Today’s health care is one of those so-called modern miracles. What doctors can do now would have looked magical to our forebears. After all, it’s not uncommon for those who appear to have died to be brought back to life. But for all its successes, health care fails us in important ways.
Not least is the vast disparity between the quality of care available to the richest versus the poorest. The former may consume services worth tens of thousands of dollars; the latter often die for lack of medication.
Or consider medical mistakes. By the most conservative estimate, they kill more than three times as many Americans as car accidents; other analyses suggest they comprise the third leading cause of death nationwide (see this 2013 NPR report for details).
But aside from maldistribution and negligence, there is another problem that is more subtle but also more widespread, because it affects virtually everyone. Medicine teaches us to fear the human body.
Animals take steps that encourage healing and prevent disease, but they don’t seem to suffer from dread of illness. Pet dogs eat grass when feeling nauseated, and similar changes in food choice have been observed in the wild. Large fish seek attention from much smaller cleaner shrimp that remove parasites. In these and other cases animals act in service of their health, but there is no reason to think they do so out of fear.
Humans, by contrast, fear disease, which has led to healing practices of all sorts. Healers help ease our anxiety, but they also amplify it. The oldest known healing traditions are practiced by shamans, who view illnesses as caused by demons, curses, and other external agents. No doubt tribal groups felt comforted by the belief that shamans could exorcise demons, but picturing humanity surrounded by hostile supernatural forces must also have been frightening. Shamanic practices ease anxiety in the face of illness, but they simultaneously reinforce belief in dangerous unseen forces.
In tribal days we feared evil spirits, and today we fear bacteria, viruses, and cancer cells. Granted, unlike demons, microscopic threats can be detected by technology. But the necessary equipment isn’t available for household use, and it’s not reliable in the earliest stages of disease. Right now, as I sit here typing, a malignancy could be forming inside me. I can feel the dread of that thought, but there’s no way to take direct action.
Invisible threats lead to a quality of fear that is more pernicious than anything nonhumans face. All animals other than top predators remain vigilant against becoming prey; they live in fear. But predators can be detected. Rabbits can scan the sky for raptors; gazelles can sniff the wind for lions; small fish can remain alert to the vibrations of larger ones. These detection systems sometimes fail, but the animal has at least some means to protect itself in daily life: if it looks carefully and sees no threat, it can relax. But once we believe in invisible dangers, we can no longer relieve our fears.
My response to that background fear of cancer might be to seek regular checkups, eat organic vegetables, limit my intake of meat, and so on. In fact, I do all those things. But they fail to give me the sense that I can truly protect myself. I can’t fend off or run from cancer; after all, I can’t even see it.
As moderns, we feel the same fear as our hunter-gatherer ancestors. We’ve just replaced one type of invisible threat (supernatural) with another (biological). Biomedicine has updated the shaman’s pantheon of curses and demons with a list of biological pathogens. The focus of fear changes, but not fear itself.
Fear kept the shamans employed, and today it motivates the building of hospitals and research institutions, leading to the impressive edifice we know as modern health care. Still, although we can now treat many illnesses, the fear remains. Biomedicine hasn’t lessened our fear; we still worry about unseen dangers.
If all we did was replace one type of external threat with another, we wouldn’t be much more fearful than our hunter-gatherer forbears. But recall that shamans locate the causes of disease outside the body, while we know the body contributes to disease through failures in immune surveillance, mutations in normal cells leading cancer, breakdown of joints, degeneration of brain tissue, and so on.
We anticipate failures within the body itself, and knowing the body can betray us, we come to fear it. In both popular media and medical clinics, the emphasis is on internal dysfunction; seldom do we hear reminders about how much our bodies do to keep us alive on a day-by-day basis. We end up fearing rather than trusting them.
Unlike biomedicine, shamanism doesn’t turn people against their own bodies. The shaman might say a person invited misfortune through bad behavior but won’t say illness comes from the physical body. Shamanic traditions fuel fears of the unseen, but not fears of the body. Shamanism may even discourage people from fearing the body by absolving it of blame.
Modern medicine has brought disease home to the individual. It’s no longer an externally imposed affliction; all too often, it’s an internal failure. The body, upon which our lives depend, appears unreliable. It seems suspect and flawed. Hence the perennial science fiction theme of people uploading themselves into computer systems, or replacing their native, aging bodies with technological marvels. Never mind that all technologies breakdown, often much faster than biological systems; we continue to dream of improving on the human body with our machinery. And why? Because we fear what evolution has given us.
During my clinical training, there were several times I felt convinced my body had contracted a life-threatening illness, such as testicular cancer, lung cancer, or AIDS. When trainees fall prey to imagined illness they call it ‘medical student syndrome’. It’s understandable: a person learns about the diseases to which a body can succumb, and tiny lumps or minor symptoms turn into harbingers of doom. If medical knowledge can encourage a vigorous young man to fear his body, imagine what it can do to the average person at a lager stage of life.
Today, everyone suffers from a touch of medical student syndrome. For just about any symptom (including common ones like fatigue) Google pulls up terrifying possibilities. Dozens of deadly diseases make the news every year. We see pictures of horrible outcomes: such as multiple amputations due to war trauma or the severe wasting of AIDS. In times past such sights were rarely seen by the average person; now they’re ubiquitous. No wonder we’re afraid of our bodies.
In another post I’ll discuss what we can do to rebuild faith in our bodies. For now, I’ll point out that you wouldn’t even be reading this if your body weren’t breathing, circulating blood, and performing countless tasks that give you life. Even the sickest among us still possesses an amazing living body. If medical clinics reminded us of these simple facts from time to time, we might feel more reassured after our visits to them.