Saturday, January 19, 2008

What is the nature of wellness?

Today I was reflecting with wife Ginny about the immune system. My cancer treatment last year involved getting very large boosts to my immune system, and a number of things about my body have responded, beyond the cancer’s retreat. When I combine that with the much-studied interaction between the mind and the immune system, I saw this pattern: “The immune system’s way of being is ‘I am, and I have a right to be,’ and it fights anything that says ‘No you’re not’ or “No you don’t.’”

So the question arises, what has the brain be on one side or the other of that tug of war?

I assert that one factor – a big one – can be the presence of an affirming community that says “Yes you are.” My own blog community during my 2007 cancer experience was a big boost to my sense that I matter to people, and I have no doubt that boosted my sense that I deserved to survive.

About the mind-body connection, years ago I read that in a very real sense, the immune system is a sixth sense, bringing information to the brain about what’s going on in the “corners of the empire” and carrying instructions back. Googling leads to some similar items here (“the nervous and immune systems use a common chemical language for intra and inter-system communication”) and here (“the immune system [serves] as the sixth sense that notifies the nervous system of the presence of entities, such as viruses and bacteria, that are imperceptible to the classic senses”).

The New York Times “Well” blog has a conversation with Michael Pollan, author of In Defense of Food.I am no nutritionist but this makes sense to me:

Americans are a people so obsessed with nutrition yet whose dietary health is so poor. That strikes me as a paradox. We worry more about nutritional health, and we see food in terms of health. Yet we’re the world champs in terms of obesity, diabetes, heart disease and the cancers linked to diet. I think it’s odd. It suggests that worrying about your dietary health is not necessarily good for your dietary health.

I think health should be a byproduct of eating well, for reasons that have nothing to do with health, such as cooking meals, eating together and eating real food. You’re going to be healthy, but that’s not the goal. The goal should just be eating well for pleasure, for community, and all the other reasons people eat. What I’m trying to do is to bring a man-from-Mars view to the American way of thinking about food. This is so second nature to us — food is either advancing your health or ruining your health. That’s a very limited way to think about food, and it’s a very limited way to think about health. The health of our bodies is tied to the health of the community and the health of the earth. Health is indivisible.

My favorite brain author is Robert Ornstein. I heard him speak once, and he too puzzled about all the talk about not ingesting fats, when (at that time) there was no evidence at all that changing your intake made any difference in what showed up in your blood. Rather, he said, "What about the salutary effects of enjoying a great meal?" Shortly after, he published Healthy Pleasures. (If this concept interests you, check other mind/health books he's co-authored.)

I personally have a strong sense that our beings - our physical beings and our metaphysical ones, be they "souls" or something else - do resonate with each other, and there's something about the very nature of being well that's worth looking at. And it includes having a strong, supportive community.

More about this in future posts, I expect. For now, think about it, and if you have personal experiences to share, post a comment (at the link below).


  1. Also, pain is bad for you. I think studies have shown that the body heals quicker with pain meds (when they're necessary) than without.

  2. Rhonda, if you can find any specifics about those studies, I'd love it! That's the first I've heard of it.

  3. It's been a very long time since I read some mention of this, and a quick Google finds mostly alternative medicine sites, which is probably not what you're looking for. But I believe pain is a stress on the body, and I think stress usually taxes the immune system more than it stimulates it. A simple example: pain causes your muscles to tense up, it can interfere with sleep, if you have a toothache it's hard to think of anything else, etc. Pain relief, if it doesn't totally dull the mind, can free the system for healing. I am extrapolating from a faintly remembered item I read a long time ago, but it makes sense to me. Anyway, so often a news article might mention one study but that doesn't mean other researchers follow up on that line of thought.

  4. After some investigation when Jay developed lymphoma, I changed our diet fairly radically, including as much whole (unprocessed) food as I could stand to take the time to shop for and process myself. One change I made that was fairly easy and made a huge difference to our baseline health was the addition of a morning fruit smoothie: 1/3 yogurt, 1/3 juice, 1/3 fresh fruit (often frozen by myself from the farmers market). Protein powder optional but why not. Blend the heck out of it.

    The first sign of improved health was the lack of hangnails around the fingernails. It's been years since either of us had a serious cold. It's an easy change that adds a lot of micronutrients.


  5. Dave, I finally had a chance to follow up on the pain relief research... which I needed over the weekend when a friend fell and broke her ankle in four places. I found this article--

    Diana Dickinson

    (whole abstract follows)

    Henrik Kehlet MD, PhD*

    Available online 25 May 2005.

    The alleviation of postoperative pain is primarily provided for humanitarian reasons but also to reduce nociception-induced responses, which may adversely influence organ functioning and contribute to morbidity.14 As discussed in this issue, much progress has been made in our understanding of pain physiology and the effectiveness and side effects of various analgesics and techniques of administration. Based on this knowledge, optimal pain relief allowing normal function can usually be obtained following most surgical procedures, especially when using multimodal or balanced analgesia. This approach provides sufficient pain relief through additive or synergistic effects by different analgesics and with a concomitant reduction of side effects because of the requirement of lower doses of individual drugs and differences in side-effect profiles.13

    In recent years, awareness of pain relief and pain education has been introduced in the surgical literature.15 The introduction of acute pain services has increased the quality of postoperative pain relief; however, further improvements in perioperative care and outcome require increased attention among surgeons to choices and availability of different analgesics and techniques in different operations because pain relief is a prerequisite to improved outcome.

    This article provides an updated review of the differential effects of different analgesics on perioperative pathophysiologic responses and organ dysfunctions, hospital stay, and convalescence. Furthermore, updated knowledge is provided on the integration of postoperative pain relief in a multimodal approach to hasten recovery, based on recent reviews.16 and 17

    Address reprint requests to Henrik Kehlet, MD, PhD, Department of Surgical Gastroenterology, Hvidovre University Hospital, University of Copenhagen, Kettegård Allé 30, 2650 Hvidovre, Denmark
    * From the Department of Surgical Gastroenterology, Hvidovre University Hospital, University of Copenhagen, Denmark

    Surgical Clinics of North America
    Volume 79, Issue 2, 1 April 1999, Pages 431-443

  6. Interesting. I spent ten weeks (!) in hospital in 1975, and I know that a nurse told me then that "if you're in pain, you're not healing as fast as you could." It's a truism in medicine that nurse's observations are ignored or undervalued; I think they have known this about pain and pain meds for a long time.


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