The Dangers of Being Different
When someone else drives my car, the first thing I notice when I drive it again is that my seat is pushed way back, and the rear-view mirror needs to be tilted so I can see it. I’m short, so just about everything has to be adjusted if anyone else drives my car.
What isn’t so adjustable is the seat belt — it perfectly fits an average man with a height of 5’9”.
But when I put on my seat belt, it becomes apparent that this contraption was not exactly designed for a smaller person. Rather than sitting comfortably over my chest, the belt tends to slide around toward my shoulder.
This made me pay attention when I saw a recent study that shorter people are more likely to die in ICUs. Interestingly, we don’t yet know why. Is there something inherent in people’s bodies that makes them more likely than others to die? Or does the fault lie in the hospital equipment and medical staff around them?
On the flip side, taller people seem to do just fine. They tend to report being happier with their lives. They also make more money, which can amount to hundreds of thousands of dollars more over a lifetime. The reasons why aren’t crystal clear, but researchers agree that tall people tend to be treated better.
If something as simple as height can have such a profound impact on people’s lives, imagine how a major difference can affect their careers, health, and well-being.
We tend to think of medicine, and the world in general, as customized. We can choose our own phone, our own clothes — why not our healthcare? But sometimes, we encounter rigid structures that don’t conform to our individual needs.
The word procrustean means strictly enforcing conformity, and disregarding individual variation. Procrustes was a devious figure in Greek mythology. He attacked travelers, cutting off their legs or stretching them so they fit into his iron bed.
This gruesome tale has echoes today. Think about airplane seats: there’s no give if you’re really tall (one drawback for that), or if you’re over a certain weight. You’ll simply be crammed in, uncomfortable.
Going back to the seat belt example, women are much more likely than men to be injured in a car accident, even when both groups wear seat belts. People who are overweight fared worse, too. Researchers are using this data to make cars safer, but there’s still a lot to be done.
In other areas of life, there are shadows of Procrustes, too. In hospitals, there are standard orders and standard expectations; deviate too much, and your care might suffer. Diseases can present wildly in different people, but they’re not always treated that way.
Take, for example, a heart attack. If you exhibit the classic symptoms — chest pain, shortness of breath — you’re more likely to be whisked off, have your pain correctly identified, and treated.
But what if you have different symptoms? What if you’re covered with sweat, with pain in your neck or jaw, not your chest? That’s what a heart attack can look like for a woman, who can have worse outcomes if her condition isn’t recognized right away.
But when we talk about mental illness, the script flips. Men are much more likely to commit suicide than women. There’s an expectation that women get anxiety and depression, but men don’t. This can be dangerous, and lead to men not getting the help they need.
Even something as simple as hair color can affect your medical needs. Some research has shown people with red hair — 1–2 percent of the general population — are more sensitive to pain and require more anesthesia.
Architecture also doesn’t always keep everyone in mind. Newer buildings are designed to be much more accessible, but a writer recently brought attention to the awkwardness of wearing a skirt in a building with glass floors or staircases, or large areas of metal grates.
When we design something — a staircase, a hospital, a medical plan — we need to think about everyone who might use it. Our bodies and our needs aren’t all one size. Why are our expectations?