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Fixin' Healthcare

Sunday, March 02, 2008

An Invitation To Common Sense

“Solving puzzles is useful for detection. But framing mysteries is necessary for prevention.”

Gregory f. Treverton, Smithsonian Magazine, June 2007, pp 98-102

Daily life contains moments when a few words or passing thought project a vivid image and convey an instant meaning. The moment passes but the message may linger like an echo. Many years ago at the conclusion of a counseling session a medical student commented that life is like a chess game. My response that I found life to be more like a poker game was not intended as a lesson. If there was educational value, I am the beneficiary because that exchange lingers with me to this day. The intervening years have broadened my perspective but the response remains the same and for the same reasons. In our “twenties” we are problem solvers and by age fifty we recognize the mystery of life.

Life can be a series of problems or puzzles requiring the gathering of data necessary for the formulation of solutions. Solving problems is a process in pursuit of short-term objectives presumed to advance toward goals, which are vaguely defined because they exist outside of the process. Medical care is such a process consisting of diagnosis and treatment with the objective to resolve health problems. The goal is optimum health status but it can be achieved only by successful resolution of health problems after they have occurred. It was not surprising that a medical student undergoing indoctrination to medical care would think in those terms and look at life as a chess game.

But, life is most often a mystery consisting of “ambiguities without clear answers where the task is to determine which critical factors might interact in some unknown way in an uncertain future” (Gregory Treverton). Health care is the utilization of this mind-set to frame the mysteries of health and prevent health problems to achieve the goal of optimum health status. Optimum health status of individuals and the population is an essential and integrated end-point of health care. Health care is not dispensed; it is a participatory process and a group activity. If there are health care providers, they are educators, guides, and coaches. Public health comes close to health care but it needs to be much broader and involved with every aspect of life.

Human behavior is a mystery of life. Long causal chains, impatience to see results, and insensitivity to the passage of time are critical factors in understanding ourselves and others. Individuals and society exist at any given moment balanced within nature and the world where the balance is controlled by a vast array of forces. These forces vary in strength and relationship to each other, and they are in a constant state of flux. It is a complex existence with many unknown factors and it is dependent upon a will to live that affirms life as possessing intrinsic value. Skepticism promotes the need to think about the balancing forces of life and adapt to change. The complexity and lack of complete knowledge about life can blunt optimism and generate pessimism that erodes the will to live. When the boundary of rational thought encounters the mystery of life, the will to live depends upon art, mysticism, belief systems, faith, and religion.

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