By Joy Stephenson-Laws, Managing Partner

As a society and as individuals, we often strive to have the “perfect” everything. The perfect mate, the perfect body, the perfect job, the perfect house or even the perfect nose. We also often believe that once we achieve the “perfect” fill-in-the-blank that our lives will be better, and we will be happier and healthier as a result.  

While psychologists and anthropologists may debate whether this drive is nature or nurture, one thing that is unequivocally certain is that the definition of “perfection” is quite ephemeral and constantly changing. This is especially true when it comes to our bodies.  

Consider, for example, that at one point having a “rubenesque” (so more voluptuous) figure was the ideal for women. Only a few decades later, being almost stick-thin was considered the ultimate in feminine attractiveness. Today, that “perfection” now leans toward the traditional “hourglass” figure.  

Men are also not immune to passing ideals of “perfection.” At one point, weight on a man was equated with status. Later on, the “perfect” male body looked more like a Greek statue. Today, having a “dad bod” is what some men go after.  

And when it comes to health, the concept of being “perfectly healthy” has also evolved and changed over time. As our understanding of human physiology, and especially microbiology and genetics, has advanced, so too has our definition of what it means to be healthy. On one hand, it has become much more inclusive and holistic to lump together physical health, mental health, social health and even financial health. On the other hand, we are still prone to letting our eyes be the judge as to whether someone “looks healthy.”

Back in 1948, the World Health Organization (WHO) defined “healthy” as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. This definition was updated some 40 years later, when the WHO added that health is a “resource for everyday life” rather than being an end in itself. And, a little more than a decade ago, the respected periodical The Lancet published a new definition posited by some researchers that health is the “ability of a body to adapt to new threats and infirmities.” How relevant this is right now with the coronavirus pandemic!

While all of the above are workable definitions that give healthcare providers, and the communities they serve, some guideposts for defining “healthy,” they unfortunately are rooted in an obsolete understanding of “perfect health.” This understanding permeates every aspect of healthcare and, in fact, is the foundation of how most providers approach patient care. Unfortunately, it has resulted in most healthcare being focused on the absence of symptoms.

Many people consider themselves healthy if they do not have symptoms of a disease, and healthcare is usually focused on providing acute care for diseases once they present rather than on preventing these diseases in the first place. 

But, as with many things in life, the fact this has been the norm for centuries does not necessarily mean that it is the best approach. In fact, this approach unnecessarily – as well as unintentionally and unwittingly – can end up making it harder for healthcare professionals to address underlying health issues before they become problems. Often, a potential health issue is not recognized – or addressed – until a patient is already in crisis.

A tragic recent example brings to focus the urgent need to redefine “perfectly healthy.” In April, a 16-year-old in Indianapolis succumbed to complications from Covid-19. His family described him as “perfectly healthy” before he fell ill and suffered a cascade of medical challenges ranging from previously undiagnosed Type 1 diabetes to Covid-19-related issues with his brain, heart, lungs and kidneys. He had so much trouble breathing that he eventually was placed on a ventilator. He later died from heart failure.

What is important to consider here is that reports say he had no underlying medical conditions and was described as “resilient.” He also enjoyed basketball and bowling and was quite accomplished at both.  It is understandable that some would describe him as “perfectly healthy.”  

Unfortunately, pictures of the young man give the impression that he also was overweight, a condition that can be the precursor to a wide variety of diseases such as diabetes, cardiovascular disease, hypertension and respiratory problems.  So, while he may have seemed or looked to be perfectly healthy, the reality is that he most likely was on his way to developing obesity-related diseases at some point had he survived his bout with Covid-19.

Another area of healthcare where the illusion of being “perfectly healthy” occurs is the way many doctors and patients interpret blood panels. For example, a person may have very unhealthy dietary habits, be obese, not exercise, smoke and/or abuse prescription medications or even street drugs and still have a blood panel whose components – for example, cholesterol, glucose, creatinine, blood counts, and liver enzymes – all fall within the generally accepted reference ranges. Many times, upon reading such a panel, both the provider and patient will assume that all is well since the blood work indicates that the patient is “perfectly healthy.” This approach can create a false sense of security which could lead to even more less-than-healthy behaviors and lifestyle choices. At the very least, this type of panel will be of little motivation to a patient to adopt a healthier lifestyle.