Picard Martin
Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY 10032 USA.
Department of Neurology, Merritt Center, Columbia Translational Neuroscience Initiative, Columbia University Irving Medical Center, New York, NY 10032 USA.
Phenomics. 2022 Jan 28;2(3):145-155. doi: 10.1007/s43657-021-00037-8. eCollection 2022 Jun.
Modern Western biomedical research and clinical practice are primarily focused on disease. This disease-centric approach has yielded an impressive amount of knowledge around what goes wrong in illness. However, in comparison, researchers and physicians know little about health. What is health? How do we quantify it? And how do we improve it? We currently do not have good answers to these questions. Our lack of fundamental knowledge about health is partly driven by three main factors: (i) a lack of understanding of the dynamic processes that cause variations in health/disease states over time, (ii) an excessive focus on genes, and (iii) a pervasive psychological bias towards additive solutions. Here I briefly discuss potential reasons why scientists and funders have generally adopted a gene- and disease-centric framework, how medicine has ended up practicing "diseasecare" rather than healthcare, and present cursory evidence that points towards an alternative energetic view of health. Understanding the basis of human health with a similar degree of precision that has been deployed towards mapping disease processes could bring us to a point where we can actively support and promote human health across the lifespan, before disease shows up on a scan or in bloodwork.
现代西方生物医学研究和临床实践主要聚焦于疾病。这种以疾病为中心的方法已经产生了大量关于疾病中出了什么问题的知识。然而,相比之下,研究人员和医生对健康却知之甚少。健康是什么?我们如何量化它?以及我们如何改善它?我们目前对这些问题没有很好的答案。我们对健康基础知识的缺乏部分是由三个主要因素造成的:(i)对导致健康/疾病状态随时间变化的动态过程缺乏理解,(ii)过度关注基因,以及(iii)对加法解决方案普遍存在的心理偏见。在这里,我简要讨论科学家和资助者普遍采用以基因和疾病为中心的框架的潜在原因,医学最终如何变成了实行“疾病护理”而非医疗保健,并给出初步证据,指向一种关于健康的替代性能量观点。以与绘制疾病过程相同的精确程度来理解人类健康的基础,可能会使我们能够在疾病出现在扫描或血液检测结果中之前,在整个生命周期中积极支持和促进人类健康。