Why are attractive women as rare as dodo birds in emergency rooms? A reader responds--and so do I!

I found your website while searching the web for the TV show ER. I scanned through your site and happened upon your argument that attractive women don't go to the emergency room. Though I agree women who have the money and time to eat, dress, and exercise properly usually use the ER as a last resort (so they would not be seen often in the emergency room), I think you miss another major reason for the lack of beauties in your ER. Very few women roll out of bed in the morning looking beautiful. Though beauty can be viewed differently by different people, the generic 'hot woman' has spent much time showering, doing make-up, and picking out clothes. My first emergency room experience was when I had a badly infected hip joint; I had not showered and I just had on jeans and a T-shirt. I also had thrown up everywhere right before the doctor came in to see me. Whether I'm a supermodel or a witch, I'm not going to be attractive to that doctor. My second trip to the ER, I was brought in by ambulance. I was half-conscious and still had on my pajama pants and a T-shirt (again not having showered or done make-up). A usually attractive woman would not appear attractive in the many situations that would bring her to the ER. So I think it's a combination of the two reasons. First, women with the time and money to beautify themselves would not go to the ER for common strep throats and broken hands; they would go to their primary doctors and specialists. But, in the emergency situations that these 'hot women' would go to the ER, they would be so ill that it would be practically impossible to view them as beautiful. Imagine Barbie covered in vomit with a nose tube and IVs, pale and unshowered. Mary

My response
I agree that an otherwise attractive woman's appearance can be degraded when she is seriously ill or injured, but such cases constitute a distinct minority of ER visits. I previously worked in an ER that was in the top 5% of ERs in this state for acuity (i.e., we saw more serious and involved cases than 95% of the state's emergency rooms), yet even in that ER most of the cases we saw were ones in which appreciable degradation of appearance would not be expected to result from the relatively trivial illnesses or injuries. For example, if a woman has a bladder infection, a vaginal discharge, a sprained ankle, a sore back, an allergy, or needs a tetanus shot (all common reasons for going to the ER), will those conditions degrade her appearance? I don't see how. Consequently, since we saw so many of those women and so few of them were attractive, it is natural to ask, as I did, "why?" Gee whiz, I can walk into a store and see more attractive women in ten minutes than I saw in ten years in the ER. Even if you exclude the seriously ill or injured ones (although, as I've pointed out, a good doc should be able to "see through" the illness, so to speak), there is a glaring paucity of attractive women patients in the ER.

My primary explanation for this phenomenon is that people who don't take care of themselves (whether it be through poor diet, lack of exercise, abuse of drugs or alcohol, etc.) generally aren't very attractive as a result of this abuse and are far more likely to end up in the ER. Hence, to me, it is hardly surprising that emergency rooms are packed with such folks. People who DO care about themselves are not only more likely to eat better and exercise (etc.), they're also more likely to be careful in other aspects of their lives, and hence are less likely to do dumb things that will necessitate an ER visit.

In regard to your observation that "very few women roll out of bed in the morning looking beautiful," I'd like to point out that most women (or men, or children) who come to the ER do not do so immediately after awakening. That observation is substantiated by statistical data showing a distinct lull in ER activity in the morning. The busiest time for every ER I've ever worked in (or heard about) is the late afternoon to midnight period. If anyone hasn't had the time to hop in the shower and put on presentable clothes by that time, then I think it is fair to say that it has nothing to do with the fact that they just woke up and hence didn't have time to get spiffed up.

Next, I think there is a distinct difference between innate beauty, and a pleasing (albeit illusory) appearance that's attributable to makeup and nice clothes. However, since I think that makeup often degrades a woman's appearance (where do women get the idea that fake pigment from a bottle looks better than good, healthy skin?), its absence would not degrade a woman's appearance in my eyes. Furthermore, in regard to whether or not nice clothes (or their absence) influences my perception of a woman's appearance, the short answer is "no." The long answer is that many ER patients end up in a standard hospital-issue gown and whatever clothes the woman had on are in a plastic bag beneath the patient's gurney. Ergo, they're not a factor. Even if a patient is wearing her street clothes, that's not going to impress me if she's "all dolled up." I think that women in jeans or a simple dress look just fine, and women in expensive designer clothing don't make my heart race. Perhaps some men are turned on by these artificial adjuncts, but not me.

I think that just about every woman (or man) could be attractive if she (or he) would exercise, not overeat, avoid drugs and overuse of alcohol, don't smoke, get plenty of sleep, and avoid processed foods. What people eat has a profound influence upon their appearance, health, happiness, and longevity, yet most of us know far more about what is the correct gas and oil to put in our automobiles than we know about what we're shoveling down our throats. Let's take one example. If you put water in your car's gas tank, will it run well? Obviously not. It wasn't designed to handle water, and when fed water it will sputter and perhaps conk out. Now consider what happens when people feed themselves trans-fatty acids, as they do just about every time they take a bite of processed food these days since most of them contain trans-fats (often disguised on the label as "hydrogenated" or "partially hydrogenated" fats or oils). The human body wasn't designed to process trans fats, and when given them it'll result in noticeable degradation of health and appearance. If you remember nothing else about hydrogenated or partially hydrogenated fats or oils, remember this: every time you see them on an ingredient label, it means that the manufacturer cares nothing about your health. If you care about your health, you'll do the smart thing and not buy that product. If enough consumers did this, the food manufacturing companies would get the message and give us healthy foods.

If you still don't think that healthy eating has any bearing upon appearance, log onto an international Internet dating site and compare the appearance of women from countries in which consumption of processed food is the norm versus countries in which unprocessed foods are still the dietary mainstays. When I did this, I was amazed by the difference. I've seen the difference in my own life, too. While I now try to usually eat just healthy foods, I've gone through junk food phases in my life and I know that better eating results in a better appearance. Remember the saying "you are what you eat"? Well, that's not quite true (otherwise I'd have long ago sprouted chicken feathers!), what you eat does have a bearing upon the composition of your body. If you want to put doctors and the processed food companies out of business, eat right!

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