Nathan Daley, MD, MPH
Here’s your disease
Every person alive today will likely receive one or more of the 68,000 possible diagnoses available in modern medicine. Worse yet, most of these diagnoses will have been preceded by years or decades of troubling symptoms like fatigue, pain, cognitive impairment, depression, excess body fat, gastrointestinal discomfort, and general discontent and dissatisfaction with one’s quality of life. Perhaps most upsetting is that the healthcare system does little to prevent these conditions despite the fact that most of them are, in fact, preventable. This is why many very forward thinkers have promoted the expansion and advancement of clinical preventive medicine.
Prevention is impossible
Preventive medicine simply refers to the application of medical science to prevent disease. The term is familiar to many, but the clinical manifestation of this specialty is rarely encountered. Part of the reason preventive medicine hardly exists, is because medical science and medicine are disease-oriented. That is, action cannot be taken until diseases are defined, diagnostic criteria established, and a diagnosis given. Disease diagnoses are determined relative to the population at large and require differentiating criteria, meaning that a diagnosis must be abnormal. Yet, just about everyone on the planet lives in a dysfunctional yet subclinical condition with a trajectory toward disease and away from optimal health. The precursors to disease are ubiquitous in the population and, therefore, are actually normal. Disease-oriented medicine fails to prevent disease because these preclinical or subclinical forms of the disease process are not recognized. They are not included in the 68,000 diagnoses available. Obviously medicine cannot prevent disease if disease is required prior to medical action. Preventive medicine is impossible within the current paradigm of disease-oriented medicine. Therefore, true preventive medicine requires a health-oriented approach rather than a disease-oriented approach.
Health is happiness
Positive health is the ultimate disease prevention. More importantly, health is the primary source of happiness, vitality, and peace in life. Preventing a specific disease simply means that the disease will not occur. Suffering and discontent may remain in the absence of a disease, and possibly as the result of disease specific prevention itself. Achieving health, on the other hand, requires the absence of disease and the presence of contentment, satisfaction, and happiness. True health is a condition of being optimally alive in the world, with maximal resilience and efficacy. True health is the condition which all living things strive for, including human beings. In fact, many of the 68,000 diseases, paradoxically, result from a dysfunctional pursuit of health.
Health verses wealth
The pursuit of wealth is actually the indirect pursuit of health. Wealth is buying power and enhances the freedom of choice in a commoditized world. The value of wealth, for most people, is security and the potential to buy and choose things that bring happiness, contentment, and satisfaction. The western culture favors material items as the source of these positive conditions. However, studies have repeatedly shown that material possessions provide these positive conditions for only a short time. Stimulating and meaningful experiences, on the other hand, tend to produce long lasting experiences of happiness, contentment, and satisfaction. This is especially true when the experiences are shared with friends and family. Such long lasting positive experiences can be had anywhere in the world. The only requirements are that one is able to fully engage, mentally and physically, in the moment, ingest the sensuous content, reciprocate or participate, and remember the experience. Happiness and contentment from full mental and physical engagement with the world is one possible definition of health.
It is not uncommon to knowingly sacrifice health for wealth, with the plan to exchange wealth for health at a later date. However, this plan almost always backfires. Health needs to be pursued in parallel to wealth, the pursuit of wealth should be compatible with health, and wealth must be exchanged wisely in order to actually contribute to health. The two most powerful means of exchanging wealth for health are 1.) to “buy” meaningful and engaging experiences and 2.) to “buy” resources that facilitate the direct pursuit of health. Such resources may include healthy food, a healthy home, a healthy community, a healthy environment, and active hobbies. “Buying” the resource of time, in the form of working less or saying “no” to excessive obligations, also translates to greater health and happiness and should not be overlooked. Essentially, one needs to “buy” a healthy way of life. Fortunately, a healthy way of life is not only more fulfilling, but often less expensive than an unhealthy way of life!
Health is a truly complex entity and the pursuit of this universal desire is dynamic and multi-faceted. In a culture which does not teach nor encourage the direct pursuit of health, trying to define and establish a healthy way of life can be overwhelming and confusing. Health-oriented medical care is intended to eliminate this confusion and help each individual fully access the many capacities of health. Unlike disease-oriented medicine, health-oriented medicine is a medicine for every day and every person. It is still about healing, but it is also about making good days, good times, and good health even better, and then keeping it that way. Health-oriented medicine is the general term for any approach to directly improving or assessing positive health, without the need to refer to disease states or negative dysfunctional states. A great deal of terminology and definitions are needed before this field can be considered well developed. A functional definition of positive health is the first step and part of the effort of EcoHolos.org. Ecological medicine as defined on this website can be considered a discipline within health-oriented medicine. An ecological approach to health offers a truly holistic, dynamic, and individualized approach to health that utilizes modern scientific paradigms yet finds congruence with ancient and indigenous health paradigms. Therefore, I believe the EcoHolos version of ecological medicine offers the best foundation for a clinical health-oriented medicine.