I really thought about my purchase. Yes, I could buy a half-pound of turkey, a head of lettuce and a tomato and make it myself. But here’s the thing: It just tastes better when the nice deli guy makes it for me. He uses far more turkey than I’d use. He has a perfect amount of mixed lettuce greens to balance the bright, thinly cut tomatoes. He sprinkles just the right amount of salt and pepper on it, too. The rolls come from the in-house bakery. I’ve often sat there and watched the pastry chef mixing up a new batch of something fluffy, seeing the eggs and the flour go into the large mixing bowl.

You know that cheap $4.99 hero? It’s not as good. The lettuce is iceburg; there are no leafy greens to be seen. The rolls come out of a big bag. They weren’t freshly baked the same morning. Even the turkey seems of a lesser quality.

So, was my sandwich worth the extra $1 or so? Absolutely. I put less food into my body, but the food that went in was high quality. I’m lucky I can make this decision. There are an awful lot of people out there who, because of finances, have to make an even harder choice: buy something off the $.99 menu at some fast food joint or skip lunch all together.

And what’s in that $.99 menu choice? Let’s take a random item off the McDonald’s menu: The 360-calorie McChicken sandwich. Here’s what’s in it:

McChicken Patty: Chicken, water, salt, sodium phosphates. Battered and breaded with: bleached wheat four, water, wheat flour, food starch-modified, salt, spices, partially hydrogenated soybean oil and cottonseed oil with mono -and diglycerides, egg whites, wheat gluten, paprika, dextrose, leavening (sodium acid pyrophosphate, baking soda, monocalcium phosphate, ammonium bicarbonate), garlic powder, yeast, natural flavor (plant source), extractives of paprika. Prepared in vegetable oil (Canola oil, corn oil, soybean oil, hydrogenated soybean oil with TBHQ and citric acid added to preserve freshness). Dimethylpolysiloxane added as an antifoaming agent.

Regular Bun: Enriched flour (bleached wheat flour, malted barley flour, niacin, reduced iron, thiamin mononitrate, riboflavin, folic acid, enzymes), water, high fructose corn syrup, sugar, yeast, soybean oil and/or partially hydrogenated soybean oil, contains 2% or less of the following: salt, calcium sulfate, calcium carbonate, wheat gluten, ammonium sulfate, ammonium chloride, dough conditioners (sodium stearoyl lactylate, datem, ascorbic acid, azodicarbonamide, mono- and diglycerides, ethoxylated monoglycerides, monocalcium phosphate, enzymes, guar gum, calcium peroxide, soy flour), calcium propionate and sodium propionate (preservatives), soy lecithin.

Mayonnaise Dressing: Water, soybean oil, distilled vinegar, maltodextrin, food starch-modified, enzyme modified egg yolk, salt, sugar, xanthan gum, mustard flour, potassium sorbate (preservative), lemon juice concentrate, polysorbate 80, natural flavor (animal source), calcium disodium EDTA to protect flavor, beta carotene (color).

All those ingredients for $.99? And you know they must be making some sort of profit. How can this be? And an even more important question: Why would you want any of that in your body or — even worse — your child’s body. (And, BTW, buying McDonald’s may not even be cheaper. At least that’s what another smart blogger found out when she figured out how much it costs to cook at home versus buying McDonald’s for a family of four. Scroll down past the yummy-sounding recipe if you click through…)

Anyway, digressing as always: I won’t stand here and condemn anyone for eating their McChicken sandwich because that’s all they could afford. (I will make a wish that some day soon everyone will be able to have access to healthy, fresh foods regardless of their income.) But for anyone who can afford to make a different choice I ask: Aren’t you and your health worth the extra couple of bucks?

This post is how I am participating this week in Real Food Wednesdays, an awesome campaign to get people thinking about and eating real food. Would love to hear about your lunch. What did you have? Was it worth the time and effort?

I can’t go into all the messy, nasty, painful details because he’s not going to love that I am writing about him in the first place. However, this has been a part of our lives for so long it had to make it to the blog.

This week he will go for an MRI so the doctor knows exactly what he’s dealing with. The operation is next week, we hope. I’m used to the drill by this point. He’ll go to the hospital in the morning. They will give him anesthesia. They will operate for an hour or so. He will spend an hour in recovery. Then I will take him home with a prescription for something that, if we sold them pill by pill, could probably pay for his entire surgery. The same pills that, once he takes them, will stop up his works so he has to take all sorts of laxatives and fiber to reverse the damage. The same pills that, after only taking them for a week the last time, gave him the jitters, kept him awake, and made him feel like crap because his body was already addicted to them. Thank goodness he lives in Organic Land, where his crazy wife tells him not to fall under the spell of the evil Western pharmaceutical companies. But I digress.

Since this process started six months ago, I’ve seen a lot of good, a lot of bad when it comes to modern medicine. The prices for one thing. The bill was the best part. The first operation cost $7,167. JUST for the hospital. NOT counting the doctor’s fees. It cost $992 for the 45 minutes he was in recovery! Except we have insurance, so after the insurance write-offs, the entire operation cost us $1,804. Only. And if we didn’t have that insurance? Take that operation and times it by four. Then add the other $2,500 per operation for the doctor. We’d owe almost $50,000. People, I know everyone is against healthcare reform, but there’s something wrong with that picture.

Back to the medicine. I’ve already covered the aftercare — pain killers that hook you in so quickly you can end up with another problem before you recover from what ails you. And the surgery? Eh. The anesthesia sort of sucks. The first time was fine. The second time they gave my husband too much medication and he was outright sick when he woke up. He was in recovery so long I started getting nervous and demanding to see the doctor. Ooops, we gave him too much, was the answer. Sorry. Or how about the operations? Three times was not a charm. Each time the operation that was supposed to work didn’t. Each time the doctor let my husband make the decision for the less invasive fix even though the more invasive one definitely would have worked the first go-around.

The doctor, all doctors, don’t really DO very much anymore except cut, which leads me to another  aspect of his care — everyone’s care, really — that really pisses me off: The treating the problem without looking at the big picture. Take my husband’s diet. Sure, he eats the organic stuff in our house. But he doesn’t eat any whole grains, no veggies, no dairy other than pizza cheese. No fruit other than orange juice. His food groups are beef (meat sauce), pizza, peanut butter and toast, and Joe’s Os. I am not exaggerating. After the first operation I told the doctor this, and asked if changing diet could help my husband heal. I was hoping he would tell my green-phobic husband to take better care of himself. The doctor didn’t want to give that advice, though. Sure, he said, he should eat good food, but he stopped short of telling my husband to take better care of himself. Just, “Here’s the pain medication. He’s going to need it.”

And that kind of half-assed care can be found all over America and the world. How about one  375-pound guy I know who keeps hurting his knees? His cure to date: surgery and physical therapy. No one has the guts to tell him that his knees wouldn’t get screwed up so much if he lost 200 pounds. Or the diabetic I know who can’t get her wounds to heal, but no one tells her to stop eating so much crap. Or the friend’s kid with ADHD who pounds caffeine and preservatives, watches tons of TV, and never goes to bed? Sure, he would benefit from an organic, all natural diet, and a 7 p.m. bedtime. But the doctors are too afraid to ask the parents to make such a difficult choice. Diet and lifestyle aren’t even on the table. Here, take some Ritalin. Yes, I know that healthy people who never smoke and eat raw foods often drop dead of a heart attack, stroke, cancer, or worse when they are still young. It happens. All the time, actually. But you can’t tell me that what we eat and how we live doesn’t have an affect on how we feel.

[The above language is judgmental and, although I believe doctors are not doing a good job of taking care of people rather than focusing on the problem at hand, I know my husband's problem is not because he won't eat his broccoli. I am just really upset that we are still dealing with this annoying, painful problem that is messing with all our heads.]

Getting back to my hubby: I yelled at him tonight as he was peanut buttering two slices of organic bread. After eating six English muffin pizzas. Where’s your fruits? Where’s your vegetables? He yelled back that he ate all the organic crap in the house, and he did eat healthy. Maybe he’s right. Maybe I’m wrong. At this point, I just want my husband to feel better. But when he does I’m hoping he’s willing to see a nutritionist. It can’t hurt, right?

My husband’s rebuttal: The doctor wanted to do the invasive surgery first. Your husband opted for the less invasive options first so he had less of a chance of PERMANENT INCONTINENCE at 36 years old. You are complaining about cutting but the other “surgeries” were to *avoid* cutting. They were surgical procedures to manipulate the area into healing on its own.

I don’t eat candy, I rarely drink soda, I don’t eat cakes or pastries or ice cream. I don’t eat anything with high fructose corn syrup in it, or hydrogenated oils. I don’t eat enough green vegetables. Oh well. I’m 6 feet tall and have spent almost my entire life under 180 pounds. My blood pressure is 120 over 80 and my bloodwork is always perfect. Clearly, my awful eating habits and unhealthy lifestyle are to blame. And of course my evil doctor with all his right-wing conservative “medical degrees” is the problem. Could never be that I just wound up with a difficult to treat condition out of bad luck.