You only live once

[Inspired by a lovely little article here]

Something me and CW and Skeeno were chatting about over dinner a few weeks ago. What defines health? What is the state of health that we are aiming to acheive? Is there such a thing as ideal health?

Me and CW are fairly passionate about what we do, more so as time goes on it seems. Medics don’t often talk about this in work situations – at least that seems to be what I find. Most seem pretty focused either on the shift at hand or more depressingly their careers. It is not that often I chat to a doc about the fundamental aspects of what we do everyday. I do this more everyday. Maybe this just reflects how much I’m frustrated with my job. Who knows.

Anyhow. Back to definitions of health. This will naturally have cross over with a slightly larger question – what’s the definition and point of life itself? What are we aiming towards and why do we do any of it? This is a huge topic and I suppose I’d prefer to avoid the wider picture and focus on the health aspect.

Back in medical school we had all these nonsense lectures that I never went to that were titled “the man in society” (how did they git away with “man in society” in the early noughties, surely it shoul have been “the person in society” given how PC they were) which were largely about the sociology behind medicine. Despite either hating or missing or dismissing all those lectures as touchy feely nonsense I have to confess that in retrospect they were all true.

The concept of health is undeniably holistic. Which is of course a fashionable word. I tend to describe such concepts as making the remarkably obvious exceptionally complicated.

People are not so easily defined as pathologies. Doctors study and treat pathologies and occasionally we make some impact on those pathologies – though I would stress how occasional that is.

Patients have lives and relationships and desires and hopes and ambitions and fears despite their ejection fraction of 15% or their incipient renal failure.

I spent a good 5 minutes the other day encouraging an 80 year old to keep smoking. What’s it going to do? Kill him?

If you’re 80 and mobile and continent and conscious you’re doing pretty well. You’ll be dead within 10 years. Why stop what you do everyday and enjoy.

Any healthcare decision or intervention is a balance of pros and cons. Of you’re thirty with two young kids and a bad family history of heart attacks then I’d happily spend as much time as needed persuading you to stop smoking – presuming of course that you think seeing your kids grow up and develop as something that is vital to you. As a paternalistic and well educated medical professional I have decided that what you’ll miss and find hard about not smoking is nothing compared to the joy of bouncing your first grandchild on your knee.

Trust me I’m a doctor.

Health is more complicated than cholesterol levels and life expectancy. Our patients need and want us to advocate for their health. Maybe we should ask them what that means occasionally.

2 Responses to “You only live once”

  1. 1 anna January 23, 2009 at 3:29 pm

    I read somewhere that “maybe health, like beauty, is in the eye of the beholder and that a definition cannot capture its complexity”.

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January 2009

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