A New American Phenomenon
I spent probably the first half of my life in one or the other state of acute fear. Due to a variety of circumstances, one of them asthma, I came to know the fear of imminent death. It was so visceral, so primordial and pre-verbal, it still defies description for me. I can fully understand why someone would do almost anything to make that feeling stop and to live his life as if death were someone else's problem.
But over the years, as I've gotten healthier, I've become less and less afraid. I don't believe that was just because of my improved physical state. There were at least a few times that I thought death was possible if not within proximity. On looking back, it seems to me that the process actually worked in reverse. I think I became healthier because I became less afraid. In particular, I became less afraid of death.
One reader, Synduatic, commented on one of my recent Huffington Post blogs on suffering. He implied that a good portion of our well-being stems from our ability to meet death. He paraphrased a few great thinkers who concluded that to avoid death was to avoid a free life:
A rich philosophical tradition, to which you gave passing reference, surrounds these ideas, too. Plato said that philosophy is a meditation on and a preparation for death; Seneca said that he or she who learns how to die unlearns slavery; and Montaigne said that to philosophize is to learn how to die.
I had to agree. He pointed to a deep fracture in the American psyche because there is no culture that shuns death (or suffering) the way ours does. And what we shun, we fear. And what we fear controls us.
This resistance is so pervasive, that death itself surprises us even though, as we can all agree, we've all been dying since time began. Tunnel-visioned this way, we behave illogically, as if with just one more pill or one more wave of research or one more face lift, we could somehow skip the last stop on the line. On his blog, a bemused Terry Roberts recalls one 90-year old woman who found out she was very ill and would soon be dying. Stunned, she said, "How could this happen to me? Just bad luck I guess."
Richard Heffner (on the PBS series, "The Open Mind") alluded to what may be one of the many reasons we resist death the way we do in the United States. Its very nature has changed over the last 40 or 50 years. Where at one time a stroke would have been the end point of a life, that point has become an interminably elongated line with a perpetually retreating horizon. Due to the entrenchment of chronic disease, he writes, the "possibilities for a gentle closure of life are often overwhelmed by uncontrolled physical pain, excessive financial burden, unresponsive care plans, and emotional isolation."
He goes on to underline that with the following:
"There has developed in contemporary culture a profound dread of death and the process of dying."
I'd like to take it a step further. My observation is that we don't just fear death, nor do we just ignore it by housing our dying in group homes or hospitals. Out of unprecedented decades of comfort in this country, we simply refuse it. It is the most systematic -- and systemic -- delusion in world history.
And if what Synduatic says is true -- that spiritual and physical health are built on an acceptance of our mortality -- then we are either forced to redefine health or remake ourselves in our own distorted images.
What Makes You Healthy? Not What We Think.
In that same post, which seemed to bring out the best and brightest readers and the most thoughtful comments, someone asked me what I meant by health. I had to stop and think about it. I had been using the word as it is used in common parlance and didn't really consider what I was saying more specifically.
And when it comes to my work, this is significant because the movement towards health is the goal of all that I do. How do I know when my patients are "done?" Is it because they say so? Because I say so? Because an insurance company says so?
Most people, if asked, would say simply that health is the absence of sickness. But that just begs the question and then we have not one but two undefined concepts, both health and sickness.
While I obviously can't speak for everyone, I believe there is an American Gestalt or cultural philosophy about health. And I also believe that this perspective is neither healthy nor accurate.
For one thing, the modern medical philosophe doesn't accept death at all. He works furiously against it. On at least one level, he defines health by the absence of death. I am not referring to health solely in the physical sense. Obviously once we're dead, health has no meaning in the way people normally use the word. Yet, that is where we are all going. Death is a part of who and what we are. Thus, the colloquial and accepted definition of health precludes us from being mortal. This may sound simplistic, but philosophically it makes all the difference in the world because it perpetuates a belief system that is a lie. Health, by definition if it is to be accurate, must somehow incorporate the idea of mortality.
Furthermore, it denies another even more important truth: that we are not just our bodies and real health does not stem from an HDL reading that is within "normal" parameters. It is much, much more than that.
For most moderns, health is what looks good. Clear skin, thin thighs, white teeth. Healthy has a growing family, works for a high salary, and never takes a day off. It doesn't get a cold. It doesn't need a lot of sleep. And it doesn't feel pain. Healthy never suffers, has endless energy and is in a state of constant productivity and unrestricted enjoyment.
So, what if I said, "Not necessarily?"
Health as Reality, Adaptability and Vitality
Most of what's involved in having those Hollywood healthy looks is the suppression of symptoms -- the wiping away of acne or rashes, the sucking out of body fat, the bleaching of teeth. Got a cough? Shut it down with a teaspoon of dextromethorphan or codeine. Got dyspepsia from eating poorly? Pound it down with a little Prilosec™. Very little thought is given to what erasing the symptoms without treating or changing the cause can do, but that's the way Western medicine has evolved. And that has affected the way we see ourselves --as potentially immortal if we stay symptom free.
Over the years, I have met an astonishing number of beautiful people who don't get colds, haven't had a fever since they were children, and are as sick as they can get. And I have met other people in the throes of incredibly uncomfortable acute disease who are far healthier than pharmaceutical companies would have them imagine. In truth, it takes quite a bit of vitality to produce a fever or an inflammatory response. An acute disease that is fought off is a sign of a healthy organism. The truly sick ones bypass that altogether and move into chronic disease which indurates, alters, and weakens at far more fundamental and dangerous levels.
Health is not solely a matter of being symptom-free. It is, in my eyes, more the byproduct of a spiritual state.
A choice one of my teachers put to us: "Who was healthier, Evel Knievel or Helen Keller?" A few people in class picked the motorcycle daredevil. After all, with the exception of some broken bones, wasn't he full of energy and adventure and had full use of his faculties? Wasn't Helen Keller blind and deaf from a terrible fever? How could that be healthy?
And he explained that even though her body was imperfect, her spiritual, emotional and mental state was a better example of true health and balance than the deliberate recklessness of Evel Knievel. Even with her deficiencies, she was more centered, more focused, more capable of being of service, more vital, more loving.
The best definition of health I have ever encountered is to be found in the Organon of the Medical Art by Samuel Hahnemann. According to Hahnemann, health is a spiritual, mental and physical amalgam. It begins with an accurate awareness of one's self as a spiritual being, the absence of delusions and fixations, an understanding of one's purpose in life, the vitality necessary to pursue that purpose (even if one is blind or limited to a wheelchair), the ability to adapt to change as it arises, and the willingness to give and receive love.
In his philosophy, to actively suppress acute disease is the beginning of all true chronic physical and mental illness. And that suppression unfortunately is all that our current medical protocol is based upon.
Health as Meeting Mortality Head On
I'm not looking for an early death. I don't want to suffer either. But I know that Synduatic is right. There is no way to avoid it. Not if we want to be truly healthy. And that is the paradoxical truth right at the heart of it: To be healthy, we must be able to die.
The more delusional we are, the more in denial about who and what we are; the more in denial, the sicker we are. It may manifest in our minds or our bodies, but manifest it will.
In the U.S. that denial manifests to a large extent as thrill seeking and addiction (gambling, alcohol, meth, danger, pornography). When I was still a graduate student, my supervisor told me, "All heedlessness is based in a fear of mortality. All addiction is a way of denying both the fear and death."
Damiano Iocovozzi, a fellow Huffington Post blogger, wrote in a comment to another post ("Modern Medicine:Healing or Stealing?"),
The great American medical business machine cranks onward with unhealthy advertisements offering every tonic & pill, inventing diagnoses that are pushed with the greatest solemnity. It feeds into the stigma most have on anything in decline or dying. Sometimes I think that in the USA death is optional!
So, in answer to that simple and incredibly difficult question: Health is not what we think it is. It is more. More than the end of a cold. More than a creature comfort. More than a pimple-free skin. It is balanced thinking and acceptance of reality, whether we like that reality or not.
Here's the truth for me: I don't like death any more than I did 25 years ago. I lament it every time. I can't watch a rabbit get chased by a dog without cringing. I am not complacent about suffering. It moves me to either help or to frustration if I can't. But I'm not afraid. And I don't turn my gaze. I look straight down the road, knowing where it leads and where we all must go. I have learned that I am not my body and that Love transcends all things; that the emphasis currently placed on how we look and what we have is the foundation not of good health but of illness in its most insidious form.
I'd like to close with this quote from Synduatic and my thanks:
Thus, at a basic level, your piece is about philosophy to the extent that suffering is a form of death. And as you may have gathered, philosophy, for me, has everything to do with death and various forms of death. We die when we give up certain dogmatic presuppositions. We die when we give up certain unarticulated assumptions. And when we give them up and turn them loose it's a form of death in order to be reborn, regenerated and reformed, so we can mature and develop as human beings. Philosophy has everything to do with learning how to die in order to live more critically, more compassionately, more sacrificially, so that in one's own death, your death (or suffering) becomes a weapon for truth, love and justice.