My comment, "No one knows how to “do” health" on last night's #hcsm radio session brought some puzzled tweets my way. Let me expand:
Health is learned
On the most fundamental level, a health encounter in our system is a learned transaction. It is a learned experience. No adult or child knows how to “survive” cancer, or “beat” diabetes, or be a parent for that matter when he or she starts on day 1. Quite the contrary.
Health is developmental
Health is a developmental process, a series of baby steps deeply and inextricably linked to cultural norms and expectations. Since so many of those norms are being challenged right now, it is a great time to think about how we learn to navigate the health system and what opportunities exist today to make improvements.
Oversimplifying this I realize, but if you were taught not to ask questions of your doctor, then you'll probably need more encouragement to start asking questions and participate more. If you were taught (from experience or environment) that medicine is a crap shoot, then you may be more comfortable advocating for yourself or another in a health care setting. You might feel righteous ... as many do. Or, you may simply give up from the stress of it all and become uncompliant.
We learn by participating
My point is that we learn to "do" health. We learn by participating. By showing up and "muddling on through" in many cases. We learn by accepting uncomfortable treatments, procedures and interventions; by asking questions and wrestling with the answers we get until we are able to take a step forward. The maddening paradox is that healing often brings discomfort, at least initially.
And more discomfort is hard to tolerate when you're in a healing crisis.
"Just right" health care
A patient learning how to participate in her own care can look a lot like Goldilocks from the children's classic. An empowered, participatory patient won't stop looking and learning until she finds what feels "just right" right to her. While the social web can help a patient climb a steep learning curve, so may pharma, tech, friendship, prayer, play, and (____you name it here___). These are all powerful cultural modalities in the healing repertoire.
So, while we don't start out knowing how to "do" a health crisis, the silver lining is that wherever you begin your challenge along the continuum of health, you will have an opportunity to learn and develop. That's right; we are all beginners. Even doctors and nurses are beginners when it comes to their own health crises. And while anything can happen, there is no guarantee that it will.
Get better at health by practicing it
Whether it is learning to eat better and exercise; stay calm and organize a response to a terrifying diagnosis; work like hell to seek alternative treatments; or advocate to “free the damn data,” as ePatient Dave says - adults learn how to “do” health by participating in it.
The good news is…we get much better at "doing" health with practice. Start when you are healthy.
Communicating with doctors: Practice when you're healthy
Are we betting on the "me" in medicine?