SALT AND SHAKE

By Blair Smith
Contact the author via the editor by e-mail at christopher.johnstone@ntlworld.com

Those who, like me, are now of a certain age will remember Charlie the Cat. This member of the feline race was wholeheartedly devoted to public education on accident prevention. After witnessing some dangerous breach of the rules, he would caterwaul unintelligibly but wisely in his cartoon voice, to be interpreted by his master, a boy slightly older than I. The translation would always prove to be a kindly paternal saw, dripping with common sense, which we children would observe thereafter. For example: “Miaaoweeowarrrgheeohaow!”

“Charlie says, ‘Never cross the road with a foreign stranger eating uncooked meat in the winter!’”

Common sense, according to Bertrand Russell, is the metaphysics of savages. John Stuart Mill classed children and savages together, and Charlie the Cat’s advice therefore provided for us children a structure with which to frame our world.

I’m not sure when Charlie met his ninth demise, but I haven’t seen him for a generation. Unfortunately, his place seems to have been suddenly taken by Sid the Slug. “Sid says, ‘Never eat salt or you will definitely die horribly, and so will your children.’” Was it just me, or did Sid’s slithering arrival take anyone else by surprise? There I was, confidently telling my patients about the dangers of smoking, lethargy and unprotected sex (an awkward, though not impossible combination of events). Dietary measures often entered my preventive lexicon, but usually with reference to sugar, saturated fat or fibre, and generally individually targeted. Then, all of a sudden WHAM! (or rather PHTHRRG!) Sid the Slug is splatted all over the TV screen and billboards, telling us all that salt is the biggest danger to 21st century Britain.

Now, I acknowledge that there is good evidence for salt restriction leading to reductions in blood pressure which, though individually small, may have public health benefit. I also acknowledge that public health education campaigns can have some modest success in changing society’s attitudes. But really, this is tinkering at the edges, with potentially huge opportunistic cost. I’m certain, for example, that the dangers of sugar consumption or lack of exercise at our society’s level vastly outweigh those of salt, and we’re not even nearly at the end of the tobacco campaign yet. The suddenness of Sid’s grotesque arrival, and the revulsion stirred by his form suggests that new evidence has proven salt’s danger to be beyond these other risk factors, and maybe even that we can continue to smoke, over-eat, and bungee jump, so long as we avoid sodium chloride. We therefore risk (a) diverting resources away from more important public health campaigns, and (b) permitting a re-uptake or maintenance of other riskier behaviour. And, of course, none of these behavioural factors have the order of magnitude of importance for the public health as social and political factors, such as access to healthcare, social equality, housing and poverty.

How did this happen? I suspect two important factors: (1) there is an intentional diversion of our attention from these other, more important social and political factors; and (2) the salt industry is not as devious or powerful as either the tobacco or sugar industries.

By associating the consumption of salt with such a repulsive character, we are all charged with responsibility for the public’s health. We all eat salt, therefore society’s illnesses are our fault. We have a shared feeling of guilt, the reasons for which are apparently justified, and are therefore unlikely to argue. This, of course, is a simple extension from a creeping process that began with the piling of blame on to minority groups, such as homosexuals and drug users, extended to larger groups, such as smokers, and has now engulfed the whole population. At the same time as conferring them or us with culpability, the need to address seriously the distribution of wealth or the comprehensive provision of adequate housing is apparently minimised.

Don’t get me wrong. We all know that people have to accept responsibility for their health, and that sharing this between patient and physician is demonstrably appropriate. But such shifts of responsibility need to be sensitive, proportionate and prioritised. Our new sluggy friend is none of these things, and I will therefore be saying sod off to Sid the Slug this Christmas. There – I’ve said it!

Which reminds me: at Christmas we celebrate the birth of Jesus Christ, subsequently renowned as a wise physician, among other things. In one of his memorable approaches to public health, he referred to humans as “the salt of the earth.” Now, this alternative, constructive view of salt was designed to develop a positive sense of identity and well-being among the community. I am certain that his approach, which is in direct contrast to Sid the Slug’s, had (and continues, for many, to have) an equally contrasting, and therefore beneficial, effect on health. I know whose message I will listen to.

Other hoolet online articles by Blair Smith can be found at:
hoolet edition 49 - Ethics and Repression in the Bloo Toon
hoolet edition 48 - May The Best Team Win
hoolet edition 47 - Hunting Pink Elephants
hoolet edition 46 - Predictive Texting
hoolet edition 45 - Role Models
hoolet edition 44 - Time To Go Killorglin'
hoolet edition 43 - Salt and Shake
hoolet edition 42 - Stepping up the Pace of Life
hoolet edition 41 - Smoking out the Irish Question
hoolet edition 40 - Not Cricket
hoolet edition 39 - Anniversaries and Predictions
hoolet edition 38 - Is There Life on Mars?
hoolet edition 36 - Onwards and Upwards
hoolet edition 35 - Goal of the Season‘s Greetings
hoolet edition 34 - Chickens and Eggs
hoolet edition 33 - On Shifting Goalposts
hoolet edition 32 - Period Zero
hoolet edition 30 - Annual Appraisal
hoolet edition 29 - Working Towards Scotland's Healthier Children For Us All 2020 and A Framework for Maternity Services in Scotland
hoolet edition 28 - In Memoriam Admiral Byng. A cautionary Tale

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.