Some change in culture will be needed to implement this hunger scale. We all had to adjust to the fact that a sleeping patient with normal vitals can have 10/10 pain. I’m all with that. So now everyone must adjust to the fact that a 300-pound man with fresh mayonnaise in his beard can still have 10/10 or dinosaur (please refer to the scale) hunger.

Attitude adjustment time. It is not your station in life to pass judgment about how hungry a man can be. You’re going to have to adjust to the cultural norms or we’ll be using your picture instead of the dinosaur on my nifty new scale. Hunger is everywhere. A girl with a BMI of 37 recently told me that she had to fast from lunch until dinner twice in the same week. This is a national crisis, and you are part of the problem if you are not using this scale.

I’m making an introductory offer to ACEP members to buy genuine laminated Dave’s Hunger Scale cards for $10 each. But wait; if you act before the next issue, I’ll double your order. As an added bonus, I’ll include the numbers of the local fast food restaurants plus directions for the Heimlich maneuver on the back of this useful clinical tool.

The card may become obsolete one day, as there is a risk that folks may get so heavy they’ll need motorized scooters, “big boy” wheel chairs, and bariatric CT scans. Oh … I guess that already happened, so no need to worry. Use the scale on every patient. What’s the worst that could happen? It’s not like an epidemic of opiate overdoses happened after we started using the pain scale.

Be happy.

Dr. Baehren practices emergency medicine and is an assistant professor at the University of Toledo (Ohio) Medical Center. Your feedback is welcome at David.Baehren@utoledo.edu.