“Tis healthy to be sick sometimes.”
I’ve always been fascinated by Henry David Thoreau, who wrote those words in his journal on January 10, 1851. I appreciate his belief in the inherent goodness of people and his work as a reformer. During the two years he spent at Walden Pond, he became one of the earliest Western pioneers of mindfulness. “I went to the woods because I wished to live deliberately,” he wrote in Walden; or Life in the Woods. His daily walks were a form of meditation, and he intentionally stripped away distractions to become more fully present.
I’ve had three significant health crises in my lifetime, and I can now see the wisdom in Thoreau’s recognition that there can be purpose and meaning in experiences of physical frailty. My first health challenge was triggered by a middle-of-the-night call notifying me that an FBI investigation into fraudulent healthcare billing practices (in which I had been serving as an unpaid advisor on billing practices) was about to become public. My determination to expose the illegal practices had triggered a deep stress-induced fear that I did nothing to stop. It reached the point where I couldn’t drive and couldn’t function.
The second significant health event happened several years later, when I was on a road trip that involved lots of driving. I was running on the hotel’s treadmill after we’d settled, and I noticed a constant pain around my groin. When I got home, my doctor did an immediate ultrasound, which revealed a significant blood clot that, if untreated, could end my life at any moment.
The third event happened during my second month in a new job. I’d traveled by train to Philadelphia and spent the night in a hotel. I felt that I wasn’t quite at my best during my meetings, but I boarded the train back to DC, sending several text messages while I was traveling. When I walked into the office, my assistant immediately noticed that the left side of my face was drooping. She called my wife, who was alarmed by my slurred speech. That brief conversation with my wife was the last thing I heard. When I woke up, I was in an ambulance, speeding toward the hospital. I later learned that my speech had been slurred during the meetings in Philadelphia, and that the text messages I’d sent during the commute back to DC had been completely garbled. My colleagues hadn’t recognized the symptoms of a stroke—and neither did I.
These three events took place over the course of several years, in different parts of the country, under different healthcare systems. They happened despite the fact that I’ve been a marathon runner and an active yoga practitioner who eats well and takes care of himself.
With each of these crises, I’ve learned a bit more about my health and the health of our healthcare institutions. Stress is a common factor when my health has been compromised, and I believe it’s the same for our institutions. They’ve been under stress for decades. We’re seeing the cracks and, in some cases, the broken places where there aren’t enough providers, not enough hospitals, and not enough quality care for the people who need it.
Each of my crises holds a lesson about the American healthcare system and the crises it’s facing. The first happened slowly, while I worried and denied that anything was wrong. There’s a lesson there in our current system that rewards acute intervention over preventive care, waiting for emergencies instead of treating conditions when they first emerge. The second—a blood clot I didn’t know I had, caught because my primary care doctor knew me and took my symptoms seriously—points to the importance of routine screening and continuous care from a primary care team that knows a patient’s history. The third—a stroke that was unrecognized for several hours—is in many ways a sign that we need to pay attention to the worrisome signs that something is wrong in the current healthcare landscape. We need to avoid the temptation to neglect what’s wrong and take quick action to respond to the signals being sent of the looming crisis. We need to ensure health care, not sick care.
I’m optimistic about our capability to use the lessons from health crises to build something significantly better. As Thoreau wrote to a friend, “There is one consolation in being sick; and that is the possibility that you may recover to a better state than you were ever in before.”