There’s no such thing as wellness.
Surprised? Unless you’ve been living under a rock these past few decades, you have been bombarded about the mythical state of “wellness” and what you must do (and buy!) to achieve it.
Wellness is different from health. Health is freedom from disease or control of disease. It is a state of “good enough.”
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]At best those seeking wellness end up poorer; at worst they end up dead.[/pullquote]
- High blood pressure? We can control it with medication and you will be healthy.
- Appendicitis? We can remove your appendix and you will be healthy.
- Nearsighted? We can give you glasses or contacts and you will be healthy.
- Diphtheria? We can immunize you against it and you will never even get sick.
In contrast, according to Dictionary.com, wellness is:
An approach to healthcare that emphasizes preventing illness and prolonging life, as opposed to emphasizing treating diseases.
In other words, it is a state of perfection.
There’s just one problem; absence of disease and long life are NOT the natural state of human beings.
That’s because human beings, like all living things on our planet, have evolved and evolution isn’t about perfection; it’s about survival of the fittest.
Think about that for a moment. Survival of the fittest means that for a given environment, some animals (or plants or bacteria or viruses) will be fitter than others. Critically, “fittest” is not a fixed set of characteristics. If the environment changes (either naturally or technologically), those who were once fittest might easily be out-competed by animals within or outside the species that, in a reversal of fortune, are now fitter.
The engine of natural selection is genetic mutation. That means that in each new generation there will be individuals who have heretofore unseen errors in their DNA. Some errors are devastating and the animal (or plant, bacteria, virus) dies; most DNA errors result in no functional difference. Every now and then a DNA error leads to an individual that is fitter for its environment than its compatriots. Since the holder of the error is fitter, it is more likely to survive to have many children who will also have the error and over time, the error will spread through the population.
When it comes to survival, there are many competing demands. For example, a woman with a narrow pelvis (like a man’s pelvis) is faster and better able to outrun predators. But that same woman with a narrow pelvis has less room to deliver a baby and therefore is more likely to die in childbirth.
Each individual animal, plant, bacteria or virus is the sum of its compromises and all are competing with other members of its species as well as other species. Some compromises leave us less vulnerable; some compromises leave us more vulnerable; and some do both. For example, humans who were under siege from malaria evolved a genetic mutation that made them better able to resist malaria. Yet the very same mutation, in the right circumstances, causes sickle cell anemia. Who is “well” then, the individual with or without the genetic mutation? The answer is: neither.
Indeed the term “wellness” did not even exist until the latter half of the 20th Century. We understood that our natural state was not wellness. Our natural state involves copious death and disease. Fully 20% of pregnancies end in miscarriage. The natural infant mortality rate is 7% or higher. The average lifespan in nature was 35 years.
That changed with the advent of modern medicine. We developed a myriad of ways to address the traditional scourges of human existence. We discovered the germ theory of disease and that led to clean water, proper disposal of bodily wastes, and anti-sepsis (all technological discoveries). We also developed antibiotics to cure disease and vaccines to prevent disease. Indeed we were so successful in applying technology to the vulnerabilities of human beings that some of us actually began to pretend that being well is our natural state.
Since then wellness has developed into a trillion dollar business, the bulk of it devoted to unproven fads that merely deprive people of their hard-earned money for no benefit.
What’s the harm of pursuing the mythical state of wellness?
1. It has led to a pervasive health moralism. Disease and dysfunction, which used to be viewed as God’s will or the result of bad luck, have been transmuted into a Calvinist view of health. Calvinism is a form of Christianity noted for its belief in predestination. God had predestined some people for entrance to heaven and the mark of that predestination was wealth. The meek might inherit the earth, but heaven would be the province of the wealthy.
Because of our belief in the mythical state of wellness, we have come to view disease not as a matter of luck, but as a sign of moral fitness. Got cancer? Then you must have done something to deserve it. Instead of supporting those who are ill (generally through no fault of their own), we torment them with our smugness that we are not sick and therefore we are more deserving. We force those who are sick in body to suffer in spirit as well by blaming them for their own misfortunes while patting ourselves on the back for being superior though we are nothing more than lucky.
2. It has led to a plethora of poor screening tests, many of which do more harm than good. If you believe that the natural state of human beings is wellness, then you assume that disease is a failure of prevention or detection. That leads to screening tests which are meant to preserve wellness by identifying those at risk for disease and treating them.
But the natural state of human beings is not wellness and therefore lots of healthy individuals are identified with early cancers that might never have become life threatening. From mammograms to PSA testing for prostate cancer, we have created screening tests that lead to unnecessary biopsies, unnecessary surgeries and, in rare cases, unnecessary deaths. In an effort to attain the mythical state of wellness, we are willing to turn health into disease.
3. It has led to a never ending stream of erroneous and conflicting recommendations about what we should and should not eat. While it may be true that you can overeat your way to obesity and associated diseases, the idea that you can eat your way to wellness is a pernicious fiction.
Our Paleolithic ancestors did not spend their days cavorting around food pyramids ensuring their good health. Our Paleolithic ancestors were NOT healthy. No group with a life expectancy of 35 is healthy.
They lived a subsistence existence where starvation was always a risk and vitamin deficiency was common. The fittest survived and being fit meant being able to get a sufficient amount of food and nutrients. You ate what you could and hoped for the best. Moreover, diet varied substantially depending on location and climate. There was NEVER an ideal diet that guaranteed wellness then and there isn’t an ideal diet that guarantees wellness now. That’s why the never ending stream of dietary recommendations is constantly changing. There is literally no such thing as an ideal diet.
4. The search for the mythical state of wellness has given rise to the trillion dollar industry of quackery. All forms of quackery — from homeopathy to chiropractic, from herbal supplements to nutritional cures, from fad diets to nonsensical detoxes — are based on returning people to the mythical state of wellness, a state that never existed in the past and does not exist today.
Quackery is nothing more than socially sanctioned robbery. Purveyors of quack treatments get rich, while buyers not only don’t get well, they get fleeced. At best, those seeking wellness end up poorer; at worst, those seeking wellness end up dead, either poisoned by the supplements that were supposed to make them healthy, or diverted from treatments like chemotherapy, which though arduous, can actually cure cancer while quackery cannot.
Wellness is a myth. It is incompatible with everything we know about evolution and prehistoric existence. In pursuit of the myth of wellness, we moralize health, we create screening tests that do more harm than good, we propose dietary guidelines that are useless, and we spend trillions of dollars on nonsense designed to return us to a state of perfect health that not only never existed, but could never exist.
The ultimate irony? The quest for wellness isn’t making us well; it’s making us sick.
