Right to refuse

Image: Simon Cocks, via Flickr.

I lead a double life.

By day, I am a trainee physiotherapist, one of those over-energetic pains in the arse that reckons exercise is the answer to all the world’s problems.

At night, I sell liquor. I don’t work in a sports bar or a wine bar, but a liquor barn. Everything from Marlborough to Marlboro.

Until now, I had no qualms leading this double life. I considered retail liquor a sidecar to my pursuit of physio, the two never converging. This has changed since conducting my prac.

On the wards, I have seen some very sick people. One patient only needed to walk a single lap of his room to induce a coughing fit so violent that he would blackout. Another patient was so unfit that she could not transfer from the bed to the adjacent chair without becoming dangerously short of breath. Then there are the bariatric wards, fixed with ski-lifts to transport very heavy patients. The majority of patients I see in hospital (approximately 70% according to the Australian Lifestyle Medicine Association) have conditions caused by lifestyle decisions – smoking, poor diet and lack of exercise.

Now I am no self-righteous physiotherapist who resents these people for having lifestyle-related conditions. Often, these are out of their control. What I do resent is that these people should have to spend their last twenty years housebound, relying on a portable oxygen tank and shuttling only between their bedroom and lounge room. This is not living. And yet, I directly fuel this fire.

Back to the bottle shop. Every day without fail, a young man purchases a bottle of our cheapest scotch and a pack of B&H Smooth. Heavy panting signals his entry into the store. Regardless of the weather, he sweats profusely. I know this man’s scotch and cigarette addictions will cause many years of pain and suffering and will be the death of him.

He is now a customer. Soon, he will be a patient. One of those patients. The ones that cannot wash themselves properly. The ones that the hospital staff dread attending to because they emanate a confronting bouquet of sweat and excreta. The ones spending way-too-many days in hospital because their painful chaffing means that they cannot clear physiotherapy discharge.

I am aware of his fate, yet I guide him to his grave with a receipt offer.

I must serve this man. To refuse him service based on his physical appearance and his frequency of purchases is judgemental, discriminatory and illegal. But I can refuse intoxicated customers. This is why I get angry.

Should I serve an intoxicated customer, I would incur a fine of up to $11,000. Fair enough. Making a drunk person even more so could cause their death or death to innocent others.

But there are no such restrictions in place for this man’s scotch and cigarette addictions.

Both the government and I know that his addictions will cause his premature death. We know he will spend the last twenty years of his life persistently short of breath and housebound, with day trips to specialists and weekend hospital getaways. But that’s cool, he can buy as much booze and as many fags as he likes.

Why are so many steps put in place to prohibit short-term excessive alcohol consumption – fines, lockouts, marshals – when the more pernicious long-term abuse is permitted to take place without question?

Are the consequences of one messy night out more severe than a lifetime of tobacco and alcohol abuse? Well, a messy night could end in stomach pumping, a car accident, perhaps even a coward’s punch. A forty-year history of heavy smoking and drinking will probably leave you impotent, with oesophageal cancer and a domestic violence record. Long-term abuse is just as, if not more damaging than a messy night out.

Then there’s the cost. A messy night out isn’t cheap for the taxpayer. But consider the cost of a lifetime addiction and twenty years spent in and out of hospital. Also consider that tobacco and alcohol addictions will render an individual unable to work and contribute tax. And don’t forget fewer hospital beds for everyone else.

What if we were to refuse service to addicted individuals based on appearance and their frequency of purchases? Not as radical as it sounds. Aren’t these the same grounds on which we currently refuse drunks? There would be some angry customers, but I doubt they would be more aggressive than some of the intoxicated customers I have refused. Hurting feelings but saving lives. Pharmacists must log patient details for drugs of addiction. Why should alcohol be any different? Our government is hypocritical. It directs so much attention to short-term excessive alcohol consumption but completely neglects long-term abuse, which is arguably more detrimental to human health and places greater strain on the system.