I killed two chairs at Christmas. Not
intentionally and not the leaders of my two least favourite committees. Both
were made of wood.
The first murder occurred in a
playground in our neighbourhood where, with friends from our street, we were enjoying
a happy Christmas afternoon catch-up.
The chair was a wooden folder, in its
senior years, and gave up when I went to sit on it. Fortunately, my landing
strip was designed for falling children and with help I tottered to my feet,
none the worse for wear save for the sad loss of a slice of delicious pavlova I
had been cradling at the time of the crash.
The second chair murder occurred in
the sitting room of a holiday rental in January by the sea. I attempted to
stand up after watching too much wonderful tennis and the chair gave way, the
rear legs splaying with a puff of bamboo dry rot, tipping me on to the floor
and landing on the point of my right shoulder.
You can guess the rest; and now my
infra and supraspinatus muscles are resting, with their tendons snapped, with
nothing to do.
What to make of these ‘tragedies’?
First, they both happened extremely
quickly. One moment I was okay and within a nanosecond I was sprawled. I
suppose that is no surprise but, rather as with sudden cardiac death, the message
is with falls that unless you prevent them well ahead of the provocative
trigger, you have no hope.
Get rid of unsafe chairs, engineer
hotspots out of our roads, and encourage smokers to quit.
But second, I wondered what kind of prevention algorithm I would need to
avoid future chair murders. Should I check all wooden chairs that I encounter,
test their legs and if they are folding chairs make sure the mechanism is
clicking closed correctly? Rather boring and probably not practical.
And if I extended this principle to
things other than chairs, would I have time in the day to do things other than
all the preventive surveillance required?
Third, and a derivative of the second
point, these two falls made me stop and consider what we might call the
time-economics of prevention more generally.
I recall decades ago a conversation
with a single mother from western Sydney who told me just how scarce her time
was for anything beyond survival.
An early start to the day to get
children fed and to school, then to work a full day to pay bills, home in the
early evening to handle kids and household chores.
The attraction of takeaway food was
overwhelming and there was no time for exercise. By dinner she was exhausted.
Cigarettes provided comfort.
Time is at the heart of it all
Time — whether there is so
little of it you can’t prevent a fall or a crash or a heart attack, or enough
of it to satisfy so many competing demands on it — is a dimension of
prevention.
For both reasons — at times too
little, at times too heavy the competing demands — we should be sensitive
to this ‘social determinant’ of health in our communications and plans for
prevention.
It’s wise and humane not to ask
people to do what’s impossible.
Oh, and don’t be like me: keep
in mind the well-being of old chairs!
Professor Leeder is an emeritus professor of public health and community
medicine at the Menzies Centre for Health Policy and School of Public Health,
University of Sydney.
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