Rethinking Disease with Dr. Jeffrey Bland's New Book - "The Disease Delusion"
As a family doctor, the majority of my work days are spent performing routine physicals and maintaining chronic disease. Sometimes I catch myself enjoying the change of an occasional broken bone or infectious illness amidst the usual fare of diabetes, asthma, hypertension, heart disease and other more longitudinal disease states.
More typically, it's analysis of disease prevention and treatment involves inquiry of genetics via family history, analysis of pharmacology (medication) and adherence to certain benchmark goals for the various diseases. This is my existence it seems. I treat generations of diabetics and cardiac patients. I plow through endless numbers - blood pressures, blood sugars and various laboratory values.
I strive to meet benchmark goals in chronic disease, mostly through managing medications. But, sometimes it's easy to lose the patient amidst the standard factors of chronic disease. I was recently challenged to rethink my notion of disease, however, as a "diseased illusion." Here's why.
The Disease Delusion
As a doctor, the norm for diagnosing a chronic disease is to run tests, establish the diagnosis and then treat. In diabetes this involves blood tests and moves swiftly to pharmaceutical intervention with side thought to weight management. In chronic obstructive pulmonary disease this involves lung function testing and moves swiftly to pharmaceutical intervention with side though to environmental factors such as smoking. In high blood pressure this involves measurement of elevated blood pressure readings and moves swiftly to pharmaceutical intervention with side thought to diet and exercise.
Am I establishing a trend?
It seems that modern medicine has moved more to treating disease symptoms than getting down to the root cause or preventing the onset.
However, in a book by the provocative title, The Disease Delusion, Dr. Jeffrey Bland, an expert in functional medicine, sets out to break up the rut that guides the way we deal with chronic illness. The book challenges the notion that chronic illnesses like diabetes, high blood pressure and reactive lung diseases are distinct and fixed processes that should be treated and monitored in distinct and fixed regimens. Rather, according to Dr. Bland, examination of disease should begin with examination of the person's environment and physiology. We should look for the openings through which disease entered.
"But Isn't Disease Just Inevitable in Some People?"
When it comes to chronic disease, much, if not the majority, of the emphasis is placed on genetics - a misguided notion according to Dr. Bland. As he relays in his book, with the evolution of the Human Genome Project, various codes and traits have been mapped on the DNA blueprint of mankind. In this deciphering, however, it has been learned that the actual coding for disease per se is quite rare. Rather, the genome codes for the functions of the human body. Miscoding enhanced by factors such as poor environment, nutritional state, cardiovascular fitness or other stressors leads to dysfunction. It's the culmination of all this is that we see with chronic disease.
Though genetics can give us clues - opportunities to maximize health and prevent the downward spiral created by negative factors enhancing genetic tendencies - Bland challenges society to rethink how we approach disease and our tendencies toward disease. Every disease is a potential in every person on a spectrum! While, it's true that some people are more genetically susceptible than others on this spectrum, an understanding of this can lead to positive lifestyle decisions and in many cases, avoidance of disease.
People, according to the book, should not take a "one size fits all" approach to disease risk. Genetics should be examined closely for the good and the bad potential and then a health plan involving diet, exercise, meditation and environmental factors should be formulated for the individual.
"Doctors Mark Hyman, Jeffrey Bland, and Frank Lipman explain functional medicine at Urban Zen"
Making What We Have to Work With Work
As explained in The Disease Delusion, the goal of formulating a specialized, individualized health plan is to maximize the good and turn around the inevitability of disease. To Bland, this notion is as revolutionary as various historical landmarks in the understanding of health and illness such as the bacterial etiology of infection. In the way that this understanding culminated in increased the life expectancy of man, so shall a better understanding of the individual in turning on the code of good health and turning off the code of bad health.
The Disease Delusion by Dr. Jeffrey Bland has some thought-provoking ideas, especially for this primary care physician in the trenches battling daily with chronic disease. This book offers some valuable insights whether you are managing chronic disease in yourself or a loved one or if you are keen on preventing chronic disease that may be a legacy in your family.
The Disease Delusion, Jeffrey S. Bland PhD, 2014.