Describe health part 2

 Science has contributed to our understanding of wellbeing through an ingenious apparatus of techniques that reveal not only the causal pathways of ill health but also evidence for their amelioration. But the language of science can be inhibitory. For example, the notion of suffering is no longer fashionable. It is not a scientific word; it seems vague and old-fashioned, harking back to a time of clinical impotence, when patients had to endure and tolerate pain without respite or relief. Science aims to deliver the means to eliminate much of what once passed for human suffering.

But as the opening article in our Series on health in the occupied Palestinian territory shows, dimensions of suffering, especially at the community level, are measurable and often severe. Science has not eradicated suffering, despite its enormous power to deliver technologies to improve health. Being more humble about the experience of individuals, rather than simply drawing up reductive report cards of their health status, opens up the possibility for a more realistic understanding of what it means to be healthy. The fact is that one cannot be healthy in an unhealthy society.

Health certainly has to encompass these complex determinants of illness. But to say this can induce a feeling of fatigue, even defeat. The obstacles to a minimum quantity of health seem so huge and so complex that it is almost impossible for a single doctor to have any influence on their effects. But if we take a more modest view of what health means, perhaps we may be able to transcend the complexities of disease and offer a very practical mission for modern medicine.

That mission was set out most clearly by a French physician, Georges Canguilhem, in his 1943 book, The Normal and the Pathological. Canguilhem rejected the idea that there were normal or abnormal states of health. He saw health not as something defined statistically or mechanistically. Rather, he saw health as the ability to adapt to one's environment. Health is not a fixed entity. It varies for every individual, depending on their circumstances. Health is defined not by the doctor, but by the person, according to his or her functional needs. The role of the doctor is to help the individual adapt to their unique prevailing conditions. This should be the meaning of “personalized medicine”.

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