Breaking Bad: Healthcare can be simpler if we want it to be
Running up the stairs of my engineering college in Manipal one day, my head started spinning and I had this intense urge to throw up. A few days later a family physician diagnosed me for hypertension and promptly put me on a beta blocker after ruling out secondary causes. I continued popping that pill day after day and year after year. I trusted the diagnosis without a second thought.
That was 20 years ago. Over the years, my life slowly moved from sedentary to active and from stressful to mindful. Meditation and trekking in the mountains unexpectedly made me more curious about the capacity of my mind and body. My work and interests took me through several medical explorations – from top hospitals in Manhattan to Buddhist monasteries in the Himalayas to upscale medical centers in the Middle East to rural clinics in South Africa to Chinese hospitals in Laos. I tinkered with the future of medicine through programs at Singularity University and MIT. In the end, I wondered what exactly it meant for someone to be healthy.
A couple of months back, I met a well-regarded cardiologist in his late 70s to discuss both my medical condition and explorations. He exhibited the wisdom that comes with vast medical experience – of listening intently to the patient with an alert mind. He skillfully and methodically examined my principal organs and the suppleness of my veins. Finally, almost as a peculiar climax to my story, he said I may never have had hypertension. He went on to suggest that we must be careful in applying reductionist ideas to the ever-changing chaos of the human body.
I’ve observed our healthcare systems at work on the inside as an entrepreneur and on the outside as a patient. I’ve tried to separate chaff from the grain. Here are a few things I learnt.
1. The disease-target-pill paradigm is changing.
Over the last 50 years, our obsession with medications has ballooned out of proportion. According to Siddhartha Mukherjee (author of The Emperor of All Maladies: A Biography of Cancer), our current way of medical treatment of have disease, take pill, kill something needs to be re-imagined. Of over 1 million chemical reactions in our body, only 250 can be targeted by our entire pharmacopeia. We need to address the sources of ill-health rather than finding band-aids to diseases.
2. You are much more than your own genes.
Micro-organisms outnumber human cells 10 to 1, each carrying its own DNA. Just our gut has 100 trillion ‘bugs’ that we know too little about – we just know they can influence conditions from obesity to depression. What’s more, Rob Knight, the Director of the Microbiome Initiative at UCSD says each of us has our own microbiome fingerprint making us even more unique. I suspect that this microbiome marker is a moving target changing with environment and time. We may be able to influence it more than being able to catch it.
3. The space around you influences your health.
From air to food to habits to stress to sleep to exercise, the spaces we live/work in are hugely responsible for our health outcomes. Playing for half an hour in the sun makes us more alive than coffee ever would. People we associate with play a big role in our health behaviors (and vice-versa). Where our food comes from, how and when it’s consumed is almost as important as what we consume.
4. The body is within the mind, not the other way round.
Unlike the brain which we can reach more directly ( see this creepy demo of taking away someone’s free will and controlling their arm using a DIY kit ), the mind seems to be beyond any tangible reach. Unless of course, we use breath and mindfulness practices to center our faculty of consciousness, which in turn impacts our entire physical body.
5. Health inheritance is something that we pass on.
For a simple check on your risk factors, list the conditions of your parents, grandparents, uncles, aunts and siblings. This is our health inheritance. We don’t easily recognize that we add to this inheritance and pass it on. Think of genes as the software that we actively program everyday through our behaviors and environment. We then pass this code to perpetuity through our offspring.
Health largely by itself is simple and so are the conditions to maintain it. In a recent company workshop, I asked my colleagues to define health and we didn’t get beyond being disease free. Then I changed my question. I asked how people knew if their kids were sick or healthy. Pat came the responses: a child who is sick is dull, cranky, doesn’t eat or sleep well and a child who’s healthy is cheerful, enthusiastic and has a definite positive vibe.
Yet we find it difficult to apply this unambiguous definition of health to ourselves, leave alone our complicated healthcare systems. But we need to.