Illness Is Not A Moral Failing

Screaming loudly from more than a corner of the quest to repeal and replace the Affordable Care Act is this notion that moral, upstanding people take care of themselves and do not get sick; therefore, they do not need guaranteed health insurance or subsidized premiums to make insurance affordable. This line of thinking suggests we who have chronic illness somehow bring the malaise upon ourselves. We don’t lead clean, healthy lives; instead, we make bad choices which lead to our illnesses. If we put our money on organic food instead of smartphones, I’ve heard said, we’d be healthier. If we pulled ourselves up by our bootstraps and worked to become wealthy like regular Americans, rather than laying around bemoaning our ailments, we’d stop being a drain on the economy . . . and we wouldn’t need to see the doctor so often.

The trouble is, science doesn’t support this kind of thinking. Having a chronic autoimmune disease like celiac disease as I do, or Sjogren’s as my sister does, or ankylosing spondylitis as my other sister does, is more a fuction of genetics plus environmental risk factors than of moralilty.

People are more likely–but not guaranteed–to develop an autoimmune disease, for example, if they have relatives with autoimmune diseases. A child whose parent has an autoimmune disease has a higher risk–but is not guaranteed–of developing an autoimmune disease, than someone whose relatives don’t have autoimmune diseases. It may be the same autoimmune disease or it may be a different one or the person may have no disease at all. It’s complicated and scientists are still working out the math but in no case does the equation say you’re sick because you deserve to be sick. The National Institute for Health has an awesome website detailing the genetics of thousands of diseases and conditions: the Genetics Home Reference.

Our mother had celiac disease and her mother had Hashimoto’s disease, an autoimmune disease that attacks the thyroid. My mother’s sister has rheumatoid arthritis.

On the other side of the family tree, my father is a super go-getter who celebrated turning 80 by hacking down a tree and and a bunch of bushes using his own hands–and my husband to hold the ladder. My dad’s active and healthy yet he’s had two torn rotator cuffs, three hernias, and now has arthritis in his neck which is pinching the spinal cord . . . and he still gardens like it’s a gladiator sport. His three brothers had multiple hernias, as did his father and his father’s brothers.

The orthopaedic doctor I recently saw for my fourth bout of tendonosis plus tendon and cartilage tears from doing nothing much more than living said our genes make for weak connective tissue. People who are prone to connective tissue injuries tend to have relatives who are prone to connective tissue injuries, he said.

Cancers have strong genetic links, too: women whose mothers, aunts, grandmothers and sisters who had breast cancer are much more likely to get breast cancer than women who don’t have relatives with breast cancer. Much of this has to do with the BRCA1 and BRCA2 genes. You can read about them here.

Now, I know some people actually believe immorality begets disability. I, however, don’t believe God mangles children because their parents spent the rent  money on poker or lied on a job application or even robbed a bank. I don’t believe my sisters and my mother developed autoimmune diseases because my grandfather ran rum for the Mafia in Jersey City during Prohibition. I don’t believe disease is doled out by a punishing God.

Think about it. If morality defined health, there would be an awful lot of philandering, lying, cheats’ progeny suddenly writhing on the floor in agony as their sins twisted them into wheezy, sneezy, oozing bags of pus. We’d see corporate raiders pacing the waiting rooms while their kids gasped for air or struggled to walk on limbs that didn’t work. You’d see thieves struck immediately with arthritis in their stealing fingers and people who physically or sexually abuse others suddenly suffer amputations of their offending parts.

That’s not what we see because illness and wellness are not wholly measured by the weight of one’s morality. Illness and wellness are the results of complex biochemical processes inside us and within our environment we don’t fully understand. The world was set in motion by a Creator so superior to us in intellect and creativity that we don’t know–and may never fully know–how and why life and death happen, how and why imperfections emerge or disappear.

Then again, science has show us the direct and devastating consequences of ingesting things proven to be toxic, carcinogenic, and just plain bad for us. We also harm ourselves when we stuff ourselves with fast fried foods and ooey, gooey sugars on a day-in, day-out basis with nary a fresh fruit or an unadulterated green in between. Yes, we can make wise choices about our food and about our activities to improve our health and prevent certain kinds of damage to our bodies.  Yes, we are setting ourselves up for biochemical and genetic disaster by allowing dangerous chemicals to billow into our air and infiltrate our water unfettered and we have to do better before we wipe ourselves off the planet. And yes, there is a strong mind-body connection that links negative emotions to negative health consequences and positive emotions to positive health benefits but the math isn’t one-to-one.

At the same time, we must not let twisted rhetoric and corrupted moralizing convince us to blame those of us with cerebral palsy, multiple sclerosis, leukemia and lymphoma, any number of cancers, ALS, lupus, Crohn’s diseas or ulcerative colitis, rheumatoid arthritis, congenital heart or other defects, celiac disease, tuberous sclerosis complex , Ehlers Danlos syndrome, epidermolysis bullosa, and the list goes on and on and on for being sick. Illness is not the result of immorality.

And we cannot afford to pull the plug on life-saving health care made possible by guarateeing everyone access to affordable insurance that covers preexisting conditions. Doing so will pull the plug on our friends, our neighbors, our brothers, our sisters, even our children, and that, my friends, would be a mortal sin.