Health and illness are categories or concepts that appear to be self-explanatory and given. We all know when we are healthy and when we are sick. We have a common understanding what it means to be healthy or sick (i.e. when I have a fever I am sick) and which behaviors are healthy or prone to contributing to illness (i.e. smoking is unhealthy and engaging in regular exercise is healthy). In my upcoming book Health-in-Sickness and Sickness-in-Health I am deconstructing our thinking about health and illness.
What is health emerges as a much more complex question. Health and sickness co define each other and health has no purpose on its own. It is ontologically connected to illness. Both health and illness are processes that overlap and are entangled with each other. They can even occur simultaneously or parallel to each other. It is not healthy or sick but healthy and sick, sick and healthy. Friedrich Nietzsche differentiated between a small health of physical and mental well-being and a big health that contained sickness. He saw sickness ultimately as an opportunity for a deepening of self-awareness and a change in attitude toward life. Life, he said, needs sickness as a fishhook for awareness. Because of illness we lose trust in life, which then becomes a motivating energy that paradoxically allows us to participate in and rediscover life despite illness.
Ira Byock, a prominent palliative care physician wrote a book he called Dying Well. In his book he describes a possible way of being well at the end of life when sickness and death dominate[1].
On the other hand mainstream definitions of health marginalize people who don’t have the privilege of physical and mental well-being. A concept of health that is not inclusive of sickness puts people who suffer from chronic disease and disability at the margins of society. This excludes them from the so-called wellness of the healthy and productive members of our society which adds a layer of social sickness to their mental and/or physical health challenges.
Courage is borne out of vulnerability, not strength says Brené Brown. Health is borne out of embracing sickness as part of our lived experience.
[1] Krista Tippett interviewed Ira Byock in her weekly radio podcast OnBeing: http://www.onbeing.org/program/contemplating-mortality/11072013