We all tend to associate the term ‘healthcare’ with medical care; we picture hospitals, doctors, sterility, drugs. However Google’s algorithms do it, we’re told that it refers to the ‘organised provision of medical care to an individual or community’. Look at this Google Trends time series, though, and it seems pretty clear that the term was probably invented as a euphemism by the wizards of PR.
But let’s zoom out for a moment and think about this again. Why should caring about our health only be associated with medicine, which largely involves fixing things that are broken? To the extent that health and well-being are synonyms, shouldn’t healthcare also include the set of activities pertaining to the maintenance of that well-being in the first place?
Greg Glassman, CEO and Founder of CrossFit Inc, makes the following ‘physicians-as-lifeguards’ analogy:
If I have a heart attack, I’d go to the emergency room and see a doctor; a CrossFit coach yelling at me to run faster is pretty much the last thing I need. That much is obvious.
But the point here is that I don’t want to have a heart attack. Sure, probability plays a major role, and I can’t completely control my odds of having one. But to make no attempts at doing so isn’t just stupid, it’s probabilistically suicidal. This is all the more obvious when we consider the immense aggregate costs inflicted by metabolic syndrome (whose ‘four horsemen’ refer to diabetes, obesity, coronary heart disease and hypertension) on well-being in the developed world: these are largely preventable costs.
That’s where the swim coach metaphor comes in. Here we’re talking about nutrition (my working hypothesis: no sugar, no wheat). We’re talking about fitness (my working hypothesis: CrossFit). We’re talking about psychological health (my working hypothesis: stoicism).
We can go one step further here. Psychologists – in my opinion, particularly Viktor Frankl – have generally managed to shed light on what makes a life worth living: meaning. If health and well-being were means to an end, that’s probably it: to fulfil the meaning of one’s life, whatever one chooses that to be.
Healthcare professionals, then, probably have an expanded responsibility. In his latest book Being Mortal: Medicine and what matters in the end, my favorite author Atul Gawande puts it best (emphasis mine):
“We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?”
