Intended for healthcare professionals

Letters Rethinking medicine

A call to think about health rather than medicine

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l256 (Published 21 January 2019) Cite this as: BMJ 2019;364:l256

What is Health?

Life is metabolism. Health is metabolic efficiency, and sickness is metabolic inefficiency. Nobody is totally healthy or totally sick. Each of us is a unique combination of health and sickness. Each of us has a unique combination of abilities and disabilities, both emotional and physical.

As we grow up, we learn that we are loved for our abilities, but hated for our disabilities. This happens at home, at play, at school, and at work. Sometimes, this even happens with our doctors, especially if our disabilities mystify them or remind them of their own hidden disabilities.

So, we try to hide our disabilities from people and from ourselves. Sadly, this charade undermines our relationships and our self-esteem. We learn to fear society and hate ourselves.

Self-hatred is the most debilitating sickness. It interferes with our ability to seek and accept help. And everybody needs help. How do we free ourselves from self-hatred?

First, we reclaim our disabilities, whether society accepts them or not. This means that we learn to accept ourselves. Then, we cope with our disabilities. This means that we learn to take care of ourselves. Self-care is healthcare.

Competing interests: No competing interests

29 January 2019
Hugh Mann
Physician
Retired
New York, NY, USA