- Glimpse of a highly simplified equation for disease X etiology
In two of my recent posts (The Logical Shame, The Righteous Anger, and The Good Doctor), I hinted at my beliefs about meaning and disease development. The question is ageless, and variously answered at different times in history and among different cultures – Why do some people become so very ill, while others enjoy good health? The query is both fascinating and dangerous. I’d like now to flesh out, or rather, to clarify, my stance on this antiquated inquiry.
To what I DO NOT subscribe
1) Karma and/or Divine Punishment.
As I wrote in a recent comment, I believe in “karma” so far as it relates to the natural consequences of one’s choices and actions. If one smokes, one is at a high risk for lung cancer. If one drinks, whether he is an angry drunk who beats his wife or a delightful drunk who tells fun stories, he is at risk for hepatic cirrhosis. If one is a glutton and quite sedentary, one is at risk for type II diabetes mellitus and sundry cardiovascular disease. If one is caustic socially, one is at risk for loneliness and all manner of social and personal consequence. And, if one exhibits poor professional comportment, one is at risk for demotion and reassignment. However, I do not favor broad application of the phrase “what comes around goes around,” or ” you reap what you sow.” Individuals who develop diseases based in genetic and unavoidable environmental factors do not in illness suffer for previous or current moral wrongdoing. I do not subscribe to the belief that such disease (or natural disaster, or true accident) is a punishment dealt by the balance of a measured world.
Similarly, as regards “Divine Punishment,” apply the thoughts I expressed on “Karma.” Concerning consequences of lifestyle choices, I understand if you abuse something or someone, it may eventually fail or come back to flail you. But I don’t believe that everyone (heck, anyone) who develops a disease brought on by uncontrollable factors must be some terrible or chronic “sinner.” The etiology of illness unrelated to identifiable lifestyle choices or habits does not lay in some brand of moral stain. We are all of us corrupt; that Providence would deign to punish one type of “sin” or one specific “sinner” and ignore another, or stoop to honor the personal, vengeful desires of the particularly faithful by inflicting arbitrary disease, is beyond my comprehension. I do not subscribe to the belief that disease (or disaster, or accident) is a punishment dealt by a just or wickedly wise deity.
But, you say, I knew a bad person who a bad thing happened to, or who got a bad disease.
Apologies. And eureka. I am a scientist. I don’t do anecdotal. And the plural of anecdotal is NOT data. You show me a giant chart review comparing carefully selected social criteria to well chosen disease and mortality measures – NO – you show me a meta-analysis, a Cochrane Review, of a large number of such studies, show me not just significant, but AMAZING odds/hazard ratios or relative risks to correlate poor (or high) morality unrelated to poor (or good) lifestyle habits with disease (or health) – and you show me all the biostats to rule out confounders, avoid bias, analyze all possible variables and effect modifiers – and then I’ll consider adopting it as theory.
2) Divine Design.
Yes, I am a religious person, and, no, I’m not going to broach the subject of the union or non-union of the scientific and the spiritual. And, no, what I believe on the topics of evolution and angels and near-death experiences and prayer and faith-healing and divine intervention and signs is not at issue here, either. And, no, I’ve no scientific proof of anything I’m about to say.
I don’t think that God, (or god(s) or forces of nature, as you like) sits about with two decks of cards – one being cards displaying living or to-be living persons, the other a set indicating different diseases in numbers keeping with the prevalence or incidence of that malady – making thoughtful pairings between members of those two decks. I don’t believe God thinks at all about who would “be strong enough to bear such a burden” or who would (shudder) “benefit by disease,” choosing “capable” or “deserving” victims accordingly. I’m a “He got the ball rolling, and now He’s just standing by watching it play out” kinda gal. I do believe He is omniscient and omnipotent and omnipresent and all that jazz, but I don’t think He’s sitting here now tweaking my ANAs or poking my kidneys or diddling about with ideas in my brain. I think He hears my prayers and He sends me strength and balance and such, but I don’t see that He is minutely involved in my everyday experience, or the detailed planning of my whole lifespan. Again, that’s just me. Free will and all. Got no evidence. But got plenty a’ spit.
3) SLE, CVID, and APS.
I made no charitable contribution to these particular entities, enjoyed no subsequent tax deduction for my generosity. I have no idea who sold me out so that my name does appear on their lists. Indeed, if I had known I was a candidate for their solicitations, I would surely have sprung to the Better Business Bureau for help, or paid them off. And yet, they send me their newsletter – their symptoms, their complications, their damage. How do I write in and end this blasted annoying subscription!?
To What I DO Subscribe
Genetics + Environment + Lifestyle = Disease.
The etiology of many diseases has been at least partially uncovered – faulty genes, mutation, combinations of contributory alleles, infections, toxic exposures, damage, bad habits, etc. But for the many illnesses that still allude science in these (and other) respects, although we know they are the product of genetic and environmental factors, and may have discovered some of the contributory factors, avoidance of disease development is currently beyond our grasp. In short, disease is a complex combination of genetic predisposition and environmental triggers (some known, some as yet undescribed), an accident of birth and circumstance, neither inflicted nor planned. Here I stand amongst millions of scientists and physicians, having not only learned and read the scientific literature, but having participated in colleagues’ and performed my own basic research and seen the strong basis of this theory.
So, where does this leave me and the stacks of others who’ve been victims of chance and circumstance? Well, a bit unlucky, I’d say. A little bummed, I’d wager. Perhaps feeling angry, and empty. Most of us have probably entertained or still receive some guilt in their innermost parlours. But we are NOT GUILTY. And, certainly, never should we subscribe to any theory which bids us pass judgment on those who Misfortune, in her vast and winding and unscheduled, blank-itineray journey, has visited.
____________________________________________________________
The new edition of The Lupie Log Autoimmunity Collection is out! You can view the Feb Installment,
and learn more about The Lupie Log Project at the provided links. Thanks to all for sharing their insights!
.
 |
| Glimpse of a Highly Simplified Equation for Disease X Etiology |
In two of my recent posts (The Logical Shame, The Righteous Anger, and The Good Doctor), I hinted at my beliefs about meaning and disease development. The question is ageless, and variously answered at different times in history and among different cultures – Why do some people become so very ill, while others enjoy good health? The query is both fascinating and dangerous. I’d like now to flesh out, or rather, to clarify, my stance on this antiquated inquiry.
To what I DO NOT subscribe
1) Karma and/or Divine Punishment.
As I wrote in a recent comment, I believe in “karma” so far as it relates to the natural consequences of one’s choices and actions. If one smokes, one is at a high risk for lung cancer. If one drinks, whether he is an angry drunk who beats his wife or a delightful drunk who tells fun stories, he is at risk for hepatic cirrhosis. If one is a glutton and quite sedentary, one is at risk for type II diabetes mellitus and sundry cardiovascular disease. If one is caustic socially, one is at risk for loneliness and all manner of social and personal consequence. And, if one exhibits poor professional comportment, one is at risk for demotion and reassignment. However, I do not favor broad application of the phrase “what comes around goes around,” or ” you reap what you sow.” Individuals who develop diseases based in genetic and unavoidable environmental factors do not in illness suffer for previous or current moral wrongdoing. I do not subscribe to the belief that such disease (or natural disaster, or true accident) is a punishment dealt by the balance of a measured world.
Similarly, as regards “Divine Punishment,” apply the thoughts I expressed on “Karma.” Concerning consequences of lifestyle choices, I understand if you abuse something or someone, it may eventually fail or come back to flail you. But I don’t believe that everyone (heck, anyone) who develops a disease brought on by uncontrollable factors must be some terrible or chronic “sinner.” The etiology of illness unrelated to identifiable lifestyle choices or habits does not lay in some brand of moral stain. We are all of us corrupt; that Providence would deign to punish one type of “sin” or one specific “sinner” and ignore another, or stoop to honor the personal, vengeful desires of the particularly faithful by inflicting arbitrary disease, is beyond my comprehension. I do not subscribe to the belief that disease (or disaster, or accident) is a punishment dealt by a just or wickedly wise deity.
But, you say, I knew a bad person who a bad thing happened to, or who got a bad disease.
Apologies. And eureka. I am a scientist. I don’t do anecdotal. And the plural of anecdotal is NOT data. You show me a giant chart review comparing carefully selected social criteria to well chosen disease and mortality measures – NO – you show me a meta-analysis, a Cochrane Review, of a large number of such studies, show me not just significant, but AMAZING odds/hazard ratios or relative risks to correlate poor morality unrelated to poor lifestyle habits with disease (and you show me all the biostats to rule out confounders, avoid bias, analyze all possible variables and effect modifiers) and then I’ll consider adopting it as theory.
2) Divine Design.
Yes, I am a religious person, and, no, I’m not going to broach the subject of the union or non-union of the scientific and the spiritual. And, no, what I believe on the topics of evolution and angels and near-death experiences and prayer and faith-healing and divine intervention and signs is not at issue here, either. And, no, I’ve no scientific proof of anything I’m about to say.
I don’t think that God, (or god(s) or forces of nature, as you like) sits about with two decks of cards – one being cards displaying living or to-be living persons, the other a set indicating different diseases in numbers keeping with the prevalence or incidence of that malady – making thoughtful pairings between members of those two decks. I don’t believe God thinks at all about who would “be strong enough to bear such a burden” or who would (shudder) “benefit by disease,” choosing “capable” or “deserving” victims accordingly. I’m a “He got the ball rolling, and now He’s just standing by watching it play out” kinda gal. I do believe He is omniscient and omnipotent and omnipresent and all that jazz, but I don’t think He’s sitting here now tweaking my ANAs or poking my kidneys or diddling about with ideas in my brain. I think He hears my prayers and He sends me strength and balance and such, but I don’t see that He is minutely involved in my everyday experience, or the detailed planning of my whole lifespan. Again, that’s just me. Free will and all. Got no evidence. But got plenty a’ spit.
3) SLE, CVID, and APS.
I made no charitable contribution to these particular entities, enjoyed no subsequent tax deduction for my generosity. I have no idea who sold me out so that my name does appear on their lists. Indeed, if I had known I was a candidate for their solicitations, I would surely have sprung to the Better Business Bureau for help, or paid them off. And yet, they send me their newsletter – their symptoms, their complications, their damage. How do I write in and end this blasted annoying subscription!?
To What I DO Subscribe
Genetics + Environment + Lifestyle = Disease.
The etiology of many diseases has been at least partially uncovered – faulty genes, mutation, combinations of contributory alleles, infections, toxic exposures, damage, bad habits, etc. But for the many illnesses that still allude science in these (and other) respects, although we know they are the product of genetic and environmental factors, and may have discovered some of the contributory factors, avoidance of disease development is currently beyond our grasp. In short, disease is a complex combination of genetic predisposition and environmental triggers (some known, some as yet undescribed), an accident of birth and circumstance, neither inflicted nor planned. Here I stand amongst millions of scientists and physicians, having not only learned and read the scientific literature, but having participated in colleagues’ and performed my own basic research and seen the strong basis of this theory.
So, where does this leave me and the stacks of others who’ve been victims of chance and circumstance? Well, a bit unlucky, I’d say. A little bummed, I’d wager. Perhaps feeling angry, and empty. Most of us have probably entertained or still receive some guilt in their innermost parlours. But we are NOT GUILTY. And, certainly, never should we subscribe to any theory which bids us pass judgment on those who Misfortune, in her vast and winding and unscheduled, blank-itineray journey, has visited.
____________________________________________________________
The new edition of The Lupie Log Autoimmunity Collection is out! You can view the Feb Installment,
and learn more about the The Lupie Log Project at the provided links. Thanks to all for sharing their insights!
Ah, tummy troubles. I’ve written here before on this subject, about the nausea and vomiting, (and, oh, the stains), and the (gulp) gut issues (see # 2 here) associated with my lupus bowel vasculitis. These particular symptoms are a drag to say the least. But the match lupus played with team GI last night was a whole new ball-game. The lupus players were burly and dishonest and really very angry…and that umpire was lettin’ ’em get away with moida‘!
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