The PRH (Personal Responsibility for Health) Chronicles, Part 1: The Way We Were

The issue of personal responsibility for health and weight control comes up frequently in my professional circles, generating strong and opposing views. I have addressed this theme recently -- and many times in the past -- and expressed my own opinions.
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"With great power comes great responsibility." -- Uncle Ben, the Spider-Man movies

"Before taking responsibility, one must be empowered." -- Yours truly, David L. Katz

The issue of personal responsibility for health and weight control comes up frequently in my professional circles, generating strong and opposing views. I have addressed this theme recently -- and many times in the past -- and expressed my own opinions. There is now an opportunity to do so in the context of an ongoing dialogue, exploring agreements and disagreements -- and, ideally, cultivating constructive insights in the process. Since each entry will be one part of an ongoing series, don't look for closure in any one column. Rather, each is just one serving of food for thought in our shared, and ongoing, repast.

And so it is I initiate "The PRH Chronicles" with this entry, and as is only right, I begin at the beginning... or at least the beginning, as I imagine it might have been.


Mik-tal huddled nearer to the fire, keeping it between her and the chill blowing in from the cave mouth. She was cautious, though, to avoid the sudden surges of flame a strong, capricious wind gust might create; her body hair had once caught fire, and only Bo-tu's quick thinking had saved her life. She fingered the scar on her left flank gently, and squared her shoulders against the cold.

As her fingers moved up, thoughtlessly, they tumbled over her ribs, and her thoughts moved on. The season had been harsh. Of course, it always was, but not like this. Bo-tu was an excellent provider. That had much to do with Ga-juk's leadership, she knew. He had brought them to this cave three seasons ago when the clan's prior home was destroyed in an avalanche. Had the hunting party not been out at the time, they might all have perished then. But they survived, or rather most did, and left the shambles of their home.

The trip to their new home was arduous, but none complained or expected any different. The journey took almost three months, although to Mik-tal that was a vague concept, cast more in terms of seasons; they left the Valley of the White Water as winter gave way to spring, and reached the Valley of Forked Trees just as summer heat descended. Along the way, they gathered food as they always did on the move. Wandering did not allow for the hunting of large game, certainly not mammoth. The clan's best defense against predators was numbers; the men could not go off for days (or weeks) at a time and leave the women and children alone without the protection of a permanent home. So on the move, they gathered. Real hunting would start again once their new home was found.

Mik-tal gazed at Kanda, sleeping in a heap of skins, as close to the fire as the mother dared allow. The sound of her daughter's breathing in sleep was perhaps the most soothing thing in Mik-tal's world. For winning the struggle to survive meant winning it for one's children. Ikron was grown, Min-dra had died during her first year. Now, there was only Kanda, and Bo-tu.

Mik-tal's thoughts went back to the journey, and of seeking constantly for food with Kanda on her back. Sometimes, because she was of that age, Kanda would cry or coo at just the wrong time, alerting Mik-tal's prey just before she could cast a stone from her sling. On such occasions, Mik-tal never became angry, but rather frightened. One less thing to eat always evoked fear. One thing less, or one thing more, might make the difference.

Mik-tal was an excellent hunter in her own right. Like most of the clan women, her senses were all acute; her hearing in particular was excellent, as was her vision in dim light, better than the men. She was a veritable botanist, familiar with most of the plants she encountered, knowing which were safe to eat, which not, which yielded salves and medicines. She could move quickly and almost silently. She could throw fast and hard. And with these skills, which she took for granted as they were both expected and necessary, she made her contributions to her own survival, and that of Bo-tu, Kanda, and the clan.

Mik-tal's fingers, and her thoughts, returned to her ribs as she looked at Kanda. The depressions between them might have depressed Mik-tal had she considered her world, her circumstances that way. This was not a world for depression nor, for the most part, happiness. The struggle to survive was simply too abiding. There was the fear and anxiety of an empty belly, and the calm, reassuring comfort of fullness. Little else. These ribs made her anxious.

That was why Bo-tu was out, along with Ga-juk and the others. For it was too early, and that, too, made Mik-tal anxious. Too early in the spring for a mammoth hunt. The weather was still unpredictable, the mammoths too far south, their flesh too thinned and their tempers too frayed from a season of want they, too, had endured. But looking around the cave at the other family fires, Mik-tal reaffirmed what she already knew, that the dried meat and roots laid in for winter had been depleted. The rawhide straps looped around the beams that crossed the cave beneath its ceiling all hung down empty, looking to Mik-tal, in an unusually pensive mood, like the many fingers of desperate hands. The bony fingers of longing hands.

Her fingers lingered over her protuberant ribs, as her thoughts wandered on, or rather back to the previous mid-summer. How glorious the bison hunt had been! Bo-tu had been the hero, lead hunter of a highly successful hunt. She thought of Bo-tu, whom she might be said to love, although there was little sentimentality in her, little room for it. Mik-tal was pragmatic, as the business of survival was all-consuming. But certainly the thought of Bo-tu warmed her.

She saw in her thoughts the massive bison carcass. The hunters, with Bo-tu in the lead, recapitulated the hunt, their courage and daring, in a dance around it. She remembered the clear pride in Bo-tu's face, the strutting, jumping, shouting. Bo-tu was impressive, and Mik-tal was not easily impressed. She could ill afford to be. She herself could almost effortlessly throw a burden of 100 pounds to her shoulder, and carry it, if necessary, for hours. Bo-tu could do the same with 2 ½ times that weight. Most of the hunters could, and often did. Ga-juk could manage three times as much; that, in part, was why he led. Nearly the entire carcass of the 3,000 pound bison had made it back to the cave on the shoulders of the 12 men in the hunting party.

So of course Bo-tu was powerfully built. He was nearly 6 feet tall, and weighed 190 pounds. A large proportion of that weight was distributed in the major muscle groups: the calves, hamstrings, buttocks and thighs, the shoulders, arms and chest. Mik-tal thought of Bo-tu's powerful physique in a satisfied way that had little to do with sexuality. She was in no such mood at the moment, certainly. Rather, his strong arms, his vigorous stride, reassured her. He would provide. And so far, he had.

After the dance, the clan had feasted. They knew too much want to take plenty for granted. When food was abundant, everyone ate until they could eat no more, and then, somehow, they ate more anyway. Mik-tal recalled the hot tears of pleasure that filled her eyes as she sank her teeth into the first mouthful of bison. She recalled as well an orgy of eating over the next two days that left many in the clan, herself included, sated and blissfully lazy. Eating, sleeping, and eating again, the clan enjoyed a rare interlude, an oasis in their endless desert of want.

Back again, the fingers to the ribs. Then to her face, where Mik-tal felt the sunken hollows of her cheeks. Perhaps the snows would melt and they would survive even without the early mammoth, but she doubted it. She looked again at Kanda, diverting her eyes not so much from something else as from somewhere else, some other time. Kanda's cheeks were full, her breathing strong and steady and peaceful. So far, Mik-tal had compensated. So far.

She, too, was lean and strong. Not that this interested her in any way. Beauty was a luxury to which the harsh survival struggle of clan life was largely inattentive. But she did care how the contours of her body changed over time almost as reliably as the seasons, and generally in accord with them. At the end of a good summer and early fall, Mik-tal, if not actually plump, was certainly full of figure. Her breasts, buttocks, thighs would fill out with a soft kind of flesh the winds of winter invariably stripped away. She knew nothing of fat or muscle, only of the seasons of plenty and the seasons of want, and the concordant seasons of her body. And she greatly preferred plenty, always the shorter season. So when she could, she luxuriated in the fullness of her figure, the slight dimpling of her flesh, the smoothing over of her ribs, the rounding of her face. To the extent such changes occurred, and it was never enough to suit her, it meant, as much as anything could, that she would survive. And if she survived, then by all the forces, so would Kanda. So would Ikron. So would Bo-tu.

But never had the winter winds worn as deeply into her flesh as this year. The summer had been too dry, the prey too scattered. The bison, massive beast though it was, could only go so far. Roots had withered from the lack of rain and by summer's end were simply not to be found or, if found, stunted, rotted, and not worth eating. Of course, they ate them anyway; they were known to eat bark under such circumstances. So the fall supply had been paltry, and the winter, even by the standards of a people inured to the ice age, brutal. It started early, raged relentlessly, and seemed, still seeming, inclined to never end. Until at last Ga-juk weighed the impending starvation of his clan against the folly of an early season hunt in the deep, wet snow, and settled on the latter. Not that he was particularly sanguine about the hunt, but anything was preferable to just withering in the cave.

Bo-tu, and all the men, felt the same, nor did the women protest. Mik-tal recalled their departure, something furtive about it, as if they hoped the dying winter might not notice, might not be roused from its torpor. But the winter had been roused, screaming its perpetual rage at their defiant survival in a blizzard that began four days after they left and lasted six days beyond that. Six days. That was some two weeks ago, not that Mik-tal could have said so. But she knew it was long. Quite possibly, too long.

Suppressing tears, Mik-tal gathered what she could of the fire's heat within the skin she wrapped around herself. She curled next to Kanda, taking her hunger, and her hope, with her into sleep.

-PRH Series, to be continued

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