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What
are the lessons of the last 100 years? And can we apply them in
our daily lives to make the next millenium happier, healthier, and
sustainable for us and our children?
The
first half of this century began with childbirth, influenza, and
everyday trauma inflicting high casualties. Medical education
improved such that in 1911 "for the first time in history the average
patient seeing an average doctor for an average problem had better
than a fifty-fifty chance of benefiting from the transaction." By the
mid 1950's progress in sanitation, immunizations, and antibiotics led
to the eradication of polio and smallpox, the expectation of living
to old age, and new wonder drugs. Spirits were high. There seemed to
be little that science couldn't eventually conquer.
The
last fifty years have seen dramatic shifts. Knowledge,
technologies, and entrepreneurism accelerate ever-faster. Acute
diseases have been replaced by new illnesses of body and psyche such
as coronary heart disease, chronic fatigue syndrome, pain syndromes,
arthritis, cancers, teen age suicide, and addictions of all
varieties. And for all of these chronic maladies, medicine typically
fails to effectively address the root causes.
We
are now said to be entering "the post-antibiotic era" as use of
progressively stronger antibiotics turns our hospitals into training
grounds for super-pathogens. Science has brought us immense material
benefits but threatens to bury us in its increasingly complex and
expensive products: organ transplantation, genetically engineered
drugs at a cost of several thousand dollars a dose, the human genome
project including ability to detect hereditary diseases. We are
beginning to reach real limits.
LESSONS
1.
What we eat really does count.
Coronary
heart disease, our leading killer, has shown gradually
decreasing incidence and mortality in the last forty years. Lowering
fat calories from 45% of our diet in 1957 to 34% now has been of real
benefit. Limiting saturated and unsaturated fats to below10% each and
raising monounsaturates such as olive and canola oils should further
help. Attention to quality is perhaps of greater importance.
Virtually all commercially refined oils are loaded with harmful trans
fatty acids. Use of natural unrefined fats and oils such as olive and
fish has been shown to lower heart attacks and is strongly
recommended.
Adverse
blood lipids contribute to hardening of the arteries. But
heart attacks often occur in minimally narrowed arteries as placque
ruptures and blood clots. The use of clotting inhibitors such as
400iu of vitamin E or one aspirin taken daily lowers actual heart
attacks by about 40%. The same type of benefit might be expected from
use of omega-3,6,&9 oils, Ginkgo biloba, and certain other
natural substances. For the 20% of people who carry high blood levels
of the amino acid homocysteine, taking extra folic acid, B6, and B12
prevents heart damage. These are matters to discuss with your medical
doctor.
The
enormous range of health benefits from appropriate use of natural
food substances (and avoidance of man-made toxins) is only beginning
to be widely explored and employed. Particularly promising is the use
of essential fatty acids, amino acids, and newly discovered
glycoproteins in preventing and treating specific diseases. The risks
as well as benefits of burgeoning food supplements need to be more
clearly delineated. We now know that folic acid in small amounts
early in pregnancy prevents neural tube defects such as spina bifida
(a serious disease of newborns). At the same time, overdosage of
selenium, copper, and most other trace minerals and synthetic
vitamins can be highly hazardous.
2.
Our emotional lives play a profound role in our health.
People
who hold in feelings (suppressives) and hostilities (type A's)
have higher cortisol and adrenalin levels and substantially more
heart attacks, as do those who feel isolated. Depressed people who
have a heart attack have an immensely higher death rate. The new
science of behavioral medicine is demonstrating that our beliefs and
thoughts help form our feelings, attitudes and actions and that they
can indeed be changed for the better. Self-help books, counseling,
Twelve-Step and self-help groups have proven useful in refractory
chronic conditions. What seems essential is to use new insights to
practice appropriate new behaviors so that they become established
into our daily life. Innovative medical care in this area is in its
infancy, tends to utilize group learning, and is best demonstrated by
the work of Dean Ornish, David Sobel, and Kate Lorig.*
3.
Vigorous use begets vigor--passivity kills.
Inactivity
of body, mind, or spirit predictably produces atrophy. The
new disease of "affluenza" centers about self-gratification and seems
to intensify chronic illnesses and addicitions. Material consumption
is not enough. Harnessing the energy of one's passion and using it to
achieve dreams or to live a daily life of focused simplicity both
produce health. The amount of physical or mental activity appears
less important than its regularity, focus and quality. Activities
that connect us with nature and with those we enjoy are particularly
helpful. People with an active spiritual life have demonstrably more
resilience to life's adversities.
4.
Attention is our most powerful tool.
Our
attention has become a commodity manipulated and sold by the
communications industry. Reclaiming and focusing it are vital to
maintaining health in this confusing fast-paced world. This requires
conscious choice, prioritizing, and training, as all of us have
habits that lead us astray. Focusing attention on areas of pain and
contraction paradoxically leads to relaxation and relief. Attending
to activities and relationships we enjoy produces happiness.
Fortunately, centering practices such as martial arts, meditation,
and prayer are readily available. Small oases of stillness carefully
built into our daily lives pay large dividends.
5.
Prevention requires healthy community.
We
live in a competitive culture. Yet for every kill-or-be-killed
moment in nature, there are countless interactions of interdependent
support. Churches, softball teams, car pools, lunches for the poor,
restoration projects, neighborhood watches-- the web goes on and on.
It is the vitality of this web on which our health truly depends. As
we enter the next millenium, our ability to support one another
sharing our lay and professional skills in nutrition, bodywork,
counseling, yoga, and other disciplines will be far more effective in
promoting health than further advances in medical technology.
In
the 20th century we have tried to conquer diseases. We have had
some successes and we've made messes we have to clean up-- both human
and environmental. We've mistaken science as salvation, not as a
provider of tools to be used wisely. In the 21st century we will
advance and apply our growing understanding of natural healing while
retaining useful tools from the past. We have to come back into
balance and we can. The decisions required are not complex. We can
choose to eat fresh locally produced fruits and vegetables and whole
grains. We can spend more time with family and friends and community
groups. We can cooperate as well as compete. Together, we can create
and enjoy healthy lives.
*Dean
Ornish, Dr. Dean
Ornish's Complete Guide to the Reversal of
Heart Disease, Ballantine, 1992., IVY, 1997. Kate Lorig et al, Living a
Healthy Life with Chronic Conditions, Bull
Publishing, 1994. David Sobel and Robert Ornstein, The Healthy
Mind , Healthy Body Handbook, Time/Life, 1996.
Bob Fies, M.D. is a board-certified
internist who works with the
collaborative Santa Rosa Medical Group in Santa Rosa, California. He
integrates behavioral and mind-body practices with preventive
medicine and particularly enjoys teaching self-management skills to
individuals and groups. For more information about Dr. Fies or the
Santa Rosa Medical Group, call (707) 539-3511.
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