Health, Healthcare and Medicine

The human body is a complicated machine. This is a humble effort to describe my layman's understanding of it. Let's compare our body to a relatively simple, well-understood and widely available machine, the automobile. There are many types of vehicles in the market. Trucks and pickups are meant to haul voluminous and heavy loads. Sports cars allow precision control for high speeds on smooth roads. Luxury cars are known for their style, class and comfort. Economy cars deliver on low maintenance and fuel consumption. Utility vehicles are best for traveling in rough terrain. Similarly, every person's body is well suited to perform a certain set of activities under certain conditions and therefore requires a certain type of diet and form of medical care.

If I exploit a machine, I can't expect it to run too long without complaints. A sports car won't perform well or last long if it's used to haul heavy loads on cheap gas and low maintenance. Machines and human beings are all striving for physical wellness and longevity. While our body grows and changes, machines don't. Software systems may learn, adapt and evolve with time but the change isn't physical. Hardware machines require external agents to have replacements or additions. Bodies use the fuel they ingest/inject/inhale to serve as both matter and energy, while machines only use their fuel as a source of energy.

I can't misuse/abuse my car and then expect the mechanic to keep it fit and running forever. Similarly, if I suffer from gluttonous habits, I can't assume liposuction will cure all ill-effects of my over-indulgence. I can't leave it to heart drugs or bypass surgery to cure cholesterol related heart problems, while I continuously consume processed food and sugar. Prevention is better than cure. My body is my privilege and my responsibility, not the doctors.

Some of the greatest discoveries we know of happened in modern medicine: blood groups, anesthesia, X-ray, germs, penicillin, vaccination, and insulin. Thanks to them, today we enjoy a longer and healthier life. Unfortunately, today, pharmaceutical research and development is in the hands of multi-national corporations that are driven by profit, not scientists who are driven by curiosity or compassion for those in pain and suffering. Like any corporation, they seem to invest more time/effort/money in sales and marketing than they do on actual medicinal research and development.

People with fixed salaries turn to insurance companies for managed health care plans. Insurance companies determine monthly payments and coverage based on age, diagnosed health conditions, overall health and lifestyle. While employed individuals (and dependents) with middle incomes can afford to purchase managed health plans, those in lower income brackets or unemployed find it difficult to purchase. Managed health care (vs. the pay-as-you-go system) prompts consumers to over-utilize the healthcare system since they put the burden of their health on the healthcare system and don’t invest time/effort/restraint in themselves to maintain a healthy lifestyle.

With hospitals being equipped with the latest technological instruments, prescription drugs becoming increasing expensive and physicians/surgeons purchasing medical-malpractice insurance, health insurance is unaffordable to many. Whether the expensive high-tech medical equipment is actually useful and beneficial is also a question. Hospitals keep it because it attracts patients, most of whom have blind faith in the miraculous powers of modern technology.

Over the years, deaths due to infectious diseases have reduced significantly, and chronic diseases have taken over like cardiovascular, cancer or stroke as the leading causes. A lot of research and development has gone in to prolong life beyond its natural time span, attempting to alter the course of nature to challenge the higher powers. Detection of these diseases is in their late stages, where usually there is no cure available. Chronic diseases result from a toxin buildup in our body, initiated from the food we ingest, air we breathe and water we drink. Such diseases are usually detected at late stages when immediate cures are not available.

Today, a sixth of the US GDP is spent on healthcare, a significant amount of which goes into prescription drugs. Pharmaceutical companies recover their investment in research and development from the end user. Compared to other industries, the pharmaceutical industry enjoys many tax breaks. In spite of this, drugs are expensive for the developed world and virtually unaffordable by the underdeveloped world. Drugs take many long years from inception to reach the market after passing a series of clinical trials on animals and humans. Drugs are first tested on mice, rats, dogs and monkeys. Initial human trials may be conducted in the poorest of the 3rd world where ignorant citizens are unaccounted for by local administration. A small portion of drugs conceived reach the clinical trial phases in developed nations. Most are rejected in preliminary tests because they don’t show the required quality or quantity of effect or they have harmful side-effects that can’t be overlooked to proclaim the drug safe. Once the drugs reach the physicians, still in the trial phase, pharmaceutical companies give them various incentives to promote their drug. How much of an improvement the new drug achieves over and above those currently available in the market is questionable. Pharmaceutical companies are continuously under pressure to post positive results. They introduce slight modifications of currently marketed drugs to add to their intellectual property, brand image, and sales.

Clinical drug prescriptions consist of high potency synthetic chemical substances. Whether the effect a drug is having at the target site in reversing the diseased condition is significant enough to overlook the adverse effects it is having at other sites has become questionable with drugs showing side effects years after they are introduced in the market. (U.S. pharmaceutical company, Merck, discovered its arthritis painkiller drug - Vioxx – doubled the chance of heart attack or stroke if consumed for more than 18 months, 5 years after it hit the markets.)

Modern medicine is symptomatic in its style of treatment, and doesn’t take a holistic view of constitution and history. Eruptions on the skin may be a side effect of poor digestion or poorly oxygenated and purified blood, but symptomatic treatment will prescribe medicine to subside the eruption but may not cure the root issue. Artificially forcing the brain to ‘function normally’ by taking anti-depressants that increase neurotransmitters count and flow to increase message passing across neurons is not relieving the patient of the circumstances that caused the mood in first place hence isn’t curing him/her. Can a physical disease be prompted by our philosophy of life, frame of mind, tendencies, or habits?

Surgery is a practice whose ease and frequency of recommendation alarms me. I have been surgically operated on; my sinuses were cleared under local anesthesia. I was scared even though it ultimately relieved intense pain. But, was it necessary to manually intervene, cut open and physically reach organs with mechanical/electro-mechanical instruments that are extremely crude in nature compared to the sophistication of the human body? Are there any other curative paradigms out there less invasive in nature? Was the surgical option brought up too soon, or was it appropriately selected as a last resort? I am inclined to believe the body has regenerative/purgative potential that may only need to be restored, rather than getting the body physically reconstructed.

The utility of recreational or performance enhancement drugs and appearance enhancing plastic surgery is altogether questionable. Are they addressing a defect, deficiency, or error that needs to be fixed? Or are they just addressing jealous desires that come from seeing how others are or what they can do?

In genetics, biology is studied at molecular granularity. As a result of advances in genetics over the past 100 years, we know of the existence of DNA in the chromosomes of cells that constitute the genetic sequence that encodes the total physical appearance, constitution and possibly behavior of living beings. When genes express themselves, DNA transcribes to RNA, which subsequently translates to proteins. The sequence of amino-acids in the protein, to some extent, determines its structure, which captures its enzymatic functionality that ultimately causes the chemical/biological processes in the being. Mutated genes result in altered protein formations which cause genetic diseases. With the discovery of physical and chemical processes to isolate, manipulate and reintroduce DNA, RNA and proteins, it is possible to play God. Now we can clone organisms, i.e. make identical replicas of the original, possibly to utilize their organs/parts for the faulty versions of the original. By determining RNA that interfere with selected gene expression we can prevent the formation of protein that cause disease. Much of the work in genetic engineering aims at artificially modifying the DNA of an organism to achieve a practical end. While gene therapy aims to artificially insert functional genes to supplement defective mutant ones and instead make functional proteins. Scientists have in their hands the basic building blocks of life; but they don’t have the book of dos and don’ts. What’s actually in their jurisdiction and how much they trespass into nature’s territory is a question. Will this tampering with DNA tip the ecological balance?

Eastern forms of exercise like martial arts and yoga align well with nature. Yogic poses and martial arts borrow postures, techniques, and even strategy from animals. They have been minutely adjusted according to the human body structure, to channelize energy, with a goal to minimize discomfort and maximize benefit, doing so in harmony with nature. Pranayama and Qi Gong are about deepening and regulating the breath, therefore purifying the blood without rushing the flow, aerating the organs, and relaxing the mind. All these exercises find birth in Hindu and Buddhist principles. They emphasize meditation to discipline the mind and realize the spirit. Their idea of good exercise isn’t running on treadmills in closed gyms late at night.

Health is about wellness of the body, mind and spirit. It starts with respecting the body clock, inhaling lots of clean air, drinking lots of pure water, and eating food we trust in freshness, nutrition, and hygiene. Processed food and drink contain additives we don’t require. Our organ systems require a chance to relax, stretch, contract and expand at various paces to relieve their tension, boredom and stagnation.