12 April 2013

Arms race

From a July 2000 Reuters dispatch:
Being a successful floor trader at the Chicago Mercantile Exchange is all about standing out from a crowd of competitors in the chaos of the trading floor. All the stops are pulled out: giant-lettered ID tags, top-of-the-lungs shouting, bizarre gesticulations, neon-bright jackets you wouldn't dare wear on the street.

But the arms race now stops at footwear. The exchange said last week that, beginning tomorrow, shoes with soles thicker than two inches would be banned.

It's not women wearing spike heels or those flappy, strappy high-heeled sandals that the exchange most wants to deter: It is men in platform shoes. "I've seen them that big," one broker said, holding his thumb and index finger about 6 inches apart.

Why do traders want so much altitude? To see and be seen from the depths of the terraced trading pits [...]

But twisted ankles and foot injuries on the steps around the pits have been a growing problem that the exchange feels it must address, market participants said.

"They had a ruler out there the other day," another trader said. "I saw them measuring."

I saw a few minutes of 500 Days of Summer, Zooey Deschanel's breakout film. For part of the film, she looks different because she is not slathered with her usual amount of make-up. Intrigued, I found a picture of her with no make-up and compared it to her more customary head-shot:

Although she is beautiful either way, her appearance has strikingly changed. It's commendable that Ms. Deschanel was comfortable sitting for a photo shoot with no makeup on. But it does concern me that the public is constantly bombarded with images of people with unnatural features, enhanced through makeup, surgery, or Photoshop. I steered clear of Seventeen and Cosmopolitan magazine in middle school and high school (I'm a guy after all), but now if I see a copy I'll thumb through it so I can see what adolescent patients are reading. What I see scares me. Their photo spreads give an unrealistic perception of beauty and of normalcy, and their articles fixate on the superficial, preying on readers' insecurities.

I fret about physicians' role in perpetuating this societal problem. Sometimes I see newspaper advertisements from plastic surgeons advertising cosmetic enhancement procedures. Some of the ads seem designed to make the reader feel insecure about how they currently look, with phrases like "haven't you ever wanted the perfect belly?" There are aesthetic fixes for things that weren't even aesthetic problems until recently. For example, rates of elective labiaplasty (surgical alteration of the female labia) have been going up. Is this really healing people?

By offering elective cosmetic procedures to patients, we are facilitating an arms race for beauty that echoes that in the Chicago Mercantile Exchange. It's an arms race that is unwinnable. But the race's casualties, those with eating disorders, surgical complications, and skin cancer, are largely hidden from view. That is, unless your profession involves caring for them.

What I see on the hospital wards is the opposite of what's on TV: I tend to see people when they are looking their worst. Because I'm becoming more accustomed to viewing the body in its more natural state, I am increasingly able to pick up on cosmetic enhancements, like eye shadow, make-up, and breast augmentation. And I am learning about the harms that come with trying to boost one's appearance: orthopedic damage from high heels, skin cancer from tanning, carcinogens in hair-smoothing products and nail polish. While it's one thing to be well-groomed, obsessing over one's looks just doesn't seem healthy.

We are supposed to treat patients as people, no matter what their appearance. I hope that doctors make their medical practices havens for their patients, for example, by keeping magazines like Vogue out of their waiting rooms, or by supporting efforts to eliminate Photoshopping from fashion magazines. We can be a force for making people feel more confident about their appearances.