© 2017 by Dr. David Buscher, D.Ac.
My friend and mentor Bob Duggan passed away last year. He was the cofounder of my acupuncture school and a noted author and commentator on the topics of wellness, the art of living, health care, and culture. Bob’s own mentor, Ivan Illich, has been cited as one of the great thinkers of the twentieth century. Ivan’s book Limits to Medicine: Medical Nemesis, published in the early 1970s, was a groundbreaking indictment of our healthcare system at the time – and while that book since became required reading in medical schools, he stated in the introduction to the 1995 edition that he had not taken his ideas far enough originally.
In other words, the central premises and implications of our healthcare system were worse than he thought in 1974, and they have since gotten even worse than that. I’m not talking about our modern dilemmas of widespread coverage or quality of care or outcomes, but rather the most basic assumptions about what health is.
At various times, in various ways, and in response to various questions, Bob and Ivan are both on record saying essentially that there is no such thing as health. There is no Platonic ideal of health that we can all collectively aspire to, nor some personal pinnacle we can reach individually. There is only living from moment to moment, being mindful of our sensory awareness, enjoying the pleasant and bearing the suffering well. There is an image we used at acupuncture school of life (or wellness, or qi) as a rice pot: enough water, enough rice, enough heat, keeping it boiling appropriately, not boiling over, not burning or drying up. Living is motion, action, attention, awareness; it is not a “system,” nor can it be reduced to puzzle that needs to be addressed by a system.
According to Ivan’s work, our idea of health as an aspiration started during the Industrial Revolution, when workers needed to be separated into being fit or unfit to perform their factory jobs. This eventually resulted in seeing people as functioning or malfunctioning machines, and health as transactional, something tangible conferred by a doctor in exchange for money. The art of living well – the rice pot – gets lost in that transaction.
This is a philosophy with broad implications for all of us. As a “healthcare provider,” someone who is apparently supposed to provide health, I feel I have a special responsibility to consider those implications. I consider my job mostly to help people keep the “rice pot” boiling, to keep life moving, to understand what living well means to them and help empower them to do so. The tools at my disposal are needles and words. I can get symptoms to go away easily enough, but I don’t consider my work done until I offer the idea that there is something to be learned from them about living well.