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INT--COMMUNITY HEALTH DEPARTMENT, BROOKINGS HOSPITAL, BALTIMORE, MD--DAY
In a large open area, six people sit in a circle of perhaps 15-20 chairs, having a staff meeting: JAMILA SMITH; BRENDA CONWAY*, Director of the Community Health Department and a Professor at the School of Nursing; DEREK SYKES, a Clinical Nurse Specialist; another CLINICAL NURSE SPECIALIST; a NURSE; and a SOCIAL WORKER.
CONWAY
...and since we have new people here, I thought I'd review where we are.
The Brookings Community Health Department has existed for three months.
Its goal: to stem critical health problems of the neighboring community
before they grow acute, reducing the flow of patients coming in later
with major problems. The Hospital's motives here are not purely altruistic.
Much of this local community is uninsured. These problems cost money.
And historically, our relations with the community have been poor. Many
people resent us, don't trust us...they think we're doing Tuskeegee experiments.
So we're going beyond getting referrals from the ED and L&D. We're
doing outreach activities in churches, community centers, local stores
and restaurants.
(Pausing.)
What exactly are we doing? Based on our assessments, we'll start with
major initiatives directed at violence, drugs, tobacco, obesity, and maternal-child
health problems. We'll also address communicable diseases like STD's,
and diseases of the urban poor like lead poisoning and asthma. We're on
a shoestring one-year budget, and there's no guarantee it'll be renewed.
So don't make any mistakes.
(Nodding at SMITH.)
This is Jamila Smith, a recovering M.B.A. She just got her B.S.N. across
the street--she was one of the most promising students I've ever had--and
she's now in the joint Nursing/Public Health Masters program. I do have
to warn you: she's 99 and 44/100 per cent attitude. She'll help Derek
on the obesity project.
INT--COMMUNITY HEALTH DEPARTMENT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT
In the same conference area, SYKES and SMITH sit side by side in the circle of chairs, the rest of which are now occupied by overweight COMMUNITY MEMBERS, mostly women.
SYKES
...and today, over 60% of American adults are overweight. About 20% are obese--very overweight. For African-Americans, the obesity figure is over 29%, and it's even higher for African-American women. Is this a problem?
A few seconds pass.
FIRST COMMUNITY MEMBER
Don't feel good. Don't look good.
SYKES
Whether we think it's attractive depends on cultural and personal factors.
But we do know overweight people are at higher risk for heart disease,
stroke, diabetes, respiratory problems, pregnancy complications, psychological
disorders and cancer. Obesity's an epidemic that causes 300,000 preventable
deaths and costs the nation over $100 billion annually. So how does it
happen?
No response. The group looks bored.
SYKES
Causes include lifestyle habits, family history, social and cultural environment, genetics and other diseases. Let's start with diet. It's not just how much we eat, but also what we eat. Here's an example: anyone here use vegetable shortening?
SEVERAL COMMUNITY MEMBERS
(Vague positive murmurs, and the words "fry" and "chicken" are audible.)
SYKES
Vegetable shortening won't melt or go rancid, right? It's so stable because
they bond the vegetable oil with hydrogen. Like in most store-bought cookies
and crackers. But that can be a real health problem, because it won't
melt inside your body either. The fat molecules enter your blood vessels.
(Camera shows FAT molecules with evil faces enter blood vessels. Ominous
music starts and slowly gets louder.)
They attach themselves to the walls of your arteries.
(Molecules BUILD UP on the walls.)
And they won't leave! The evil fat stays there, so the blood can't get
your heart the nutrients it needs--
(Blood flow through an artery is IMPEDED; nutrient molecules wait with
SAD faces; fat molecules REJOICE.)
--and you can get heart disease!
A few COMMUNITY MEMBERS are looking at SYKES like he's insane. Most COMMUNITY MEMBERS remain bored.
SMITH
That's all boring, right?
Silence.
SMITH
For real, it's straight-up boring. We got nothin' for you, right?
OBESE FEMALE COMMUNITY MEMBER
Maybe y'all need a video.
SMITH
(To the OBESE FEMALE.)
I feel you. But let me ask you this: anybody say anything to you about
your weight in the last week?
OBESE FEMALE
(Taken aback.)
No.
NEARBY FEMALE
Charisse, stop frontin'. Tell her what your boy said.
CHARISSE
I ain't...
(Glancing at NEARBY FEMALE.)
Aw...whatever. Yesterday my baby father gettin' set to step out with his
boys, right? So I'm just havin' me a snack, you know--
INT--CHARISSE'S HOUSE, BALTIMORE, MD--DAY
CHARISSE sits on her living room couch watching TV with two CHILDREN and eating from a BAG of CHIPS. Her BABY FATHER and two FRIENDS approach from a back room, on their way to the front door.
BABY FATHER
Hey, baby, you at it again?
(Grinning at his FRIENDS, pointing at CHARISSE with her BAG of CHIPS.)
Check it out: this product sold by weight and volume; no
settling of contents has occurred!
BABY FATHER and FRIENDS
(Laughter.)
INT--COMMUNITY HEALTH DEPARTMENT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT
SECOND COMMUNITY MEMBER
Your boy a regular Chris Rock.
SMITH
Anybody else get that?
SEVERAL COMMUNITY MEMBERS
(Murmurs.)
SMITH
Sure, it's wrong. But you gonna just wait for people to figure that out?
SEVERAL COMMUNITY MEMBERS
(Murmurs.)
SMITH
You know, I knew a guy, talked about how tame things are fat. Tame things, right? What're they like?
FIRST COMMUNITY MEMBER
Like a dog.
SECOND COMMUNITY MEMBER
Like a cow.
SMITH
Yeah. Maybe on a leash, maybe fenced in. Somebody else is in control. Kinda like a slave, right?
Silence.
SMITH
Are we slaves to the fat? Slaves to the merchants of fat?
A COUPLE COMMUNITY MEMBERS
No.
SMITH
Well, who's in charge? Us or the fat?
SEVERAL COMMUNITY MEMBERS
We are.
SMITH
We tame things?
MOST COMMUNITY MEMBERS
NO!
SMITH
We fat slaves?
ALL COMMUNITY MEMBERS
NO!
SMITH
So...are we gonna emancipate our fat asses?
ALL COMMUNITY MEMBERS
YEAH!
SMITH
All right. We ain't slaves. We got some power. Knowledge gives us more.
(Nodding at SYKES.)
That's where my man Derek comes in.
COMMUNITY MEMBERS
(Talking to each other.)
SYKES
(To SMITH so only she can hear, forcing a smile for the COMMUNITY MEMBERS.)
Don't ever do that again. And this negativity, calling people names...it's
not helpful. Who said that about tame things anyway--some friend
of yours?
SMITH stares at SYKES.
INT--A THEATRE STAGE
SMITH and two MEN are performing Act I, Scene II of William Shakespeare's "The Winter's Tale" (pub. 1623) before an audience. SMITH plays Queen HERMIONE, and the two MEN play her husband King LEONTES and his old friend King POLIXENES.
SMITH (as HERMIONE)
What! have I twice said well? when was't before?
I prithee tell me; cram's with praise, and make's
As fat as tame things: one good deed dying tongueless
Slaughters a thousand waiting upon that.
INT--COMMUNITY HEALTH DEPARTMENT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT
SMITH
(Answering SYKES' question.)
Yeah...a friend of mine.
SYKES
(To the COMMUNITY MEMBERS.)
All right. All right.
(As they grow quiet, more attentive.)
So hydrogenated oils can be dangerous. Many processed foods have them,
so it's important to read the labels...
As SYKES continues, we move away, down the hall and toward two-way double doors, above which a sign reads "Emergency Department," and through the doors.
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