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Herb Rothschild Jr.: Taking charge and letting be

Most service professionals have clients. Uniquely, physicians have patients. In England (and English), this usage dates back to at least the 14th century. It arose because “patient” meant “suffering”; a patient was a person who suffered. This derived from a Latin verb that meant to undergo, to suffer. But from its past participle, “passus,” came the modern connotation of “patient” — namely, the passive one.

For most of the last century, the medical paradigm was that the physician was the active party, the healer, and the patient was the passive party, the receiver of healing. Even childbirth, during which normally the mother does most of the work with the obstetrician intervening only if things go awry, was shoehorned into this paradigm until the natural birthing movement gained traction.

As the century neared its close, the medical profession was persuaded to adopt a more holistic understanding of health. Because the patient’s attitudes and behaviors assumed a new importance, the maintenance and recovery of health are now regarded as the shared responsibility of physician and patient. The prevailing paradigm has been modified.

But not discarded. In many circumstances, the physician’s activities to diagnose illness and administer remedy are determinative. In no circumstance is this more obvious than surgery. During surgical procedures patients are immobilized, often rendered unconscious. Post-op, of course, the patients begin to share increasing responsibility for the outcome, but not immediately before, during and after surgery.

On Nov. 1 I had a heart attack. At Rogue Regional Medical Center I received excellent treatment. An artery was unblocked and stents were inserted with a minimum of invasiveness. I was discharged in 60 hours. During that time, I was a model patient — compliant, undemanding, and appreciative of all that was done to and for me. I behaved that way, not because I’m virtuous, but because I enjoyed being cared for. It was a pleasure to be passive. I’ve spent much of my life actively caring for others.

In contrast, my current situation is ambiguous. I’m not supposed to “push it,” but neither am I supposed to “veg out.” This state between activity and passivity is a challenge to both body and mind. One can equally err by doing too much or too little.

Writ large, my condition is the human condition. I’ve treated this subject before. Thinking about human life in terms of activity and passivity, about when to take control and when to let be, is generative of insights both profound and practical, personal and planetary.

Western culture since the Renaissance has chosen the active life over the contemplative. The rise of the modern physical sciences and their stunning successes in explaining natural processes and ameliorating human suffering confirmed us in this choice. Any rebalancing of the scales mustn’t devalue a collective human achievement that is, simply put, magnificent.

Yet, our planet isn’t passive, and we have practiced on it beyond its sufferance. In our present environmental crisis, we must do less, not more. We Americans must halve our energy consumption while we expand the generation of renewable power. We must stop eating beef while we grow more of our own food. We must curb our material desires while we expand our spiritual capacities. In sum, we must seek to control nature less and ourselves more.

Ecology is holistic medicine on a planetary scale. We humans have a unique place in this ecosystem, but we still are a part of it. Respecting earth’s agency means delaying our own death.

Herb Rothschild’s column appears in the Ashland Tidings every Saturday.

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