When Disease is Bigger Than a Body

I had a crew from Good Morning America in my home yesterday morning to film an interview about the documentary, What the Health. Along with everyone else, I wait to see what sound bites survive from roughly an hour of detailed commentary. In case you are wondering, the gist of my impressions, of the film’s mission and methods, is that the former is admirable, the latter quite questionable. We can leave it there, both because the GMA producers will do the rest, and because at present – I really have another matter on my mind.

I am routinely chastised in my various social media channels for posting political content or commentary, something I concede I am not overly inclined to do in the first place. I am, after all, a health expert, not a political scientist- and that is by choice.

On the other hand, I was an American before a doctor, a human before that. I have a perfectly robust riposte to those disapproving Facebook “friends,” admonishing connections on LinkedIN, and dissenting fellow tweeters: what, exactly, do you think health is FOR?

One of the great and common mistakes in medicine is to adopt the view that health is a virtue, implying that ill health is a vice. I have seen far too many bad medical things happen to the best of people to sanction any such nonsense. There is no place in genuine care for an admonishing wag of the finger.  Everyone prefers good health to bad; failing to get there is an injury to which the insulting burden of victim blaming need not be appended.

A related mistake is to think or imply that health, per se, is the prize. Perhaps- goes this argument- health is not a virtue, but the laurels claimed by those with the right combination of pluck and luck. This, too, is misguided. I know many people who have dodged innumerable slings and arrows of outrageous medical misfortune to live lives of deep meaning and happiness that have enriched all around them. I admire these people greatly. We all know people who put perfectly intact health to less replete purpose.

Health is neither virtue, nor prize; it is means to an end. Other things being equal, good health makes it far easier to do the things you like to do, whatever those may be. Other things being equal, healthy people have more fun.

Health is the means; quality of living is the ends.

And, so, personal health and the politics of our time are inextricably conjoined. Public health and public policy are ineluctably linked. Political poison that assaults our senses and sensibilities, policies that degrade our environments, positions that undermine civility, and proclamations that menace the essence of humanism itself- are one step worse than bad for health; they are directly injurious to what health is…for.

I not only refute the contention that abstinence from political commentary is the rightful place of health professionals; I repudiate it. Health and what it’s for are the inevitable consequence or casualty of politics and policy. The rightful place of health professionals is to renounce the complicity of silence when evil assaults the very thing we have pledged ourselves to protect.

I am not interested in a career change to political science. I prefer topics decisively in my native professional purview to those connected along troubling tangents. But I renounce the irrelevance of those tangents. They are the very lines conscience follows to find the connections between pernicious politics and maladies of bodies, and the body politic alike. Sometimes, disease is simply too big to fit within the skin of only one of us.

Where the deeply disturbing erosion of our civics commingles with rising reliance on antidepressants and rampant use of opioids- silence in defense of health and the higher aims it serves will invite every manner of illness to prevail. To the critics of every alternative to such silence, my answer is: what the health, indeed.

-fin

David L. Katz

Director, Yale University Prevention Research Center; Griffin Hospital

Immediate Past-President, American College of Lifestyle Medicine

Senior Medical Advisor, Verywell.com

Founder, The True Health Initiative

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