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Feb 13, 2016

Health-What is it anyway?

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By Dr. B. M. Hegde, India [ Published Date: December 4, 2009 ]

Politics and the English Language is a fascinating paper that George Orwell wrote in 1946 to show how politics could be twisted and sold as a palatable game to the gullible public by the cunning writers of those days. They used many Greek and Latin words in their writings to hide the truth. Orwell gives several examples but, the most glaring one is that of Professor Harold Laski, whose writings take the cake. The same holds good in our present era in the area of health and illness, what with all the political maneuverings to sell the distorted version of medical care in the name of science, using Latin and Greek! Health care is equated with "quick -fix" medical care and the two are used interchangeably.

Modern medicine does what politics did in 1946 (does even now) but with more dangerous fall outs. We, in medicine, use Greek and Latin in plenty to confuse the issue and create panic among the healthy segment of society, named disease mongering in recent times. Using language confusions as our primary tool we have succeeded in medicalising the whole population in the literate world. Lucky are those that are illiterate and can't access these health scare system's scary tidings. But the electronic media is their curse. Medical care today is a big money spinner with greedy sharks, both in the profession and the industry, having sold their heart to the devil to make big money at any cost. Medical science is not a hard science like physics or chemistry but is only a statistical science.

Statistical jargons are conveniently abused to make the medical care system's quick fixes sound equal to great health givers and life savers. We also predict the unpredictable future of the human race using statistics just like the astrologers do with their predictions of the future of their gullible believers. There is one distinction, though. Unlike medicine, astrology is a science but, predictions by astrologers, per force, go wrong as all future predictions, even in hard sciences like physics do. A good example is the butter fly effect in weather predictions.  Since we do not have a scientific definition of normality in medicine, we use statistics to convert every healthy human being, who comes for a routine check up, into a patient. The screening industry is our best money spinner! Our rice-bowl is the whole of humanity!

I think it is time to demystify the definition of a normal healthy person. What IS health? Health is not just the absence of physical or mental illnesses. The World Health Organisation's definition of "complete physical, psychological, and social wellbeing," seems to be a state reached only at the moment of mutual orgasm as joked by Peter Skrabanek. It's a "ludicrous definition that would leave most of us unhealthy most of the time" writes Richard Smith in one of his recent editorials in the new Journal of the Science of Healing Outcomes. Richard was the editor of British Medical Journal for a quarter century and, at present, he is the editor of the Cases Journal in London. He goes on:

"I think I'm healthy, but am I right? I'm tubby. My hair is white and thin and gone altogether from some parts of my head. I'm short sighted and astigmatic. My Achilles tendon aches at times, and when I get out of bed in the morning I hobble. I haven't had my blood pressure measured for a while; nor my blood lipids. My prostate is, I suspect, large, but I haven't had it examined. Nor have I had my prostate specific antigen measured. And my bowel has not been sigmoidoscoped. My genes have not been examined, but I suspect something dreadful lurks there. My mother is dementing as her mother did before her. I often can't remember names. I don't smoke, but I drink more alcohol than the Royal College of Physicians thinks wise-and I'm rather too fond of pies. I walk a lot, cycle often, and run occasionally, but I don't exercise as much as I should. So as I complete this paragraph I'm convinced that I can't be healthy: I'm a mass of imperfections, and I've not bothered to discover the hypertension or latent cancer that may be about to carry me off.

But what is health? For most doctors that's an uninteresting question. Doctors are interested in disease not health. Medical textbooks are a massive catalogue of diseases. There are thousands of ways for the body and mind to go wrong, which is why disease is so interesting. We've put huge energy into classifying disease, and even psychiatrists have identified over 4000 ways in which our minds may malfunction. Health for doctors is a negative state—the absence of disease. In fact, health is an illusion. If you let doctors get to work with their genetic analysis, blood tests, and advanced imaging techniques then everybody will be found to be defective—"dis-eased."

"The time has come," wrote Mary Tinetti and Terri Freid in a recent publication in the American Medical Journal, "to abandon disease as the focus of medical care. The changed spectrum of health, the complex interplay of biological and non-biological factors, the aging population, and the inter-individual variability in health priorities render medical care that is centred on the diagnosis and treatment of individual diseases at best out of date and at worst harmful. A primary focus on disease may inadvertently lead to under treatment, overtreatment, or mistreatment." So I'm not happy with health being defined as the absence of disease. Nor am I keen on the World Health Organisation's definition of "complete physical, psychological, and social wellbeing," a state reached only at the moment of mutual orgasm, as joked by Peter Skrabanek. It's a ludicrous definition that would leave most of us unhealthy most of the time."

Health, therefore, is the capacity and enthusiasm to work and love! Even a person like Stephen Hawking, a Cambridge physicist, who can not even raise his little finger due to a serious physical illness, has been working  very hard for over forty years after the diagnosis of a serious disease, in his specialty of theoretical physics and science fiction writing! Work is that which keeps one healthy. One of the ways to keep old age at bay is to keep on working as long as one can: not stopping to work after retiring from one's profession to sit around and waste time! Work has killed no one so far; laziness has. Health was defined as the capacity to "work and love" by Sigmund Freud first but later people like Leo Tolstoy and many others had stressed the need to keep working and loving till the end. Love, in this context, does not mean the passionate love that one associates with the younger generation. We are talking of the companionate love that binds people together for very long times like the love of the parent for the child, the love of humanity by the philanthropes, and the love of wisdom by thinkers.

Whereas passionate love has an initial high only to taper off very fast, companionate love does never rise to the original high but gets slow rise gradually with steady sustenance for decades, nay almost lifelong. We shall discuss the differences at a later date. For now we should be content to know that companionate love has been shown scientifically to be not only uplifting and satisfying but also capable of being an immune booster. Therefore, while love gives work good company, the former, in addition, tries to keep people healthy. As a bonus universal love is healthy for the society as well. Let us love and work to attain the ideal state of well being to avoid diseases and disability as long possible. As George Bernard Shaw rightly pointed out in his great play Doctors' Dilemma one should never try to live here for ever as one would not succeed. Health is a state of well being which gives the owner the capacity to work and love. One must remember that all our ranting on health and disease does not apply to those that do not know where their next meal comes from! For them health is food with capacity and opportunity to work and love. As of now the poor have none of the above health boosters. The poor, thus, pay for their poverty with their lives!

Dr. B. M. Hegde MD, FRCP, FRCPE, FRCPG, FRCPI, FACC, FAMS, is editor-in-chief of The Journal of the Science of Healing Outcomes; chairman, State Health Society’s Expert Committee, Govt. of Bihar, India, Visiting Prof. Cardiology at The Middlesex Hospital Medical School - University of London, Affiliate Prof. of Human Health - Northern Colorado University, Visiting Prof. Indian Institute of Advanced Studies - Shimla,  Retd.  Vice Chancellor, MAHE University - Manipal. Prof Hedge regularly gives talks on AIR, Doordarshan, BBC and Zee TV, London. 

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A.S.Mathew, USA :
Dr. Hegde, you have said it candidly that the modern medical profession has turned as a lucrative profession to get rich faster.

If we visit Doctors, they will create more questions in our mind and create a new spirit of "hypochondria" and we will end up visiting the Doctor almost every month. We spend more money with each visit and the Doctors get rich on the other hand.

The medical profession has lost its calling and purpose. For a simple cold and fever, they will order a battery of tests and bleed the patient's pocket. Still there are a few very dedicated Doctors keeping the real mission of the medical profession.
BM Hegde, India :
How I wish I could do that!
You are probably not aware of the Permit Raj in India.

Only the Government could do any such thing and who am I in that setting?
USMLE is another one of those fact finding tests. The only advantage is that it is transparent, whereas examinations in India are so many and their standards and their authenticity is questionable.
Maya Cassis, India :
Dear Doctor B.M. Hegde, why can't you introduce USMLE like transparent exams for post graduates in India?
Doesn't our country need doctors who are proficient in what they do? A handful of doctors can't save our country, we need the whole force that's migrating and looking for better prospects in UK, US. DO something about it.
Shridhara Achar Bangalore, India :
Our beloved doctor, Dr. B.M. Hegde has come out with one more brilliant, illuminating write up about health. He has rightly punned as `health (s)care'. Yes, people are not told about heath care but about health scare!

You go to hospital for a complaint of ordinary stomach-ache. The so called specialist doctor will recommend a series of scanning, blood test, urine test and what not. If you ask the doctor why so many test and scanning, he will say just to rule out possible, this desease and that desease!

There were, I think even today there are, Vaidyas who by pulse diagnosis will say what exactly is the ailment. So one should know how to prevent desease by immune-booster. That is what Dr. Hegde has been insisting.
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