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- <text id=90TT1621>
- <title>
- June 18, 1990: A Nation Of Hypochondriacs
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1990
- June 18, 1990 Child Warriors
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- ESSAY, Page 88
- A Nation of Hypochondriacs
- </hdr>
- <body>
- <p>By Norman Cousins
- </p>
- <p>[Norman Cousins is on the medical faculty of UCLA.]
- </p>
- <p> The main impression growing out of twelve years on the
- faculty of a medical school is that the No. 1 health problem
- in the U.S. today, even more than AIDS or cancer, is that we
- don't know how to think about health and illness. Our reactions
- are formed on the terror level. We fear the worst, expect the
- worst, thus invite the worst. The result is that we are
- becoming a nation of weaklings and hypochondriacs, a
- self-medicating society incapable of distinguishing between
- casual, everyday symptoms and those that require professional
- attention.
- </p>
- <p> Somewhere in our early education we become addicted to the
- notion that pain means sickness. We fail to learn that pain is
- the body's way of informing the mind that we are doing
- something wrong, not necessarily that something is wrong. We
- don't understand that pain may be telling us that we are eating
- too much or the wrong things; or that we are smoking too much
- or drinking too much; or that there is too much emotional
- congestion in our lives; or that we are being worn down by
- having to cope daily with overcrowded streets and highways, the
- pounding noise of garbage grinders, or the cosmic distance
- between the entrance to the airport and the departure gate. We
- get the message of pain all wrong. Instead of addressing
- ourselves to the cause, we become pushovers for pills, driving
- the pain underground and inviting it to return with increased
- authority.
- </p>
- <p> Early in life, too, we become seized with the bizarre idea
- that we are constantly assaulted by invisible monsters called
- germs, and that we have to be on constant alert to protect
- ourselves against their fury. Equal emphasis, however, is not
- given to the presiding fact that our bodies are superbly
- equipped to deal with the little demons, and that the best way
- of forestalling an attack is to maintain a sensible life-style.
- </p>
- <p> The most significant single statement about health to appear
- in the medical journals during the past decade is by Dr. Franz
- Ingelfinger, the late and former editor of the New England
- Journal of Medicine. Ingelfinger noted that almost all
- illnesses are self-limiting. That is, the human body is capable
- of handling them without outside intervention. The thrust of
- the article was that we need not feel we are helpless if
- disease tries to tear away at our bodies, and that we can have
- greater confidence in the reality of a healing system that is
- beautifully designed to meet most of its problems. And even
- when outside help is required, our own resources have something
- of value to offer in a combined strategy of treatment.
- </p>
- <p> No one gets out of this world alive, and few people come
- through life without at least one serious illness. If we are
- given a serious diagnosis, it is useful to try to remain free
- of panic and depression. Panic can constrict the blood vessels
- and impose an additional burden on the heart. Depression, as
- medical researchers all the way back to Galen have observed,
- can set the stage for other illnesses or intensify existing
- ones. It is no surprise that so many patients who learn that
- they have cancer or heart disease--or any other catastrophic
- disease--become worse at the time of diagnosis. The moment
- they have a label to attach to their symptoms, the illness
- deepens. All the terrible things they have heard about disease
- produce the kind of despair that in turn complicates the
- underlying condition. It is not unnatural to be severely
- apprehensive about a serious diagnosis, but a reasonable
- confidence is justified. Cancer today, for example, is largely
- a treatable disease. A heavily damaged heart can be
- reconditioned. Even a positive HIV diagnosis does not
- necessarily mean that the illness will move into the active
- stage.
- </p>
- <p> One of the interesting things researchers at the UCLA
- medical center have discovered is that the environment of
- medical treatment can actually be enhanced if seriously ill
- patients can be kept free of depression. In a project involving
- 75 malignant-melanoma patients, it was learned that a direct
- connection exists between the mental state of the patient and
- the ability of the immune system to do its job. In a condition
- of emotional devastation, immune function is impaired.
- Conversely, liberation from depression and panic is frequently
- accompanied by an increase in the body's interleukins, vital
- substances in the immune system that help activate
- cancer-killing immune cells. The wise physician, therefore, is
- conscious of both the physical and emotional needs of the
- patient.
- </p>
- <p> People who have heart attacks are especially prone to
- despair. After they come through the emergency phase of the
- episode, they begin to reflect on all the things they think
- they will be unable to do. They wonder whether they will be
- able to continue at their jobs, whether they will be able to
- perform satisfactorily at sex, whether they can play tennis or
- golf again. In short, they contemplate an existence drained of
- usefulness and joy. The spark goes out of their souls. It may
- help for these people to know that in addition to the miracles
- that modern medicine can perform, the heart can make its own
- bypass around the occluded arteries and that collateral
- circulation can provide a rich supply of oxygen. A heart attack
- need not be regarded as consignment to a mincing life-style.
- Under circumstances of good nutrition, a reasonable amount of
- exercise and a decrease in the wear and tear of stressful
- events, life expectancy need not be curtailed.
- </p>
- <p> Plainly, the American people need to be re-educated about
- their health. They need to know that they are the possessors
- of a remarkably robust mechanism. They need to be
- de-intimidated about disease. They need to understand the
- concept of a patient-physician partnership in which the best
- that medical science has to offer is combined with the
- magnificent resources of mind and body.
- </p>
- <p> We need not wait, of course, for a catastrophic illness
- before we develop confidence in our ability to rise to a
- serious challenge. Confidence is useful on the everyday level.
- We are stronger than we think. Much stronger.
- </p>
-
- </body>
- </article>
- </text>
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