by John Bloom
As young children, my brother and I would visit our grandmother at the home for the aged. She would look at us and say, even into her nineties, “If you are healthy, you are wealthy.” That was a first mysterious inkling of how simple wisdom connects apparent disparity. Now that I am ten times older than that memory, her wisdom has settled into warm appreciation as I hold her in my thoughts. The adage holds a powerful question that, in order to be rightly understood, demands a radical recasting of the concepts of health and wealth and the extraordinarily complex relationship between them—as cultural and economic phenomena. But, before I take up that perspective, I want to acknowledge one aspect of my grandmother’s statement, the if-then proposition that says health is a precondition of wealth.
She did not say, if you are healthy you are rich. So clearly in her mind the concept of wealth was connected to something else. To an immigrant who started afresh in a new country, who had to form community and learn a new language, having a decent life was more relevant than being rich. The family she and my grandfather nurtured, and the community they joined and created, constituted their sense of wellbeing. And, it was their commonwealth. It included not only a community of religion, but also healthcare and banking, among other services. If one looks into the word wealth, its origins and use lie in shared well-being and prosperity. Wealth creation (the creation of wellbeing) is not an unfamiliar term; it is just that in modern times we have come to determine wealth as assets under management. In a kind of inverse parallel in the US, healthcare and capital have been industrialized and commoditized as ways to generate that wealth not for the commons but rather for private benefit.
So, what about health? How can we think about health in a broader context? I think the answer to this question resides in the origin of the word health. It bespeaks wholeness, which in itself points to something experienced from within as much as or more than something determined by any external measure. So, what wisdom resides in our language that we have become desensitized to? And how might we begin to reawaken not only the meaning held in the language but also reimagine how that meaning translates into practice?
Examining one aspect of language itself could illuminate a condition for bringing about such a changed imagination. Language mediates between the world of thought and ideas (spirit) and the practical and earthly (matter). Language connects each of us to the world of experience and makes it possible to share those experiences because we hold agreements about the meaning of language—agreements that philosophers call our mutual covenants. If we consider the notion of health as one of wholeness, then, like language, we cannot think of health without its spiritual dimensions even as we are daily aware of its physical challenges—especially in this time of pandemic. Further, if we think of what health represents for a human being from this fuller perspective, then we cannot ignore the spiritual import of what health entails and means for individual and community wellbeing.
It means that we cannot view the human being as a mechanistic system or healing as an industry driven by division of labor and efficiency. The former dominant paradigm is a result of centuries of scientific materialism. The latter convention derives from centuries of self-interested capital-centric economic practice. These cultural and economic factors, along with profound research and the creation of intellectual property rights (and of course there are others), have created extraordinarily beneficial breakthroughs and advances in the practices of medicine, almost miraculous ones along with ethically questionable ones. From an economic point of view, within all this advancement powerful market forces are at work, forces that have made visible the power and productivity of capitalism and its attendant wealth creation. This extraction of wealth has also led to dehumanizing the nature of work and diminishing the values of relationship, care, and loving attention—the very values upon which healing and our wholeness depend.
What this pattern raises is the need to reimagine roles of healing and health beyond the current design and impenetrable complexity of our current healthcare system. One way to approach this is to acknowledge the powerful intermediary role the doctor as healer plays in awakening wholeness by bringing the forces of the spirit into harmony with the instinct for healing that lives within the patient. The quaint term “medical arts” names this creative process through which healing—wholeness—is achieved.
Since healing is a scientific and cultural deed, a beautiful blending of the material and spiritual understanding and insight, its practices rightfully unfold in an atmosphere of spiritual freedom for both the doctor and the patient. This begs the question of what I mean by spiritual freedom in this context. What does that atmosphere look and feel like in the ideal? First and foremost a doctor and patient are two human beings who each have the capacity for self-knowledge and have found themselves on a destiny path that bring together capacity and needs. The doctor and patient recognize this pre-condition of freedom and meet each other in that atmosphere. Such a meeting or meetings makes the healing possible in a way that operates well outside allopathic convention. This imagination is what I might call participatory medicine beyond a problem (patient)- solution (doctor) approach. [Italics added—ed.] Rather, two individuals bring their particular capacities and needs to bear in a co-creative process from which wellbeing emerges.
While there are whole bodies of medical practice, protocols to follow, techniques to be applied, the sum total of that wisdom is there to be in service to what emerges out of the doctor-patient relationship. If we can accept that each individual is unlike any other individual at the deepest and highest level of constitution, then each path of healing is not only unique to the individual it is also unique to the relationship between doctor and patient. This relationship is the result of both the patient and the doctor coming together out of freedom. There is a quality of surrender in this, but again such a sense of surrender has to be chosen (even if seemingly by circumstance) and this is a conscious exercise of spiritual freedom.
Because it really matters that both doctor and patient feel that they are participating in a process that transcends each of them, what I am describing here as health maintenance would be anathema to anyone in the health care industry; it places as much emphasis (maybe even more) on the spiritual or non-measurable dimension of healing as it does on efficient outcomes.
The quality of service to the other as a healing process has significant implications for how medicine and healing can be practiced. It would change how doctors and health care providers are trained. It would transform the economics of healthcare in general—especially since it would eviscerate the producer-consumer marketplace relationship and instead foster associations of doctors and those in need of healthcare (isn’t that all of us?). Not only would healer and patient actively participate in the healing process, but they could also expect to participate in an association that determines the economic framework for healthcare in general. I know that we are far away from such an approach to healthcare, but unless we start imagining such an approach, or at least creating such an approach as an option, it most certainly will not come to pass. [Italics added—ed.] Of course, working with healthcare on such a scale across the whole country seems a far stretch from what might be accomplished on a local or community level. There are already experiments in this direction, such as doctor-patient cooperatives and community supported clinics. The financing and funding of such a system also would require a grand design—but there are those who have already imagined universal healthcare which is a step toward this even grander imagination.
What I am arguing for at bottom is that health (wholeness), and the human being and relationships be brought back to the center of healthcare. Further, that we see the wholeness of every human being as everyone’s sacred responsibility and relationships as the building blocks of a new temple of humanity. When we do, our commonhealth will also become our commonwealth—something my grandmother already knew. Given all the social and environmental challenges we face, to share an imagination of a common future built on profound interdependence and real need for the unique capacities of each other and starting from the foundation of spiritual freedom may be the most productive, if illogical, path to go.