Our Lady of Lourdes - To emerge from the shadows - The World Day of the Sick

The World Day of the Sick serves to refocus everyone's  attention on a single fact: illness exists. Unfortunately Western society has such confused ideas on this that the real definition of the word “health” is still being argued about.

The British Medical Journal recently published the step forward a Dutch work group coordinated by Machteld Huber has taken with an interesting suggestion: that “health” no longer means “a state of complete physical, mental and social well-being  and is not merely the absence of disease or infirmity”, as defined by the World Health Organization. Rather it is “the ability for self-adaptation and self management”. The first part of this definition which emphasizes that health is the ability to be on top of the events of one's own life, the ability to control and manage them without implying a utopian perfection, is interesting. The current definition of health de facto debars people with chronic mental disease from feeling that they are “in good health”, even when they succeed in living with their disability.  It is not so easy to agree with the second part of the definition provided by Huber because it returns to emphasizing the two aspects: “health” and “autonomy”, whereas it is not right to deny the possibility for  an elderly person dependent on others for various needs or a disabled person who is not at all autonomous  to feel “healthy”.

In short, the confusion on what illness is continues and many people feel ill (or at least not perfectly  healthy) even if they are well, and, staggering under the onslaught  of advertising, seek remedies to supposed flaws that are purely aesthetic. The result of this confusion is that people do not give proper priority to serious illnesses, and end by making endemic conditions that afflict entire peoples, such as malaria or tuberculosis, pass as normal. They also end by responding with abortion, that false means of prevention, to the forgotten tragedy of rare genetic diseases, or with pre-implantation diagnosis which, instead of preventing illness does away with the sick person who has already been conceived and is alive.

The World Day of the Sick, however, reminds us not only that sickness exists but also that sick people exist: because in this competitive society, those who are the same as others  become invisible. The media speak very little of illness. And those who are ill exist, but they remain in the shadows. The websites of associations for the disabled are full of  initiatives and innovations but no one talks about them. The disabled are invisible to the media, just as the mentally disabled  are invisible to the health-care system, since doctors are ever less able to deal with people who cannot express themselves and are not autonomous (The Lancet, August 2008). Then in these times of crisis moreover – as was reported by the English Association Mencap, which launched the campaign “Don't Cut Us Out” – there is a risk that those with less visibility and strength suffer the main repercussions of the budget reductions that various countries are obliged to make. This would be unacceptable: a country is civilized if it thinks first of the weakest.

This Day, lastly, obliges us to think that in Western society there is a new illness: the sick desire. It is a sort of loss of the enjoyment of things, due to the loss of the  limitation of desires and to the pressure of messages that in order to sell something invite the satisfaction of caprices. The French psychiatrists Marc Valleur and Jean-Claude Matysiak, in their book Le desir malade hold that a hundred years ago the ability to satisfy certain desires seemed a conquest of freedom but today has become a boring banality. “And this is a problem” they write. “It is desire itself that is sick, since we are inured to all gratification. Perhaps today people suffer less from the removal of desire, however hysteria has been replaced by another two illnesses: depression, from which suffer those who no longer have the energy, in the competition for pleasure, to defend their part of the booty” and dependence on gambling and various substances of abuse. The sick desire, ensnared by non-existent needs, no longer reveals the true needs, nor even its own. It is an epidemic that opens the door to chaos, in pure boredom that no longer knows what to ask and what to fight for.  And it makes people close their eyes to the real needs, to sickness and to the sick person: the disgrace of a century which would instead have the forces to treat more people, and perhaps not cure them, but certainly to treat them all.

  Carlo Bellieni