories Hawkins uses to illustrate different communication styles are inappropriate, for various reasons. For example, a couple go to see their GP about their hyperactive son. The wife wants the doctor to prescribe Ritalin; the husband does not. The author reduces this scenario to one in which good communication skills will prevail, when it is obviously a situation fraught with complex and highly emotional issues, which she does not address.

In another example, a patient suffering from depression is reluctant to accept her doctor’s prescription of drug therapy. She finally agrees to consider drugs if other routes fail. This “willingness to compromise” earns her the author’s praise, a position I find offensive. This is surely a case in which the patient should be counselled to find another doctor, one who supports her desire to avoid drugs.

This example also illustrates Hawkins’ conservatism. She mentions alternative medicine several times, but always in the context of “checking with the doctor” or finding out whether she or he has any qualifications in alternative medicine. She seems to imply that one would be unwise to consult alternative practitioners without the doctor’s approval, a position that many educated health consumers will reject out of hand.