In sickness and in health?

From birth, we are taught to value our bodies at their healthiest and to strive for that version of ourselves at all times. There is nothing intrinsically wrong with that message—health is a priority for many people, and improving our health can undoubtedly improve the quality of our lives. The problem with this mode of thinking comes when we are faced with the immovable obstacle of chronic illness.

Chronic illness is a broad category that encompasses any condition that is ongoing; it may be treated or managed but rarely cured completely. This includes mental illnesses like depression, as well as physical illnesses, such as autoimmune disorders and even cancer. To be chronically ill is to be permanently in limbo, suspended between the health we desire so desperately and the reality of our conditions. How do we handle that seeming paradox of wanting to be healthy when our bodies stubbornly remain “sick?”

When I was first diagnosed with a chronic illness, I was forced to shed that rigid definition of health. No amount of positive vibes, fresh air or kale was going to cure that sickness. That did not mean that I could not pursue the healthiest version of myself with an illness, but I would not be able to achieve the same level of health as someone without an illness. I would always have limitations; acknowledging those limitations is not the same as giving up on yourself. Denial of one’s limitations can lead to overexertion and burnout, which can easily become a vicious cycle.

In our society, we moralize health and stigmatize sickness in ways that are harmful to people with chronic illness. For example, we view certain conditions as having been caused by a person’s own unhealthy actions. People with these “preventable illnesses” are often shamed, ridiculed and subjected to detrimental stigma surrounding their condition. For example, Type 2 diabetes is often attributed to body size, a high-sugar diet or a sedentary lifestyle. Science tells us that it is a complex disease with many factors influencing its onset, from maternal birth weight to socioeconomic status to yet-unknown genetic determinants. None of the potential causes for the disease make someone inherently a bad person; morality lies on a completely different axis from health. Yet we still mock people with diabetes for being immoral and inferior to those without the disease. Is Type 2 diabetes a death sentence? Of course not. Can it be managed, if desired, with health-promoting behaviors? Yes, absolutely. Do people with diabetes benefit from social stigma and health shaming? Nope, definitely not!

However well-intentioned the advice, telling chronically ill people how to manage or even cure their conditions only adds to the stigma we experience. Do a quick Google search, and you can find thousands of blog posts about curing thyroid disease by avoiding spinach, PCOS by eliminating carbohydrates and similar claims backed by little more than anecdotal evidence from someone trying to sell you something. A person’s health is their business, and theirs alone. Whether they should take supplements, do yoga or treat their illness with pharmaceuticals is not a topic for debate or conversation unless they ask for your advice.

By the principle of autonomy, we are allowed to define ourselves by more than our absolute health, and to pursue health on our own terms. I am chronically ill, and my conditions influence but do not determine the way I view myself. My goal is and will always be to respect my body, in sickness and in health.

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