The RISE Manifesto: a call to think differently about health problems
The RISE Way: because there's more to brief illnesses and persistent conditions than just time.
What if there's a better way to think about health problems than simply chasing cures? I believe there is: I call it the RISE Way.
This is a manifesto about health problems.
Or more specifically, about the problem with how we deal with problems and what we can do about it. If life has dealt you or someone you care about some hard blows lately—or even if it’s a long time ago but the effects still linger—then this is for you. And although it’s really based on health problems, the lessons apply more broadly to problems in general.
The manifesto, in brief is this:
- There are two kinds of health problems. And what works for one worsens the other.
- Brief illnesses are math questions, persistent ones are art problems. And you can only solve one kind.
- Curable health problems are often from outside in. Problems from inside out are often not curable.
- Cure-focused thinking does more harm than good. There’s a better way.
- RISE to the occasion: Something better than a cure.
Let’s proceed to unpack it all.
1. There are two kinds of health problems. And what works for one worsens the other.
The two kinds, as I explained earlier, are short-term and long-term.
If a friend had a bad cold, you would advise them to take time off work, take things easy and get some rest so they can be back with a bang in a few days. Also, don’t come back to work until you’re sure feel better. Great advice. (All assuming you’re working in a great company in a country with proper labour laws, of course.)
The advice is not so great, though, if the person was just diagnosed with diabetes. Yes, they can take time off for a bit, but considering diabetes doesn’t go away, there’s only so much time one can take, isn’t there? And they can’t put their lives on hold in the meantime.
Except that’s what I see people do all the time: put their lives on hold while searching for the “solution” to a health condition. (“Health conditions” is my preferred name for long-term, or persistent, health problems—it’s just easier to say.)
[bctt tweet="What works for brief health problems worsens health conditions. Learn how—and what to do instead. " username="DocAyomide"]
2. Brief illnesses tend to be math questions, while persistent ones are art problems. And you can only solve one kind.
Think about the common cold example from earlier: in common cold, you know exactly what the issue is. You know what to do. You almost know how long it’ll take, even. It’s like a math formula. Simply apply it and problem solved: a “cure”! (I’ll explain the quotes soon.) This applies to pretty much any short term health condition. Apply the formula and voilà!
With health conditions, there are often no formulas, no solutions, no “cures.” Sure, there’s treatments available, but it’s never that simple. Almost all colds are treated the same way, many infections as well. But any two people with diabetes or depression or dementia, no two treatment paths will be the same. The doctor knows what can work, but figuring out what will work for you is another matter. And even that can change from one year, or even one month, to the next.
So no, you don’t solve art problems by applying a known formula. You resolve them: you create something new that brings harmony to the discord. (It’s like a lesson from my short time learning music as a kid: the teacher always insisted that we not stop when we made a mistake, but keep going. Create something with the mistake, because there’s never any going back.)
Why is this the case? Why this marked difference?
3. Curable health problems are often from outside in. Problems from inside out are often not curable.
Although this is a generalisation, and so comes with exceptions, it’s a very helpful generalisation for broadly understanding health problems.
You see, many curable health problems start with something coming into the body from outside: bacteria, viruses, parasites, fungi, foreign objects, injuries. And although the ease of curing them varies, in the end it often comes down to removing or killing whatever came in and letting the body sort itself out from there.
Previously these kinds of health problems were responsible for human deaths. But two key changes occurred in the 20th century.
- Antibiotics (and later, other antimicrobials), were discovered, making many of these sicknesses more easily curable.
- Investigations were developed that allowed us to better study the human body, making it easier to earlier recognise known issues as well as identify new ones.
These two changes, especially the ability to test exact antibiotic doses, turned many short-term health problems into math problems.
Which translated into a rise in the proportions of persistent illnesses. (Yes there’s also diet and lifestyle changes to blame, but improved healthcare itself is a major factor.) The problem is, persistent illnesses are often from inside in: something going wrong with a body organ or system, not necessarily as a result of something external, but because of a breakdown or something genetic. Unlike problems from outside, inside stuff is much harder to deal with: you can’t simply remove or kill it. It’s the difference between a messed up friend and a messed up parent: one is harder to just walk away from.
You have to work around it. Or with it. It’s an art problem.
But somehow we largely still think of both like math problems. Especially in how we focus on achieving cures…
And that brings me to the next point…
4. Cure-focused thinking does more harm than good.
Cure-focused thinking is basically seeing health problems in terms of whether or not they are curable. It’s what happens when we treat illnesses like math problems instead of art challenges. And it’s not very helpful.
[bctt tweet="Looking for cures does more harm than good. Find out why—and a better way. " username="DocAyomide"]
There’s at least 4 reasons focusing on cures isn’t the solution we think it is:
- Limiting. It automatically limits success to “curable” (and often, short-term) diseases. Anything else and you’re out in the cold.
- Binary. Even if you have a curable health problem, you either have the cure or you don’t — success or failure become like a switch that can be on or off, but nothing in between.
- Sickness-focused. Cures, paradoxically, actually put the focus on illness. This leaves people running from pillar to post, seeking permanent cures, while working so little on anything else that even when there is a cure, there’s no structure to sustain it.
- Complicated. Not all “cures” are agreeable, and many create new problems, from side effects, to the loss of surgically removed organs (as in breast cancer or amputations) or other complications.
But you might ask, if not cures, then what?
What could be a better goal?
5. RISE to the occasion: Something better than a cure
I first realised this in a way you might be familiar with: when it came out of my mouth as I was trying to explain it to a friend who wondered why I was “wasting” my time in a medical specialty where most illnesses couldn’t be successfully cured. I’d been thinking about the question before this happened, but the answer only hit me when I said the following words:
“You think I can’t succeed with my patients because you’re thinking in terms of a cure. But I’ve learned to redefine success. For me, success is making their lives better — so it’s possible with every single patient, not just a few.”
And the difference is way more than just semantics.
- No limits. It makes success possible for anyone, not just a lucky few. And because success is really being redefined, it’s not just a consolation prize type of success (“We can’t cure this, so we will have to manage”), but the real thing.
- Spectrum. It’s more useful in real life: instead of a false binary of success and failure, it has space for the full spectrum of everything in between. It includes cures (making your life better can mean ending a problem permanently), but isn’t limited to cures (your life can still be made better even with a persistent problem).
- You-focused. The focus switches from getting rid of sickness to living as richly as possible, with sickness or without—from a negative goal (focused on what you don’t want) to a positive one (what you do want). It’s less about the sickness and more about your actual life.
- Comprehensive. Focusing on as rich a life as possible not only makes space for the reality of persistent health conditions, it also allows space for the complications of cures.
Making this shift, from looking for solutions, to focusing on living as richly as possible, makes all the difference.
I’ve thought for a long time about how to describe this approach. The standard term for it within healthcare is “recovery” — but I'm sure you'll agree that’s hardly an inspiring term. And for something that’s meant to include cures, "recovery" feels rather like a consolation prize. (I’m not saying this is what recovery means — I’m saying that's what it seems to suggest for many people.)
So I decided on a different description that I think fits better:
Rise above it.
You don’t just recover. You must don’t pursue a cure for the sickness. You don’t treat it like it’s a math question. Instead you see it as an opportunity to create art with your life. You deal with the issue, knowing there’s more to who you are than the issue. You rise above it.
So whatever health problem—or any kind of problem, really—that you’re dealing with, what you want to ask isn’t, “How do I get rid of this?” only to feel defeated if you’re told maybe there’s no easy way to… What you want to ask is:
How do I rise above it?
I've developed what I believe is an answer to that question: something I call the RISE Way. It's based on my experience working in healthcare and especially in mental healthcare (which was invaluable in helping me think about this), and what I've seen as the difference between those who rise above their health problems and those who don't.
If you sign up below, you can get a PDF describing the framework right now as well as my emails over the next few days, explaining in more detail in what the RISE Way is all about.