A Talk with Dr. Jeffrey H. Boyd
Author of
Being Sick Well: Joyful Living Despite Chronic Illness
Q: Why do you say that the American people are getting sicker and healthier at the same time?
A: Americans are getting sicker in the sense that a larger proportion of the population has a chronic disease.
But we are learning to diagnose these diseases earlier and manage them better. Our quality of life is not so
damaged by a disease as would have been true fifty years earlier. So, we are getting progressively healthier.
The problem is, because we have more chronic illnesses, we are increasingly dependent on the medical profession,
with the result that the cost of healthcare is skyrocketing. Thus we are getting sicker, healthier and more
bankrupt at the same time.
Q: What is the difference between the public's definition and the medical definition of "chronic illness"?
A: Most people equate "chronic illness" with devastating illnesses and severe disability. For medical professionals, it means a diagnosis that lasts a long time, but which may cause no disability and no impairment of quality of life. High blood pressure is the most common chronic illness. It is usually controlled with medicine, and causes no symptoms. I define chronic conditions as those that are prolonged and are rarely cured completely.
Q: Once you get a chronic illness, are you doomed to misery?
A: I sought out and interviewed people with devastating illnesses who remained upbeat. I learned twenty strategies for improving your quality of life if you have such an illness.
Q: How does humour help people deal with a disease?
A: Many sick people and their families use black humour to contend with adversity. It’s difficult to illustrate because insiders think it’s hilarious, but outsiders think it is simply "sick" humour. For example: Peter Swet, a People Magazine writer, had a devastating stroke as a young man, leaving him disabled. He wrote a book, Cracking Up, about his experiences in a rehabilitation-hospital. Normally you would not find it funny to say, "Nice day for a brain hemorrhage," but in the context of Swet's book it’s hilarious. It captures how vulnerable we are. We may think we live in a secure world when "WHAM," the next minute we are stricken.
Q: Does medical research indicate that religion helps sick people live richer lives?
A: Research shows that people of faith tend to be healthier and live longer than those who do not have faith. Spiritually-inclined people are more likely to seek medical attention and follow the doctor's instructions, because they respect authority. They often have more friends because they belong to a congregation or prayer group, and having friends is healthy. Religious people also have better risk factors for health. They are less likely to engage in promiscuous sex, drunken parties, road rage, and less likely to smoke cigarettes
Q: Some people dwell on their illness and talk constantly about their suffering. What would you advise them?
A: Life consists of more than illness, and it’s important to keep the illness from eclipsing the enjoyable blessings of life. I interviewed a woman named Mary who refused to talk to anyone about her arthritis pain. At a party she put a brown paper bag on the dining room table and said anyone who mentioned her disease would have to put $5 in the bag. The party was a success because no one talked about Mary's illness and instead focused on fun things, which buoyed her spirits.
Q: Doesn't the decreasing rate of disability among the elderly mean that the epidemic of chronic illness is waning?
A: Research has shown a decreasing rate of disability among the elderly, and a lot of people are hoping that means that this epidemic of chronic illness can be dismissed. I agree that old people are not as old as they used to be. My mother goes to aerobics at age ninety and is younger and stronger than my grandmother was at age eighty. But there is a growing percentage of the population with a chronic disease, accounting for 83% of the healthcare budget.
Q: Tell me about your wife's illness and how it affected the two of you.
A: Pat had diabetes from age eleven. She had two heart attacks, two strokes. She went blind, had kidney failure, had both legs amputated above the knees and her hands became numb. At age fifty she died. But we learned to maintain a positive attitude. To begin with we clung to God, and this sustained us. Second, we kept our priorities straight. Our highest priority was our daughter Felicity, and Pat was willing to go through anything providing Felicity was OK. Felicity recently married and has a successful career at the Mayo Clinic. Third, Pat's medical disasters were not her main experience. There were long periods of normal life. Even when she was on dialysis, it became part of our ordinary routine. It was often possible to simply enjoy life.
Q: What are the three things that sick people fear most?
A: Sick people fear three things above all else: impoverishing their families; losing their independence; becoming a burden to others. This is based on research done by an organization called Partnership for Solutions, whose website is www.PartnershipforSolutions.com.
Q: Many people pray for God to heal them. How do they reconcile this belief with a chronic illness?
A: Pat and I went to a healing service at our church every week. We experienced healing prayer to have a curative power not in terms of a change in medical outcome, but in terms of keeping us in touch with the Lord. God sometimes says "no" or "not yet" to our prayers for healing.
Q: Tell me about your own chronic illness.
A: I have suffered from major depression since childhood. I have a tendency toward gloom and pessimism. I’ve had a lot of therapy and antidepressant medicines over the years. But what helped my disease most is interviewing people for this book. I learned from them how to live a healthier life. Currently I am off all medicines, exercising every day, and I have broadened my commitment to my wife, children, church, mother and friends.
Q: We tend to focus on the needs of sick people, but what about their caregivers?
A: There are ten million people in the United States who spend at least twenty-four hours a week caring for a sick person without pay. These family and friends are often ignored by physicians, when they are the most important members of the medical team. Caregivers have a problem that I call "over-functioning"— often working full-time while taking care of a sick person at home, juggling impossible responsibilities without enough sleep. There is a crisis brewing in America: just now when the need for caregivers is increasing, there is a dwindling supply of them.
Q: Do sick people benefit by helping others?
A: Absolutely! It helps you enormously to use your suffering as a way to reach out to others in similar situations. For example, Pat Mierop went blind. Because people from her church help take care of her, she has an opportunity to counsel younger women whom she would not otherwise meet. Janine Jacobsen has lived with a colostomy for years. She belongs to the Ostomy Association, and she counsels other women who are about to acquire an ostomy, telling them that they need not live in fear. I also met a Catholic priest named Father John Cockayne, whose cerebral palsy and many other health problems equip him to minister to sick people in his parish.
Q: Can medical science make this epidemic go away?
A: Chances are that future breakthroughs in medicine will make the epidemic both worse and better. Take AIDS for example. Genetics research has given us powerful medicines to treat AIDS, and we've also made progress in preventing the disease. But the problem is that there is no cure for AIDS in the sense that no one infected with the HIV virus ever gets rid of it completely. In 2001, more than 350,000 people were living with HIV. Thus breakthroughs in medicine have converted AIDS from a lethal into a chronic disease. Medical treatment also makes AIDS less severe, easier to live with. When medical advances lead to saving lives, the lives that are saved are likely to be people who still have a chronic disease, so that a reduction in the rate of death usually means an increase in the rate of chronic illness. Our task is to learn how to live with these illnesses without having them ruin our lives.