Trump needs to shape up – not just because he's obese

I have had patients like Donald Trump and I suppose every doctor has had them too. He is like a newly diagnosed diabetic, and not just because he is obviously obese.

He is the patient who has no intention of changing his lifestyle and he has no respect for any advice that does not fit in with his misconceptions. You can show him any amount of evidence-based research, but he will continue to smoke, avoid exercise and pile on the weight.

He smiles pityingly at you, confident that money will fix the problem in the end. If he only had himself to worry about then that would be all right. A patient has a right to be wrong. He may regret it in time, when his kidneys pack in, but he has been given information and a chance to change.

In this case it is more serious because the planet is the patient, not his body. It has been suffering from high levels of a sugar-like substance called carbon for decades, and it needs to cut down drastically.

The World Health Organisation has called global warming the greatest threat to human health in existence. The vast majority of scientists who study the subject are in no doubt that if we keep on the way we are going life as we know it will be unsustainable in 2050.

Trump, a notorious climate change denier, is in denial. You cannot feel high blood pressure, or deranged lipids until they make their presence felt with a stroke or a heart attack .The patient tells you that they feel fine and they see no reason to change. Of course they feel fine.

Billionaires only experience weather as they move from the private jet to the limousine. They are protected by air conditioning and central heating. They don’t experience year after year of crop failures and famine when the rains don’t come.

They don’t see the land their forefathers farmed drowned forever by rising waters. If they want to go outside they pick a place where the weather suits their needs .They don’t have to pack up their children and move to the city to live on scraps in a slum because the land has become barren.

Big picture

Doctors don’t shout at their patients. They don’t grab them by the shoulders and shake them and slap their faces, even if they sometimes feel like it. They look at the big picture, advise the patient and they know that they will be there for them when the inevitable happens; the stroke, the blindness, the amputations, the renal failure. They rarely say “I told you so”.

But Trump is not endangering his own health; he is sentencing our children and grandchildren to a terrible fate. It is worse than a war, because wars end eventually.

The planet is breaking down. The delicate web of life is being poisoned. Ice caps are melting and temperatures are rising. It is like the human body in a state of diabetic ketoacidosis, one system upsetting another until everything is wildly out of control.

Trump, like a smoker or an alcoholic, has surrounded himself with bad friends, known as enablers. They are puppets of the oil and coal corporations, and the advice a corporation gives is not in the patient’s best interests.

Years ago corporations told us there was no evidence smoking was bad for you and denied the science. They have not changed. A corporation has no conscience, no children and no soul. It is like a cancer, a malignant growth that is a terrible mutation of the cells it invaded, and these advisors who think the world is 4,000 years old are working for corporations, not people.

I saw a spectacularly ignorant woman on a chat show recently, crowing with delight at the prospect of Trump putting one over on experts and the elite, whatever that means. “I don’t believe in climate change,” she cooed, as if her saying it made it so.

Face facts

I have had patients who had many strange home-grown beliefs, about smoking and drinking and drug taking, and they found out the truth the hard way. Don’t tell me that it is all amusing, and great to see how everything needed a shake-up.

Doctors have to face facts and they have to look at things that most people would rather not look at or even think about.

Trump has started by pulling the funding of climate change research conducted by NASA as part of a crackdown on “politicised science”.

He is threatening to pull the USA out of The Paris Agreement, reached at COP21 which was adopted by all 196 parties to the UNFCCC.

As the USA is a world leader and the second biggest carbon emitter on the planet this could put the whole deal in jeopardy, with disastrous consequences for the earth.

And what is it all for?

Millions of displaced people, widespread famine and environmental disaster, the slow death of our incredibly beautiful and complex planet, so a few billionaires, who already have thousands of times more money than they can ever spend, can accumulate even more money.

Time to admit it Mr Trump, you and the boys need to shape up .