Why are attractive women as rare as dodo birds in emergency rooms?

Some interesting anecdotal observations…

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Why are attractive women as rare as dodo birds in emergency rooms?

After a decade of ER work, I can recall having had less than a dozen attractive female patients. Considering the countless thousands of patients that I've served, this fact is truly amazing and deserving of formal study. A considerable amount of money is spent every year on the research and prevention of accidents, yet I've never seen anyone look into the reasons why attractive women seem to be virtually immune to diseases and accidents that might cause them to need emergency medical treatment.

There's recently been a lot of hullabaloo in the press about the link between beauty and genetic superiority. The upshot of this research is that beauty is, if nothing else, a marker for good genes that confer a host of desirable traits, not just skin-deep beauty. If this theory is indeed true, then it may offer a partial explanation for my empirical observation that attractive women rarely need treatment in an ER. There are certainly more mundane explanations, but they alone cannot explain this phenomenon.

If you're a beautiful woman and you've actually been a patient in an emergency room, I'd like to hear your story to consider it for inclusion in my next book of ER stories. Burst my bubble of incredulousness and get published at the same time! Send your anecdote to [email protected] .

Interestingly, over five years after its inception, only four women who opined that they were attractive have submitted stories. Perhaps my asseveration (about there being an inverse correlation between a woman's beauty and the likelihood that she'll be a patient in an ER) is not as flip or as baseless as it might seem. Nevertheless, my observation smacks of political incorrectness and—like most conclusions that are true but politically incorrect—it has ruffled some feathers in a very predictable way. After having more feedback on this issue than I ever imagined (and certainly enough to draw statistically valid conclusions), there are five basic groups of responses. Specifically, they are from:

(1) Men who work in emergency rooms who've written to say that they've observed the same thing.

(2) Women (many of whom do not work in an ER) who take umbrage at my observation irrespective of its veracity. If you fall into this category and wish to send me a scathing e-mail message, please note that I'm swayed by facts, not pouting.

(3) Attractive women who agree with my observation. Such respondents sometimes pass along their conclusions about why a pulchritudinous woman is less likely to be an ER patient than a woman who is not a beauty. Here is a synopsis of just one of these conclusions: attractive women are more likely to have physicians as friends and family members. In anything short of a true emergency, those women generally prefer to call upon a doctor that they know personally rather than wait for hours to be treated in a busy ER by a doctor who may or may not be fluent with the English language, not to mention the nuances of medicine. The foregoing gray-shaded text was a synopsis; if you want to read the actual message, here it is:

I am currently reading your book, Believe It or Not! True Emergency Room Stories (which is, by the way, a great read) and I think I might have a viable reason for the disproportionate amount of beautiful women who never visit an ER. Judging from what I've understood from your book, I think by attractive you are referring to the whole package (not a life-size Barbie with a Barbie doll-sized brain). Aside from true life-threatening situations (i.e. MI's, strokes, etc.), I feel that what many people would view as an emergency is relative to their degree of education as well as their socioeconomic position (notwithstanding the “dirtbags” you mention early in your book). I also feel that the proportion of beautiful women is very high in the above-mentioned group.

You mentioned that you wondered “why attractive women seem virtually immune to diseases and accidents that might cause them to need emergency medical treatment?” Fairly educated people, with a basic understanding of diet, healthy living and hygiene most probably also have an internist (not to mention a veritable cornucopia of other specialists, as well). Any potential emergency situations are usually identified when they present themselves and are treated—rather than let progress until they actually are emergencies. It's no surprise that successful, well-educated professionals are more likely to get their “pick of the litter” when dating and selecting a spouse (i.e., the “good catch” theory—which I can expound upon later in another e-mail, if you're interested). Their social circles are comprised of other doctors, lawyers, etc. so when so-and-so's wife/girlfriend cuts her hand slicing a bagel, they simply call so-and-so's friend, the plastic surgeon, to meet in his office or hospital to take care of the matter. Attractive, well-educated people avoid the emergency room at all costs. It is the equivalent to grocery shopping in an ghetto supermarket, both because the quality of care is a crap shoot and the element of people that wait the interminable wait alongside of you leaves a lot to be desired.

As elitist as this sounds, it's true. I come from a family of physicians. I personally have never been to an ER as a patient. I don't know any of my girlfriends who have, either. We've been lucky enough never to have been involved in serious accidents, but I think you'll agree that many if not most serious accidents involve a degree of stupid behavior. In essence, pretty girls have doctor friends and family. And if you're wondering…yes, I am.

(4) People who suggest that this phenomenon under discussion is a reflection of the fact that my conception of beauty is more restrictive than that held by other men. The proliferation of “rate me” sites (in which people rate a succession of people's pictures on a scale of 1 to 10) on the Internet has allowed me to scientifically test whether this is true or not. By comparing my assessment to the average rating, I know that my notion of what constitutes beauty is fairly typical. The only time that there is a significant discrepancy is due to the fact that some men evidently think that every young woman who is slender and shows off her belly button is automatically a 9 or a 10 even if she's just a skinny young plain Jane. In summary, except for that one exception my overall assessments are similar to the average scores that are tabulated from thousands of men. Therefore, I offer this as proof of the fact that this “beautiful women aren't ER patients very often” phenomenon is not attributable to the fact that I possess an unreasonably high standard of beauty.

(5) Two people who propounded that ER patients understandably don't look good because of the very problems that caused them to seek emergency treatment. Not surprisingly, neither of those respondents were ER doctors. In my opinion, a good ER doctor should be able to automatically make an allowance for such circumstances and should be able to intuitively see what patients would be, sans the injury or illness. Want an example? Years ago I had a young lady as a patient in the ER after she'd been in a horrific car accident that mangled her face. If most people saw her they would probably wince in disgust, but I was able to instantly realize that she would be very beautiful once her face was reassembled. If I did not have this conception of the endpoint, how else could I have performed the surgery?

Another point that's even more pertinent to this topic is that most ER patients do not have emergencies. If someone sprains her ankle or has a bladder infection, will that degrade her appearance? Of course not. It goes without saying that there is nothing—not even an emergency—that will cause a woman to instantly gain 100 pounds or to develop facial wrinkles that were created by decades of cigarette smoking. Consequently, if I think that such a person is unattractive it has nothing to do with her “emergency.”

(6) Several people have written to me suggesting that attractive women must occasionally cut their fingers, thus making them likely to wind up in an ER. First, take a look at the gray-shaded text in #3, above. Now take a look at my experience. I've performed about every imaginable emergency surgical procedure on thousands of people but I've treated only one attractive woman with a cut finger. It doesn't take a rocket scientist to realize that attractive women often get someone else to do things for them that entail a certain amount of risk. If you've ever taken a college class that explores the nexus between genetics and behavior, you don't need to be told that men trip over one another in their haste to mix their genome with that of beautiful women. Furthermore, there is no shortage of rich men waiting to open up joint bank accounts with women who are very attractive. Thus, such women are more likely to drive safe cars instead of old clunkers with bad brakes, and they are more likely to live in safe neighborhoods in modern homes that have every imaginable safety feature from electrical lines protected by ground-fault interrupters to dishwashers that obviate the need for women to wash dishes manually. And how many gorgeous women toil in dangerous factories or other perilous jobs? Is there even one such person in the entire United States? Incidentally, feel free to not treat that as a rhetorical question.

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While I haven't given this matter a lot of thought, I can offer another reason (in addition to the factors discussed above) for why this phenomenon is operative. Let's begin by taking a look at a list of behaviors that are under an individual's control:

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smoking
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drug use
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alcohol consumption
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poor diet (consumption of junk food or excessive caloric intake, or both)
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excessive consumption of soft drinks (I'm listing this separately from diet since many people don't think of soft drinks when they're thinking of their diet. However, I've met countless people who consume a substantial proportion of their calories—up to 80%—from the empty calories in soft drinks. Not surprisingly, this leaves very little room in their diets for nutritious foods.)
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inadequate sleep
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inadequate exercise
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risky behavior

It is not a coincidence that people who abuse themselves in the aforementioned ways do two things: degrade their appearance and their health, thus increasing the chance that they'll end up in the ER. Conversely, people who take good care of themselves are more likely to be attractive and healthy. It's no surprise that healthy people who don't engage in risky behavior rarely have a need to visit the ER.

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