Health, Illness, and Medicine

This is my continuing conversation with Dr Abhinav Gautam; the first part is here:

Me: What are your views on what is health? Does maintenance of good health require special work by the individual? Or should we look at it from a holistic ecological perspective.

Abhinav Gautam: Good health is contingent on the alignment and efficiency of one’s physiology. I think it was Steve Jobs who suggested that the more technology becomes sophisticated, the more it recedes into the background of one’s experience. In the same way, true health is really about the body being in balance and harmony. In it, the individual experiences a state akin to weightlessness and freedom or one could think of it like floating through physical experience unencumbered by any tension or heaviness.

The human body is like an orchestra with different instruments, each playing its own specific part of the greater composition. When any of those instruments plays the wrong note or gets out of tune, then we become aware of it. Apart from its many mysterious qualities, consciousness is the listener of one’s health; we note dissonance and unpleasant sensation.

Me: Okay, let me pick up on a couple of points you made. Firstly, health is harmony. We want the body to work like an orchestra. But then the question is: how does it fall out of harmony? Is that because of a bad relationship between the mind and the body? We can’t talk just about the body and we must also bring in the mind because the human experience is an interplay between the body in itself and the mind. How does the mind come to disrupt that ideal state of weightlessness or harmony that you mention?

Abhinav: The mind and body are intimately connected, and it’s a bidirectional relationship, and one can’t exist without the other. Let’s take the example of depression, the heavy feeling in the mind that actually creates a heaviness in the body and one has this inertia with respect to physical movement. When there’s a stasis of the mind, a stasis of the body follows.

Anxiety is another example where the mind misinterprets the signals it receives, precipitating a chain reaction in the body’s physiology. Such misinterpretation can lead to a loss of appetite, rapid heart rate and other effects. The worst manifestation of this is when the mind is so disturbed that it drives the individual to do something very rash and detrimental to the body.

People harm themselves in a variety of ways. At the physical level, it can range from choosing a poor diet, or not sleeping well, or a lack of exercise. Clearly, the worst case is when someone tries to take their own life.

Me: What about mood? In some cases, the mood can lift by words of wisdom, an inspirational story, or a shift of focus.

Abhinav: Yes, perception matters. As Tony Robbins says a shift of a few millimeters or degrees can have a profound impact on the direction of one’s life.

But again, it’s not just the mind. It’s now known that at the neurochemical level the gut is basically like the second brain and it produces a huge amount of neurotransmitters, such as serotonin, that are responsible for one’s mood. One’s openness can facilitate a change in the mindset. But I don’t think someone with a very unhealthy diet will be able to make a mental shift as easily as someone who eats better and is physically active, owing to the connection between diet and perception.

Me: When there are things in a state of imbalance, there’s pain, which can be of different kinds. Thus bodily pain may be caused by injury, and the doctor makes an intervention and suddenly the body is pain free. Then there is mental pain where somebody, a wise teacher or a Guru, comes in and is able to remove that trauma by helping the individual change one’s perspective.

In the experience of pain, the body tells the mind: Hey, what you are doing is not working, so change.

Abhinav: We have known for thousands of years that pain arises from unfulfilled desires and bad experience. True pain and suffering is what the Buddha spoke about. It’s the body providing a signal to the mind that something is out of whack, and now you have to kind of drill into pain a little deeper and understand where that pain is coming from and what type of a signal it is.

The body holds trauma. If the pain is localized and neuropathic or neurological in its origin, then that is obviously physical. If it is more diffuse, and coming from a disturbance within the fascia [Note1] then it can be difficult to treat.

Mental pain, on the other hand, may be due to psychological trauma that the person has experienced or due to a problematic belief system that leads to a lack of understanding of one’s self.

If one is unable to reconcile one’s internal energy with that of the outside world, that leads to pain. Examples of this are an inability to find one’s passion or calling, or inability to understand what’s going on in the world.

Life in our uncertain time, with attendant financial insecurity, can have profound effects on one’s health. Sometimes fixing these factors can be harder than fixing physical ailments because they’re beyond one’s control.

Me: We know that one can have chronic debilitating pain from physical injury, and no matter what the person does the pain is always in the background. Is it possible to make the argument that just as one has the physical body, there is a corresponding mental body, and just as one can have injury to the physical body there can be injury to the mental body?

In the case of the physical scar tissue, a doctor can access its location and dissolve it, and suddenly the person is pain free. Is it possible that one can deal similarly with pain emerging from the mental body? The results will be extraordinary if one could access the location of that pain. That’s where psychologists, psychiatrists, and spiritual teachers come in. The relief from the mental pain by the help of the teacher or by one’s own personal effort can be life transforming.

Abhinav: Indeed, true. Also pain can arise from where the physical and the mental bodies meet. A big issue in modern society is that people do not breathe correctly. They breathe not through the diaphragm, but through the chest, creating a shallow and rapid breathing pattern, which does several bad things.

It reduces the amount of oxygen that is present in the body. It puts you in a sympathetic state so that the heart goes faster, and the blood pressure goes higher. It can be shown that slow and deep breathing (as against fast and shallow) brings about a serene state of mind. One of the biggest problems in today’s society is that people don’t know how to operate their own operating system. This lack of awareness of oneself is a source of disharmony. When bewildered by one’s own feelings, one has a much more difficult time navigating one’s way through the world.

Me: As an aside, in Patañjali’s yoga the very first step is pranayama, which means breath control. Adding to the woes caused by bad breathing, are there other disruptors in modern life that create imbalance within the individual?

Abhinav: In modern life, technology has increasingly replaced nature. Human beings are social creatures informed by tradition. But Cultural Marxism, which has become fashionable in college campuses, strives to destroy the traditional fabric of society. No matter what your personal belief of religion, it’s pretty safe to say that in the past, organized religion served as a bedrock for people to kind of gather around and interact with one another.

Tradition provided moral compass, and ways to deal with the world. This has been replaced by social media which is perhaps the most toxic invention to ever have been made. Life is becoming eerily like The Matrix. Many people have embraced fakeness and they obsessively record every detail of their life.

This is creating a generation of narcissists who live in a bubble, disingenuously curating photographs and posting them online for reactions for a dopamine high. This is playing into the mental health crisis that plagues not just young people, but almost everyone because there’s a huge change going on in the world and, sadly, technology is being used to distract people from waking up and before they know it they’ll basically be serfs.

Me: There are many threads here. One is about the isolation that is facilitated by technology and the social media. The other is that the word can spread quickly, all across the world. And that can also cause panic. Perhaps an example of that is the hysteria that set in two and a half years ago with the onset of COVID, which was taken advantage of by governments to impose lockdowns and thought control.

Many people were so frightened that some have not yet emerged from their apartments. The worst are highly educated people, whose fear is so much beyond what was warranted. But can one say that in many ways, it’s not so different from what happened in the past? Look at Europe. After it became Christianized, it fell into a dark age for a thousand years. Freedom of thought was disallowed and most art, excepting some religious art, was destroyed.

Can one say that the recent happenings are not fundamentally different from the hysteria unleashed by ideologies that pushed the dichotomy of the believer versus the non-believer, as opposed to the sensible idea of virtuous action versus unvirtuous action.

Abhinav: It was easier to control people in the past because information wasn’t so accessible. I think in Europe, and most other places, just the elites were allowed to have a real exchange of ideas. And these ideas were used to control the less educated people, to maintain privileges and power, and I think you have that same situation today. It’s just that with the advent of social media, all the information is out there.

Although every person has a voice there is also a surprising dumbing down of people, and most shouldn’t really speak up, not because their opinions don’t matter, but because they’re not well versed on the subject matter. They’re just speaking in a reactive or emotional way.

It’s easier now to manipulate people through disinformation. And through the crises that have happened one after the other, the elite are trying to keep people in a fearful state, because it’s much easier to control people who are afraid than people who aren’t.

Me: Yes, the distinction that you draw with the past is an important one. In the past, people had to work under harsh conditions just to survive. And now in this post-industrial age, where robots and machines do labor intensive work and AI machines do work involving judgments, many people have considerable free time. With information accessible to them it can be a good thing, but people can also fall victims to bad information. Governments tried to exploit this through the regime of lockdowns and the stamping out of dissenting opinions, even that of doctors. One must not forget that the world of science is only as honest as those who can stand up to authority in the cause of truth.

Abhinav: Yes, the CDC did not cover itself in glory during the last three years. Also zombie corporations exist because of their access to cheap credit, and the whole system is over-leveraged. Most people in any field are mediocre at best, and if they can use lobbying and heavy-handed regulation to stifle competition, they will.

COVID was a great example of how little people understand the working of their bodies, and how little faith they have in their own sense of well-being. Remember, physicians aren’t necessarily smarter than the average person; they just have the ability to delay their own gratification and work really hard. The medical establishment is pretty good at churning out people who will serve as cogs in the big medicine machine without questioning the system. Imagine you’re supposed to be a scientist but are forbidden to use your powers of observation.

The medical field in the United States has become part of the larger health, pharma, government bureaucracy complex, and many doctors are afraid to use common sense. They are also fearful of liability issues.

It is sad that during the pandemic years, the CDC and the federal government disallowed doctors from using off label drugs which they normally can prescribe freely. The pharmaceutical industry has become overly powerful, and it spends exorbitant amounts of money on R&D to produce drugs that end up failing because their approach to health is flawed. It is based on the reductive approach where you take one molecule and patent it as if it’s a miracle. That’s like saying that you have an orchestra but you just believe one instrument should be playing louder than everything else.

Look, 75 to 80% of all the advertising dollars in America are spent by the pharmaceutical companies. The media is at the beck and call of this industry. Things get more disturbing and confusing when you look at who owns these pharma companies, and you discover they are the companies that manage the pension funds.

Many things being done now are regressive and in some ways we seem to be going backwards. For example the ESG regime [Note 2] will hamper access to cheap energy, which will result in a lot more people dying just because they can’t get access to affordable food and medicine. Without oil, you’re not going to make cheap fertilizer, and since modern society is based on agrarian stability, energy disruptions will cause a lot more suffering than what’s occurring right now.

It is not surprising that the average life expectancy of Americans fell sharply in 2020 and 2021, the steepest two-year decline in nearly 100 years, dropping from an average of 79 years in 2019 to 76 years in 2021.


Note 1: A fascia is a structure of connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves, binding some structures together, while permitting others to slide smoothly over each other.

Note 2: Environmental, social, and governance (ESG) criteria are a set of standards for a company’s behavior used by socially conscious investors to screen potential investments. Environmental criteria consider how a company safeguards the environment, including corporate policies addressing climate change. Social criteria examine how the company manages relationships with employees, suppliers, customers, and the communities where it operates.



सुभाष काक. Author, scientist.

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