The Myth of Normal 13

For me, the process of putting the pieces together began several decades ago when, on a hunch, I went beyond the standard repertoire of dry doctorly questions about symptom presentation and medical history to ask my patients about the larger context for their illnesses: their lives. I am grateful for what these men and women taught me through how they lived and died, suffered and recovered, and through the stories they shared with me. The core of it, which accords entirely with what the science shows, is this: health and illness are not random states in a particular body or body part. They are, in fact, an expression of an entire life lived, one that cannot, in turn, be understood in isolation: it is influenced by—or better yet, it arises from—a web of circumstances, relationships, events, and experiences. Of course, we have cause to celebrate the past two centuries’ astonishing medical advances and the tireless fortitude and intellectual brilliance of those whose work has led to giant strides in many different fields of human health. To take just one example, the incidence of polio—an awful illness that killed or maimed countless children only two or three generations back—has dropped by more than 99 percent since 1988, according to the U.S. Centers for Disease Control and Prevention; most kids today probably have never heard of the disease. [15] Even the more recent epidemic of HIV has been downgraded in a relatively short period of time from a death sentence to a manageable chronic condition—at least for those with access to the right kinds of treatment. And as destructive as the COVID-19 pandemic has been, the rapid development of vaccines may be counted among the triumphs of modern science and medicine. The problem with good news stories like these—and they are very good news—is that they stoke the reassuring conviction that we are, overall, making advances toward a healthier standard of life, lulling us into a false passivity. The actual picture is quite different. Far from being on the verge of curbing the contemporary health challenges facing us, we are barely keeping pace with most of them. Often the best we can do is mitigate symptoms, whether surgically or pharmacologically, or both. As welcome as medical breakthroughs are, and as fruitful as research can be, the crux of the problem is not a dearth of facts, not a lack of technology or techniques, but an