Verandah Musings 7: How are you janitor?

Last week, we saw the immediate answers to "who are you" in introductory conversational exchanges. The second part of the greeting is often "how are you?" In response the typical answer is "I'm well. Hope you are [well too]." It's interesting that in our customary introduction of ourselves there is an exchange of names, trades and now the enquiry into wellness. Is this the basic need (wellness) in its totality for humans; so much so that it is the mutual enquiry and wish in the very first meeting between two human beings. Turns out that this was not the case historically speaking : "Joy", "Prosperity", were some of the introductory wishes in the past.

Wellness:

In an attempt to get the big picture and stretch the pedagogy in my pediatric practice, I often ask my students what exactly our clients are paying us for in the long run and one that could be applicable across the spectrum of illness and prevention. If our product were to be packaged in a brown box what would it contain? The various answers get jotted down on the white board, sliced and diced with dynamic discussions and inevitably we come to a conclusion that it would be "good health" or "wellness/well-being", be it treatment of illness, it's prevention or screens. And of course the natural question that follows is " what is good health"? One can almost hear the swishing and lashing of the dendrites of the neurons that were tickled and excited by this auditory probe. Imagine, in slow motion, the neuronal cells communicating to each other—I'd add in a strained glee of the student's mind— as they search their data in their memory files much like a "google search" for previous experiences, allusions, connections, deductions, references and finally come to an understanding about wellness. This has caught the eyes of many health care pundits and serves as a worthwhile chase in the form of metrics to confer "wellness" to the individual. The radars of many cutting edge institutions have zeroed in on this and have developed "centers of wellness or wellbeing."

Interestingly, historically speaking (in 1948), the WHO (World Health Organization) which monitors disease spread among the 8 billion known inhabitants on our planet earth, has grappled with this and came up with a definition: "good health is a state of complete physical, mental, and social well-being, rather than just the absence of disease."

Since then several high-profile institutions have wrestled with getting their arms around what wellness is and have attempted to do justice to the definition. Harvard center has added more dimensions on wellness: physical, intellectual, emotional, social, spiritual, vocational, financial, and environmental. Princeton states that wellness is not merely the absence of illness or distress; it is a lifelong process of making decisions to live a more balanced and meaningful life. Stanford describes it as the integration of positive feelings, meaningful?doing, and sustainable connecting.? Well-being is?about flourishing in multiple domains of living, not merely the absence of disease or?infirmity. A Stanford community vision for well-being focuses on what we all need, both as?individuals and communities, to function, feel, and be well.

The following dimensions of "wellbeing" or "good health" are not watertight separate compartments; but are like eccentric interlocked rings influencing each other.

Physical health:

We are all very familiar with this dimension seen now particularly with the New Year resolutions, hitting the gym at the crack of dawn and/or enrolling in exercise classes. BMI (body mass index), lab indices like triglycerides (fat content), cholesterol, A1 C (measure of the sugar control in last 3 months) liver and kidney functions are metrics measured and tracked in the physical health domain.

Mental health:

Well known are examples of where the body sculpting is phenomenal, but the mind, not so. This has sprung to the forefront of late, for a myriad of reasons; mainly attributed to the recognition and acceptance of this affection as an illness (much like a broken bone for example) but in the mind. Considerable mitigation of the stigmata that cloaked it, has also helped. Mental health is projected to override the physical illness in the future. Most of us can relate to affected ones in our families and friendship circles. The resources (practitioners) available, although increasing, are substantially lagging behind the needs. This dimension of health is also very complex as we can't see it with our eyes nor touch it with our hands; yet can be so painful and debilitating. COVID only added fuel to the fire. Emotional health could also come under this section. Recognizing and befriending our emotions as well as learning to understand/handle them well, is a skill and strength that would place us in a much better place - at home and in the marketplace.

Social Health:

"No man is an island" as it has been said. Loneliness/isolation has been declared a public health emergency in our country especially in the elderly and the young by the outgoing US surgeon general Dr Vivek Murthy. Studies have indicated that the prime factor facilitating longevity (overriding the flu and pneumonia shots) is "connectivity." Meaningful connectivity is not the hundreds and thousands of followers on social media; but a friendly open relationship with one or two, with whom we can hang out with, hash out situations and have an open conversation. Of these, the janitor has quite a few.

Spiritual health:

Almost all—if not all—of us see ourselves seeking answers to the larger than oneself questions. Questions such as: "Why am I here?", "What is the meaning of my life?", "Is there a purpose to it...what is mine?", "What happens when I die, (as all of us will) one day?", "Do you believe in God?", "Are there spiritual disciplines that we ought to be practicing similar to walking/running for physical health?" (more on this, to follow)

Financial health:

Some centers have included this as a separate dimension. Financial adequacy to meet the ongoing needs would be one way of describing it. It has been said that "the richest man/woman is the one who needs no more." Financial wellness (how much is enough?) has been the bone of contention for many, from time immemorial. Yet, we leave all of it when we bid goodbye to planet earth. Richness in the spiritual attributes affords a whole lot of abundance to life and living, this [richness] has often been wrongly attributed to other things. Often the janitor is rich.

Intellectual health/vocational health:

This dimension has also been included in some and includes affording fruitfulness and fulfillment to one's gifts, talents and skills (for the greater good as the janitor sees it). I'm glad that an intellectual spectrum with differential abilities has been included with the inclusion of the term vocation. Advanced societies facilitate the integration of individuals with differential abilities, be they children or adults and am glad to see this happening in my company (Novant Health) and in the country I love - the US of A.

Warmly

Cecil Thoppil

P.S. The above article was written without any AI help.