Health, like beauty, lies in the eyes of the beholder and a single definition cannot capture its complexity.

For a period of time, my mother has been complaining of pain in her joints, hips and more recently, her back. I always had a bad feeling that there was something sinister about her pain even though our general practitioner could not pinpoint anything serious after several differential diagnoses. However, as she has a family history of joint pains, I chose to be in a state of denial to her pain and attributed it to a ”genetic” condition she had that would go away with time.

However, that was not the case. My family observed that my mother was getting more emotionally irritable as time went by, and the nagging pain meant that she often found reasons not to take part in social activities that we organized. It got to the extent that she was constantly lying in bed and could not do her favourite activities, such as going to the market, without considering a number of movements she would have to go through. The radiating pain also gave her sleepless nights and all these were taking a toll on her quality of life, among many other factors. It was debilitating. And as her daughter, I felt helpless. More so because I was studying medicine, and was plagued with the guilt of not being able to relieve the suffering of the person I loved the most.

The persistent pain worsened and my family decided to consult a specialist for a second opinion. A tumor was suspected. While the specialist made his diagnosis, I was very worried for my mother. I tried to prepare myself mentally to cope with the worst-case scenarios, and this affected me emotionally and psychologically. I had no one to turn to as I did not want to worry others, and was at a loss of what to do. The results later revealed that my mother was diagnosed with a benign tumor (spine haemangioma). The specialist said that it was the lesser evil because it was not malignant, but that she would feel chronic pain throughout her life. What provided comfort to my family was the knowledge that there were treatments available to contain the tumor through methods such as radiotherapy and physiotherapy.

Health means the holistic well being of a person

Witnessing her chronic suffering has made me realize that health does not merely mean the absence of disease but it requires a more holistic view which encompasses the physical, psychological and social well-being of a person. I used to think of health as merely the absence of physical pain that arose from diseases, and to this extent, the physician’s task of relieving “suffering” was mere to alleviate the immediate physical pain and discomfort.

Health means caring about the people who care about you and whom you care about

I always thought of Health as merely a personal responsibility and a duty that an individual owed only to himself. However, this experience has prompted me to comprehend how the absence of health in individuals will affect the mental, social and physical health of their loved ones as well.

Research, analyse and connect

The academic literature available allows me to gain a deeper insight on what health means to me and allows me to make sense of my experience in a broader context through considering the perspectives of others.

Through examining the concept of human suffering brought about by the absence of good health, I learnt about the distinction between suffering and pain. A person who is in pain may not feel a proportional sense of suffering it is similarly possible for one to suffer even in the absence of pain.

Suffering includes physical pain, but it is not limited to it. It can be understood by examining the many aspects of a “holistic person” and when any of these aspects is threatened, suffering ensues. These aspects may include a person’s past, his or her role in society, relationships with others, day-to-day behavior, and perception of the future. The persistent pain my mother experienced affected her ability to do things that she had long associated herself with, such as playing tennis or climbing the stairs. In addition, my mother may have seen herself as being defined by several societal roles, such as being a wife, mother, caregiver to her parents, and a useful member of society.

Decide, act and evaluate

In light of the reflective writing and the academic literature reviewed, I hope that this will help me to come to terms and cope with the negative emotions I felt since receiving news of my mother’s tumor.  Her treatment is likely to expand over a long period of time, and she would need much emotional support and love from me. I have to be open to discussions about her illness and not evade any conversation on the topic as I did before.

As a medical student, I have been made aware that the suffering of patients extends beyond physical pain, and that it is necessary for physicians to focus on patient-centred medicine and attend to the biopsychosocial model of health. It is also important to be aware of the impact that caring for a chronic ill patient has on the caregiver. To this end, I can be proactive as a future practitioner in asking caregivers how they are coping, and provide them with support services that they can turn to.

A major takeaway from reflecting on what health means to me has been my understanding of the importance of medical practitioner to focus not only on curing diseases but also to relieve the sufferings of patients, understood holistically. To me, health transcends the absence of disease to include the physical, psychological and social well-being of a person; it means the empowerment of the individual and is the foundation of a fulfilling life; it also means caring about the people who care about you and whom you care about.

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