Health is the state about which medicine has nothing to say. - W. H. Auden
I have previously written about a project in which I am involved that tries to do for physical health what positive psychology has done for psychological health. That is, if we get rid of all symptoms of distress and disorder, have we achieved our final goal? Positive psychology says no, that the absence of psychological problems is not the same thing as being happy, satisfied, fulfilled, or purposeful. We need to break through to the other side of the zero point signifying problem-free. Positive psychology for the past decade has profitably explored what it means - psychologically - to reside on the other side of zero.
So what about physical health? In the abstract, most would agree that good health - positive health, if you will - entails more than being free of illness and injury. But this is often a slogan, something we are trying to change in our project by looking at actual data.
As positive health research has unfolded, it has usually taken the form of showing that there are predictors of good health (longevity and/or freedom from disease) above-and-beyond the usual suspect risk factors like hypertension, high cholesterol, and anger and depression, to mention two of the psychological risk factors often implicated in illness, especially cardiovascular disease. Our own research and that of others shows that positive predictors, health assets as we dub them, also foreshadow good health, even when risk factors are taken into account. Among the psychological health assets are life satisfaction, positive emotions, optimism, and a sense of meaning and purpose (e.g., Kim, Park, & Peterson, 2011).
These are of course important findings, but the typical research outcomes - longevity and freedom from disease - still reside in the domain of business-as-usual medical research, leaving unanswered what I think is an even more basic issue, whether there is a physical health equivalent of being really happy. That is, does super health exist?
What we have in support of the notion of super health are anecdotes, like people who never miss a day of work, or folks who are HIV+ for decades but never become symptomatic, or - in an example I like to use in my class lectures - the difficult death of the Russian monk Rasputin, who lived on for days despite being poisoned, stabbed, shot, drowned, and set on fire. The exam question I usually pose about him is "Was Rasputin a tough dude?" The correct answer is "Yes indeed-y."
But the plural of anecdote is not data, leaving unanswered the empirical status of the notion of super health.
Indeed, some knowledgeable people to whom I have spoken over the years are skeptical of the notion, except in the obvious sense that some people of course live longer and have fewer diseases than others; that's what would be expected given the bell-shaped distribution of most health criteria. They have further pointed out to me that the "health" of bodily systems typically resides between the extremes of too little and too much. Hypertension is bad, but so too is hypotension. Too much insulin production is unhealthy, as is too little. Ditto for the responsiveness of our immune systems; we want them to be neither too active nor too sluggish. Super health would seem to require something beyond a midpoint of bodily function, but the midpoint is what is usually healthy.
I remember in particular conversations I had with several physicians about super vision. I started by asking what was healthy vision, and they all said 20-20 acuity. I persisted, asking what about better than 20-20 vision, and all I received were blank stares and a repetition that 20-20 was healthy, as good as it got, or at least as good as it needed to be.
So I kind of let the notion of super-health go, except in my lectures about Rasputin, which if nothing else were interesting to my students.
Imagine my pleasant surprise the other day when reading a sports magazine that recounted studies of the visual acuity of elite baseball and softball players, the vast majority of whom have "better" than 20-20 vision, with some testing out at 20-8.9, as close to the absolute limit of 20-8 as is possible (e.g., Laby et al., 1996). To say that a good batter "sees" the ball well is apparently more than a metaphor**. Super vision exists and has obvious benefits, at least for baseball and softball players.
By implication so too does super health exist, and it has important consequenes. Our task is to discover where and how different forms of super health matter.
Hmm. I have never seen a photograph of Rasputin that showed him wearing corrective lenses.
*When baseball player Ted Williams, one of the greatest hitters in baseball history and the last major league player to hit .400, took his physical exam for World War II, doctors marveled at his 20-10 vision. By the way, an intersting factoid about Williams is that his given name was Teddy (after the President), a name he supposedly did not like. He therefore went by Ted.
**Maybe this explains why baseball players come in all sizes and shapes; visual acuity may matter more than bulk. And maybe this explains why human growth hormone (HGH) is beneficial for baseball players above-and-beyond obvious effects on size and strength; I have read reports that HGH also improves visual acuity. Interesting.
Laby, D. M., Rosenbaum, A. L., Kirschen, D. G., Davidson, J. L., Rosenbaum, L. J., Strasser, C., & Mellman, M. F. (1996). The visual function of professional baseball players. American Journal of Opthalmology, 122, 476-485.
Kim, E. S., Park, N., & Peterson (2011). Dispositional optimism protects older adults from stroke: The Health and Retirement Study. Stroke.