Connecting the Dots

            Over the past three weeks we’ve been studying the relationships between the body, mind, and spirit, and how disease can disrupt that balance. At first I was a little skeptical of the whole idea of Aryuveda and thought it to be initially quite. However, I found that by studying more about it, as well as it’s practical application with diabetes as a case study, that it turns out to be a really great tool of characterizing disease as a disruptor of harmony between body systems. 

Here, in entries from the first week, I explored the concept of Aryuveda and it’s usefulness as a broad idea to describe physical, emotional, and mental balance. Hence, tenses may change and fluctuate from past to present due to it being written as a journal entry. I decided to leave it this way so as to let the audience observe my progression in understanding the idea a little better.

“To go along with the semester theme of Aryuveda, we had a discussion in class today regarding the interconnectedness and balance present between the body, mind, and spirit. The question was posed as to what composed the spirit of a person and how that was related to the mind. I must say that this question has often puzzled me and given me a lot to think about even prior to todays discussion. It was proposed that the mind is the chemical and physical processes that effect how are body works and that the spirit is more the defined by our feelings. However, this doesn't seem to be a perfect answer because we know that so many of our emotions are stimulated and propagated by chemical signaling through various structures of the brain. The limbic system for example is where most of our emotional responses have been isolated to according to studies using pET scanning techniques. So emotion can't be what separates the mind from the spirit according to the proposed definition. I couldn't articulate a good answer at this moment other than maybe the spirit is something that is not understood at the moment and for that reason, no distinction can be made between the two because one is very poorly understood. Most likely because we do not have the scientific means to prove its existence. “

            However, as I mulled the idea over in my mind I began to think of it’s usefulness as a vehicle for exploration in discovering new knowledge leading to my following entry.

“The idea that the body and the mind are connected has gotten me thinking about the experiments that could be set up or observed to test the hypothesis.  I'm excited to do more research into it this semester. I'm excited to link concepts in scientific knowledge regarding body systems, with their correlating systems in the mind. My group wants to study particularly the effects that sleep has on the psychological function of the brain, as well as the physical repercussions of either sufficient or insufficient sleep. Maybe even too much sleep is bad for you?”

But I needed more information. My understanding of Aryuveda was still a little cloudy and I was struggling to fit it into my mindset of rigorous science being used to prove things as either true or false. This took me down my next rabbit hole;

“Upon researching specific articles and information regarding the practice of Aryuveda I came across a fact that stated that the practice is about 5,000 years old. What impacted me the most from the article was the fact that humans have always been drawn to a systematic way of determining best health practices. That our desire for good health pushes us towards scientific analysis of what does and does not work. I am particularly fond of the for just that reason. The simple existence of Aryuveda, which means "life science/knowledge", is a testament to the human drive to "feel" the best that we possibly can, and to approach the problem in a systematic fashion. Although many things in Aryuveda do not align with modern scientific theory, the discovery of Aryuvedic prevention medicine appears to have been a process of trial and error, while carefully noting down the things that do and do not work. It is if anything, a demonstration of how the mind desires to be in balance with the body, pushing itself to logically reason through and retain the different processes necessary to maintain that balance.”

In order to expand on that idea, I read an article regarding how Aryuveda does not focus so much on confronting disease as it does in preventing the appearance of disease. Aryuvedic theory proposes that disease is the manifestation of an imbalance between the body, mind, and spirit. Thus, to prevent disease, the objective must be to keep those three things in balance. One big idea in the paper that I read was that stress, both physical and emotional, is at the root of many diseases. While we know that some forms of stress are healthy and can produce growth, it is also documented as to how stress decreases our body's ability to fight disease. I particularly liked their comparison of stress to that of the roots of a tree. We do not acknowledge the tree fully until we see it's strong trunk, branches and leaves. And though we might try to prune at the tree, it will not die until the roots are removed from the ground. Stress and other undercurrents in our lives act as the roots of a tree feeding the branches and leaves which are the manifested symptoms of the disease. I thought that this was a particularly good analogy because it points out how often we use our scientific knowledge to address components, but not the whole reason behind a disease. 

            Now that I had a better understanding of Aryuveda it was nice to then come to class and have discussions, as well as think of my own life experiences, seeing how diabetes offsets that balance between the mind and body. Discussions ranged from ethics and philosophy, to real world examples and economic consequences of the imbalance. Here are a few entries showing my thoughts.

“Today we had a lively discussion in class regarding the economic burden of diabetes and obesity and what role government plays in mitigating the impacts of these diseases. One of the major discussions focused on whether or not the government had the right to direct the food choices of people receiving food through programs like SNAP. Two arguments were posed that I felt were equally valid, only adding to the complexity of the problem. The first posed that if someone who is on food stamps is already using the governments aid, then their eating habits should be directed in a way as to prevent any further burden to the healthcare system by preventing or mitigating diseases such as obesity and diabetes. The other argument to counter was that the restriction of agency in food choices could lead to discouragement in this demographic, leading to overall poorer quality of life and maybe indirectly, poorer health. I honestly don't know which camp I am in because it is a decision that involves many complexities that I obviously have yet to account for, but I am interested in studying further.”

Upon reflecting about the sheer prevalence of diabetes as a disease as well as the demographics that it most generally afflicts, I kept thinking about my experience at the Doctor's Volunteer Clinic in St. George. The DVC is a free clinic where patients who do not health insurance can come to be cared for by volunteer physicians and nurse practitioners. My job while I was there was to scribe for physicians as well as interpret interactions in Spanish. The single-most common appointment that people came in for was either a diabetes check-up, or a "let's get my diabetes under control" meeting. Mostly the latter. Upon reading this literature it makes perfect sense regarding the low-income populations mentioned and how they are most heavily afflicted by complications with diabetes. Without regular check-ups, it is ridiculously easy to let it get out of control, and for complications to then arise. The worst thing I saw was a disabled young man who had been having chronic diarrhea for weeks due to his family members failing to control his diabetes. 

As I read more and more articles I found that more and more questions arose. Particularly about the economic burdens resulting from diabetes. Not just the visible, emotional problems that I had seen in clinic. Here are some thoughts;

“Today while reading the economic article I was particularly concerned by the statistics regarding the population over the age of 65. Particularly because of the fact that 61 percent of healthcare costs for this age group are solely due to patients with diabetes. It could then be inferred that Medicare covers most everyone over the age of 65 and thus raises the question, does diabetes and related illnesses account for 61 percent of Medicare costs?”

            As I thought about our plight my mind was drawn to examples of this burden placed on society through the insurance model. I have most readily been exposed to it in the emergency medicine system and it is quite apparent, if not blatant. 

A few months ago I was working my job on the ambulance, working as an EMT. One of the most common calls that we get are diabetic emergencies, usually due to hypoglycemia and occasionally hyperglycemia. In this case the patient was hypoglycemic and was quickly brought back to consciousness with some intravenous glucose. However, what struck me about this patient, in light of this article articulating the amount of prescriptions written for diabetic patients, was the sheer volume of medications listed in their medical record. Upon reflection, I've realized that that same pattern is seen in almost every diabetic patient that I've helped while working on the ambulance. The pattern is undeniable and shows that diabetes as a disease is not contained to just itself but brings on a whole myriad of complications, each requiring it's specifically tailored pharmaceutical. 

            Overall, the big take home message for me from the past weeks of study is that the body must retain a delicate balance. Diabetes and the mechanisms of insulin dependence and insulin resistance are perfect examples of how when this balance is disrupted, both the mind and body are afflicted. A person’s emotions as well are subject to severe damage just because of all of the inevitable medical complications. I eagerly look forward to observing more examples of this balance and further practice in articulating the great need to maintain it.