I. Metabolic Workmen

week after the physical he had put off for a year (he’d actually been putting it off for three years, as his wife would have pointed out if she had still been alive), Richard Sifkitz was invited by Dr. Brady to view and discuss the results. Since the patient could detect nothing overtly ominous in his doctor’s voice, he went willingly enough.

The results were rendered as numeric values on a sheet of paper headed METROPOLITAN HOSPITAL, New York City. All the test names and numbers were in black except for one line. This one line was rendered in red, and Sifkitz was not very surprised to see that it was marked CHOLESTEROL. The number, which really stood out in that red ink (as was undoubtedly the intention), read 226.

Sifkitz started to enquire if that was a bad number, then asked himself if he wanted to start off this interview by asking something stupid. It would not have been printed in red, he reasoned, if it had been a good number. The rest of them were undoubtedly good numbers, or at least acceptable numbers, which was why they were printed in black. But he wasn’t here to discuss them. Doctors were busy men, disinclined to waste time in head-patting. So instead of something stupid, he asked how bad a number two-twenty-six was.

Dr. Brady leaned back in his chair and laced his fingers together on his damnably skinny chest. “To tell you the [bad word] ” he said, “it’s not a bad number at all.” He raised a finger. “Considering what you eat, that is.”

“I know I weigh too much,” Sifkitz said humbly. “I’ve been meaning to do something about it.” In fact, he had been meaning to do no such thing.

“To tell you more of the [bad word] ” Dr. Brady went on, “your weight is not so bad, either. Again, considering what you eat. And now I want you to listen closely, because this is a conversation I only have with my patients once. My male patients, that is; when [bad word] to weight, my female patients would talk my ear off, if I let them. Are you ready?”

“Yes,” Sifkitz said, attempting to lace his fingers across his own chest and discovering he could not do it. What he discovered—or rediscovered, more properly put—was that he had a pretty good set of [bad word]  Not, so far as he was aware, part of the standard equipment for men in their late thirties. He gave up his attempt to lace and folded, instead. In his lap. The sooner the lecture was begun, the sooner it would be done.

“You’re six feet tall and thirty-eight years old,” Dr. Brady said. “Your weight should be about a hundred and ninety, and your cholesterol should be just about the same. Once upon a time, back in the seventies, you could get away with a cholesterol reading of two-forty, but of course back in the seventies, you could still smoke in the waiting rooms at hospitals.” He shook his head. “No, the correlation between high cholesterol and heart disease was simply too clear. The two-forty number consequently went by the boards.

“You are the sort of man who has been blessed with a good metabolism. Not a great one, mind you, but good? Yes. How many times do you eat at McDonald’s or Wendy’s, Richard? Twice a week?”

“Maybe once,” Sifkitz said. He thought the average week actually brought four to six fast-food meals with it. Not counting the occasional weekend trip to Arby’s.

Dr. Brady raised a hand as if to say Have it your way…which was, now that Sifkitz thought of it, the Burger King motto.

“Well, you’re certainly eating somewhere, as the scales tell us. You weighed in on the day of your physical at two-twenty-three…once again, and not coincidentally, very close to your cholesterol number.”

He smiled a little at Sifkitz’s wince, but at least it was not a smile devoid of sympathy.

“Here is what has happened so far in your adult life,” Brady said. “In it, you have continued to eat as you did when you were a teenager, and to this point your body—thanks to that good-if-not-extraordinary metabolism—has pretty much kept up with you. It helps at this point to think of the me