Health is a Continuum

At what point does a person decide to go to the doctor? Other than emergency situations, the doctor might ask you: “Why come to see me now?” Consider this – a person truly carries out the first assessment of their illness by thinking: “I should go to the doctor because…(fill in the blank).” It is at this point that the person becomes a patient. But when do they go back to being a person again?

The mind plays a major role in making decisions about the condition of the body. Our society also shapes the boundary between health and illness. For example, would someone living in a remote area of a third-world country go to a doctor for a backache? It is unlikely. Yet, in America 90 % of the population will report back pain at some point with backaches causing more visits to the doctors – and absences from work and school – than any other illness  (http://my.clevelandclinic.org/health/transcripts/1487_chronic-back-pain). Thus, the third-world person remains in their normal state of health with a backache, and the American is classified as having an illness.
            Where is the line drawn between illness and health? There are several definitions of health. The World Health Organization’s definition of health is: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease.”  Health is also viewed as a continuum: Think of a scale that reflects a person’s condition and a person moves along from a state of well-being (good health), normal health, fair health, poor health, extremely poor health, and eventually to death. So our health fluctuates along this scale, and we make adaptations in order to maintain our well-being. It is subjective and influenced by many factors: our culture, our upbringing, our environment, what we have been taught, our experiences, etc. We also know that stress is related to illness. Studies demonstrate that a person is more likely to develop a disease after a stressful event.
            When does disease become illness?  Doctors often define diseases by category, with origins being related to microbes, hormonal deficiencies, body parts, etc. But for patients, a disease becomes an illness when it intrudes into the patient’s life as a disruption, disintegration, etc. Autopsies have been done with discoveries of unknown cancers that should have rendered people very ill, and yet when they were alive they “felt healthy.” Another interesting area of study is the fact that “the name of a disease ” can change the status of a person’s health. His/her status may change from normal health to poor health by just “hearing the diagnosis” (Kaptchuk, T. & Croucher, M. The Healing Arts ). For example, a person who is diagnosed with osteoarthritis may start experiencing pain and feel the need for pain medication. They might have been in a normal state of health up until being diagnosed; but once they heard the diagnosis, they felt ill. Thus, the mind-body connection is very influential to our state of health. Going back to the definition of health, it is really very much a sliding scale – we shift along the scale experiencing the varying degrees of healthiness to unhealthiness.
            Once discoveries are made about various illnesses, what are people willing to do to get healthy again? How far do we go health testing? Some questions to ask yourself: 
            1. Are the test results definitive?
            2. Can anything be done with knowing the results?
            3. What will I do differently knowing the results?
            4. Am I willing to change my lifestyle in order to deal with the condition?
            5. What impact will this information have on my quality of life or longevity?
For example, if a test result will indicate that you need to change your diet and you have no intention on changing it, why get the test done? Or if you know you will only need PT for your injury and there is no indication for surgery, why have that MRI done?
            In the treatment of our health in the Western world, we predominantly turn to our expert healer: the doctor. Many people want the “magic bullet” to resolve their illness and are unwilling to change their lifestyle or take the time to utilize various healing modalities. They want the passive, fast or the “easy” way out: surgery, medications, and the acclaimed quick fixes. Sometimes a condition can be easily resolved in this manner. But our bodies are not lawnmowers that can be handed over for repairs. Our health care and treatment approaches require our participation and responsibility.
            Many people live with chronic conditions, which necessitate patient management. The benefits of other healing systems (often called alternative) can very much complement Western medicine. It is called Complementary Medicine. It has become more commonplace and is covered by insurance; e.g., massage therapy, nutrition counseling, physical training, chiropractic work, acupuncture, use of supplements and vitamins, biofeedback, hypnotherapy, or homeopathic medicine. So, medical care is evolving as the health conditions and culture changes. With these new approaches, we see the value of the “art” of medicine as well as the “science” of medicine. The person who knows your body best is you! Learn to participate in the management of your illness, and keep trying to shift your mind-set toward the well-being side of the health continuum. You just might spend less time feeling ill.