Intended for healthcare professionals

Clinical Review ABC of adolescence

Chronic illness and disability

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7493.721 (Published 24 March 2005) Cite this as: BMJ 2005;330:721

What is Health?

Health is metabolic efficiency. Sickness is metabolic inefficiency. Nobody is totally healthy or totally sick. Each of us is a unique combination of health and sickness. And 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 disabilities.

So, we try to hide our disabilities from people and from ourselves. 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.

Competing interests: None declared

Competing interests: No competing interests

03 September 2006
Hugh Mann
physician
Eagle Rock, MO 65641