Saturday, June 14, 2008

How much do we value our health?

Most of us mortal humans, imagine that we are immortal.

But I guess it is only natural that we keep morbid thoughts such as dying and ill-health away from our humdrum lives and conscious level of day-to-day living, lest we slip into a downward-spiralling Charybdis of despondency and despair.

However, although the only sure thing in life is the departing, we can only hope to postpone the inevitable. Sometimes we are rudely reminded as to how fragile and how tenuous life can be; and how hopeless we can be under such catastrophic circumstances, when it is too late to do anything to change or modify its terrifyingly unknowable consequences--sometimes death just cannot wait... Sometimes, we bemoan if only...

More importantly, we should live life in full cognisance of a greater purpose and happiness for our individual selves and for our loved ones. For our more Christian and outward-looking friends, salvaging souls of as many people around us as possible, is that God-inspired calling.

Yet in between being born and that final act of departure, is what living is all about. And being healthy for a greater part of this living is a boon towards a more satisfying and hassle-free, and perhaps a more meaningful life. Luckily for most of us, being healthy forms a subconscious but natural part of our psyche.

We are able to then actualise whatever we wish to do: engage in all personal, social, economic, religious and/or political purposes, etc. without a thought on any limitation due to some breakdown or disorder of our bodily or mental functions. So, most of us are fortunate that our human bodies are often sufficiently efficient and superbly well-honed to function in clockwork precision, for a good many years...

But ill-health and misfortunes can jarringly strike, even when least expected. Some are due to abuse by our own risky habits and lifestyle choices. Others are less unavoidable--they are inherited through our wayward genes, which have somehow slipped through the evolutionary and error-filled mutations of humdrum and repetitive cell divisions of repair and replacement--our human physiological system that we call biological life.

Therefore, taking our health for granted is sometimes foolhardy.

Tim Russert, famed TV anchor man for NBC's "Meet the Press", died suddenly while at work. He was just 58 years old, and had just celebrated the graduation of his son and returned from a vacation in Italy, a few days before. He had a massive coronary--i.e. he died of a sudden heart attack, and he was found at autopsy to have had clogged-up heart arteries, and a ruptured cholesterol plaque in one of them, and a swollen heart. See Tim Russert Dies.

A few months ago, a renown and very successful obstetrician (doctor) died at his clinic in Bangsar, Kuala Lumpur, which shocked the medical community at my hospital. He was just 52 years old, hugely popular, hardworking, very kindly and gentle to all his legion of maternity patients.

It now emerged that he had been having symptoms for at least a year, but for which he had somehow decided wasn't important enough for him to seek assistance from his fellow colleagues. He was self-medicating, and kept postponing a cardiology consult for perhaps that niggling fear that he might need some surgical intervention. Perhaps, he'd wistfully thought, his symptoms weren't bad enough. Perhaps, he did not feel that he had enough spare time to sort himself out... Perhaps, most sadly, he did not think that his time was up, at least not just yet...

I have been informed that many ill patients make all sorts of bargains with God, just a while longer, and I'd do this or that; just don't make it too serious, not so soon, so that I can overcome it; soon...

But examples of such sudden dying as has happened here should prod us in the direction towards better self-awareness that we have to take our health very seriously. While doctors have always been advocating that health promotion and preventative measures are a must for the population at large, we often forget that it works both ways too.

Physicians too should not neglect themselves. Everyone needs to understand that undergoing periodic prophylactic health checks and thus allowing for earlier detection of certain disorders (such as heart disease or tumours) can be lifesaving. However, not everyone gets the opportunity to gain from such exercises, and there is professional dispute as to the actual cost-benefits of such indiscriminate health screening.

The latest Fortune magazine carried an article "The best checkup you'll ever get" which extols the virtues of the annual executive physical examination, which even promotes an upgrade to so-called first class head-to-toe workup. Among the best medical centres highlighted were the Johns Hopkins, Mayo Clinic, Cleveland Clinic, and Duke University. The bill for the standard Hopkins executive checkup came up to USD 2414, with another USD 1442 for a whole body MRI. Other optionals include: AAA abdominal ultrasound test, ankle-brachial index,exercise counselling, treadmill stress test, colonoscopy, bone density and HIV testing. A similar comprehensive exam at Mayo would set one back USD 3500.

So is this worth it? Is our health worth this annual workup, or are our cars and automobiles more deserving of their tune ups and physicals?

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