I apologize if you are sick of political references, but I couldn’t resist the one in the title of this article. The other title that I was considering for this Rheumination, “Personalized Medicine in an Era of Fiscal Constraints,” sounded like a snoozer. No doubt about it, with that ponderous title, your eyes would have zoomed right on by.
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If a disquisition on Joe the Plumber’s bodily woes piqued your interest, thank you for stopping here. I hope that you will keep on reading because I have tried to put in important stuff. To the trainees who are reading, I would like to offer a special welcome. Also, I am happy to inform you that this column highlights one of the core competencies, systems-based practice, although I confess I had to look up what that was.
Joe the Plumber is now one of the most famous people in America. In case you spent the 2008 campaign season on Mars or under a rock, let me provide some details. Joe the Plumber is basically an ordinary Joe (pun intended) who asked then-presidential nominee Barack Obama a question about taxes during a campaign stop. John McCain and Sarah Palin latched onto this episode and made Joe a touchstone of their speeches. Then, through amplification and reverberations of the media, Joe became an archetype of working-class America and has been enshrined as an iconic figure, along with Joe Six Pack and GI Joe. Unlike that of many other instant celebrities, Joe the Plumber’s fame has lasted far more than 15 minutes. Indeed, it has somehow extended well beyond 15 hours and 15 days but, unless Joe’s agent gets him a few gigs or Joe throws his hat into the proverbial political ring, 15 weeks of fame may be out of reach.
If Joe retreats from the white hot light of media attention to resume his old life, he will again spend his day unclogging stuffed toilets and installing garbage disposal units instead of opining on government policy. Back on the job, he will get wet, crawl around the concrete basement floors, and wield big wrenches, with all that torque freeing stuck valves stressing and straining vulnerable joints. In putting his joints at risk, Joe will be like other patients in the building industry—Charlie the Carpenter, Ron the Roofer, and Pete the Plasterer—and will be a set-up for arthritis of the degenerative kind. When this affliction sets in, Joe’s body will get stiff, his knuckles will swell, and plumbing work will become excruciating as every twist and turn of his tools sends shocks of pain into Joe’s joints. (Looking at Joe’s physiognomy, I would not be surprised if he also develops some gout. My recommendation: Watch out for the brewskis, pal.)