Harrison Middleton University

Investigating Health

Investigating Health

We’re excited that you’ve joined the conversation! At HMU, we want to continue the great authors’ conversations in a contemporary context, and this blog will help us do that. We look back to Aristotle and the early philosophers who used reason and discourse to gain wisdom and now we endeavor to do the same every day.

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April 19, 2024

Thanks to Alissa Simon, HMU Tutor, for today’s post.

“You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.” – Paul Kalanithi

Last week, I attended an online conference hosted by The Atlantic. The “Health Summit” promoted discussions of: “the future of scaling innovation, sustainable solutions to improve patient care, and the complexity and opportunity in this revolutionary moment in health care.” They did not disappoint. Specialists discussed future technologies, increasing longevity, and the many ways in which technology enables better patient care. This issue could never be covered in a single day, let alone a single event. It was interesting to hear from professionals incorporating cutting edge technologies like CRISPR-based therapies.

While these offer wonderful potential, and the focus on sustainable and ethical patient care should always be at the forefront of the discussion, I was also hoping to hear more about the nature of health itself. I would like to have a global conversation about what it means to be healthy. When does one feel health return after an illness, for example? At what point in our lives do we say, I am healthy? Do minor aches and pains disrupt feelings of health? We often stigmatize those with disabilities, as if there is a written standard or normalcy somewhere. For example, we prioritize color when we say colorblind, or we prioritize hearing when we say hearing-impaired. So, do those with impairments lack a sense of health that others do not?

I feel like these broader conversations need to happen in conjunction with the introduction of exciting new technologies. For example, one presenter during the conference touted the desire to have humans live an extra ten to fifteen years. He made it sound enticing and desirable, dangling the extra years as if an apple. But I wonder what those years would look like? If we are home-bound, hospital-bound, device-bound, would we want to prolong life? Maybe yes. It’s an important point that wasn’t addressed. I do realize that people are likely to ask these questions in private. In fact, it’s likely that we have all faced these questions in terms of parenting or aging, but have we faced them societally? If I asked how our society views a healthy lifestyle, could anyone offer a succinct answer?

Perhaps we don’t openly discuss these questions because they are, in the end, very personal. Yet, society’s movement towards technological aids often runs counter to the uniqueness of each being, to the practical, personal, spiritual, and healthy.

I happened to attend this conference after completing Paul Kalanithi’s book When Breath Becomes Air. While struggling with an aggressive cancer, Kalanithi, a neurosurgeon resident, wrote a memoir. The book is astonishing as it moves from a doctor’s perspective into a patient’s. As a doctor, he felt pressure, stress, exhaustion. He lost patients. He saw suffering. But as he notes, being the doctor is very different than being the patient. He states that as his sickness progressed, he found himself drawn once again to literature and scripture. Fiction and art helped him through tough periods. He sought ideas and insights that he hadn’t yet found in the medical world.

He writes:

“The tricky part of illness is that, as you go through it, your values are constantly changing. You try to figure out what matters to you, and then you keep figuring it out. It felt like someone had taken away my credit card and I was having to learn how to budget. You may decide you want to spend your time working as a neurosurgeon, but two months later, you may feel differently. Two months after that, you may want to learn to play the saxophone or devote yourself to the church. Death may be a one-time event, but living with terminal illness is a process.

“It struck me that I had traversed the five stages of grief – the ‘Denial – Anger – Bargaining – Depression – Acceptance’ cliché – but had done it all backward. On diagnosis, I’d been prepared for death. I’d even felt good about it. I’d accepted it. I’d been ready. Then I slumped into a depression, as it became clear that I might not be dying so soon after all, which is, of course, good news, but also confusing and strangely enervating. The rapidity of the cancer science, and the nature of statistics, meant I might live another twelve months, or another 120. Grand illnesses are supposed to be life-clarifying. Instead, I knew I was going to die – but I’d known that before. My state of knowledge was the same, but my ability to make lunch plans had been shot to hell. The way forward would seem obvious, if only I knew how many months or years I had left. Tell me three months, I’d spend time with family. Tell me one year, I’d write a book. Give me ten years, I’d get back to treating diseases. The truth that you live one day at a time didn’t help: What was I supposed to do with that day?

“At some point, then, I began to do a little bargaining – or not exactly bargaining. More like: ‘God, I have read Job, and I don’t understand it, but if this is a test of faith, you now realize my faith is fairly weak, and probably leaving the spicy mustard off the pastrami sandwich would have also tested it? You didn’t have to go nuclear on me, you know…’ Then, after the bargaining, came flashes of anger: ‘I work my whole life to get to this point, and then you give me cancer?’

“And now, finally, maybe I had arrived at denial. Maybe total denial. Maybe, in the absence of any certainty, we should just assume that we’re going to live a long time. Maybe that’s the only way forward.”

Kalanithi’s book describes the painful struggle of a patient and a disease. In it, he digresses into family history, literature, anecdote, and unanswered questions. I found it very interesting that, despite the access to medical professionals, therapists, and others, he returned to literature as a way to find direction, solace, and help. In my mind, big questions such as “What does it mean to be healthy?” are often relegated to the literary world alone, but I would really like to see them paired with the scientific discussions as well. Perhaps they are too unwieldy for public discussion, but I still have hope of a conference in which science and literature will sit side by side for those difficult discussions.

I must also say that I did truly enjoy The Atlantic’s “Health Summit.” This topic has been on my mind for some time, and the combination of the conference and Kalanithi’s book struck me as particularly relevant.

Photo credit: Shutterstock/ REDPIXEL.PL

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