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Patients-recovery-and “fighting spirit”

The current discussion about those who survived the tragedy in Tucson, is now exploring the role of the “fighting spirit” that will or will not restore the lives of the injured (see link below). It is unlikely, however, that the answer is simply a binary Yes/No.

The use of the words “control” or the “right attitude” regarding anyone’s health seems to be ill-fitting as it colloquially implies our ability to dominate, having the power of the mind over the body. Surprisingly, this view, sometimes portrayed as new, actually perpetuates a historic model of health as a long assembly line of organs with a dispatcher, the mind, controlling its flow.

Systems science points toward a concept that health is a system’s emergence, where the whole is greater than the sum of its parts, an evolving and transient state of the “mind and body” and not “mind over body.” It frames our body as complex adaptive system with reciprocal relationships among all of its parts which is attempting a balancing act between the extremes of chaos and entropy which may or may not result in health (see second link below). Our cognition is an essential part of the system especially in its ongoing adaptation to the external environment and communication/coordination among its parts; it’s not a “commanding officer of the Universe,” however.

Biology dominates. Destruction or severe alteration of key aspects of our bodily system can be devastating; the degree of recovery is strongly dependent on the ability of the remaining biologic sub-systems to reconnect and reestablish their relationships into organized complexity, as well as the ultimate ability to recreate health as the new system’s emergence. Cognition needs to focus on creating ongoing coherence among all the remaining bodily system’s components. For those patients who do achieve the needed coherence, this process could be called a reflection of a positive “fighting spirit,” for those without it, it is just “fighting.”

Sloan R: A fighting spirit won’t save your life. NYT, Jan 24, 2011 http://www.nytimes.com/2011/01/25/opinion/25sloan.html?nl=todaysheadlines&emc=tha212

Janecka IP: Cancer control through principles of systems science, complexity, and chaos theory: A model. Int J Med Sci 2007; 4:164-173. http://www.medsci.org/v04p0164.htm