Modern hi-tech medicine claims that it has increased human life expectancy. In fact, the life expectancy started increasing with better food supply, control of communicable diseases, and better education of the masses making them live a healthier life style. In developing poor countries life expectancy could have a quantum jump if only infant mortality comes down. Life expectancy is a statistical term, which does not mean that human life span has increased in this century due to all the hi-tech stuff that we are trying to sell to the gullible public! On the contrary, life span has, if anything, come down from the usual 120-140 years that some of the aboriginal races in certain pockets of the world still enjoy. It is now estimated that the average American life expectancy can not go beyond 89 years even in the next millennium.



What is life expectancy?



If a mother gives birth to ten children and if eight of them die around birth, as used to happen in many parts of the poor nations, even if the other two children live up to 100 years, the life expectancy of another child being born to any mother in similar settings would be only twenty years. (100 multiplied by 2 and divided by 10) This could change dramatically if instead of eight children dying around birth, only four die and the rest live for 100 years, the life expectancy in that setting would jump to 60 years! Now one could understand the meaning of the word life expectancy. The change in life expectancy, therefore, has very little to do with the so-called hi-tech curative medicine.



What is life span?



The maximum number of years any species (Homo sapiens) could live is called life span. This is fixed, as early as the day one is made in the mother's womb, in the genetic material. This can not and would not change with even the highest tech. efforts. The Hayflick's rule gives each cell its maximum capacity to reproduce and apoptosis tells the cells when to die (in certain cells like the heart muscle cell there is no apoptosis under normal circumstances). Recent efforts to increase the life span by genetic engineering also have come to naught, as senescence could not be halted in those modified cells. It is no use having a 150-year-old very senile vegetable in society! The latter would be a burden on society, any way. Life span has remained the same since the dawn of the human race.



What is health expectancy?



It is the time interval between birth and the end of healthy life-before the onset of any major incapacitating illness. Man is healthy only when he is creative in society. Absence of physical illness is not the complete definition of health. In fact, many people with physical diseases are more creative, and consequently healthier, than their counterparts in society without any physical disease, but having no enthusiasm. Thus defined, health becomes a very useful commodity in society. In fact, healthy people in society could even make society more tranquil. Crime of every kind from petty theft to murder and terrorism are all signs of disease (dis-ease)-not of the body but of the mind. Mental illnesses are not only depression and schizophrenia. Aberrant behavior patterns should also fall into that category.



Now let us critically examine if the present day scientific hi-tech methods have increased health expectancy in society. The most advanced country in the world, United States of America, probably is the unhealthiest country in the world with the lowest health expectancy, despite the fact that Americans have a very healthy life style among the white races! Health screening surveys there have shown, in larger cities like NewYork, that every other man had either high blood pressure, heart disease or diabetes. There is hardly anyone who has not seen a doctor for a major illness or has had some surgical procedure done on him or is taking some kind of a medicine or the other at a given time. Crime is on the increase, novel methods are being discovered now and then. Even high school students resort to shooting their own classmates in school!



Time has come for us to ponder over this tragedy very seriously. Professor Eiesenburg, an American professor of medicine, recently wrote to say that a truly well man is not available in America. If all the available screening tests are used on every American all of them will have some sort of an abnormality or the other requiring intervention. In an interesting article The Last Well Man the author, an American doctor, laments on the present state of the art in this field.



Our aim should be see that majority of people in society have at least half their lifetime free of disease. Next millennium should aim at having the populations health expectancy come up to, at least, fifty years.



What are the prerequisites for attaining decent health expectancy?



Clean water, adequate food supply, care of the pregnant women, adequate pacing of pregnancy, universal literacy so that every one has access to information, avoiding tobacco and alcohol, avoiding dependence on others for any reason including religion, avoiding unhealthy competition in life which begets hostility, hard physical work or regular exercise for all, proper immunization methods in childhood, trying to live in a clean atmosphere without excess pollution, controlling the world population by reassuring the poor man that his children need not die prematurely in the new set up rather than selling contraceptive methods to him, empowering the poor man economically by narrowing the gulf between the haves and the have-nots in society and bringing up children, especially our adolescents, correctly should go a long way in achieving the health expectancy for the population of, at least, 50 years.



To cap it, we have to make man more tranquil by the ancient Indian methods of meditation and breathing techniques; the latter go a long way in postponing the onset of illness thereby increasing health expectancy. Prevention is better than cure may not be true always, but changing the mode of living of people is definitely cheaper than both the former. Hope we canalize our efforts in this direction rather than continuing the rat race of more and more technology for fire fighting (curative methods). The fire fighting hose seems to be perpetually short of its target!



Trying to change the mode of living of society is much cheaper in the long run and more effective than screening large populations for diseases and then trying to set them right. There is no guarantee that the change in the initial state of the organism (man) due to drug treatment or surgical intervention of the apparently healthy population is going to do good in the long run. Human body does not follow the linear mathematical rules! To give a concrete example: if one brings down the mildly elevated blood pressure in an apparently healthy man that in itself might not do any good; on the contrary it may do more harm due to the side effects of long term drugging. Whereas trying to change his mode of living might bring the pressure down by the natural means for the long term good of the victim. Similar is the story with diabetes or even cancer.



Screening large populations is prohibitively expensive and only increases anxiety in society resulting in large-scale sick absenteeism. In a well-researched editorial in The Lancet the authors make out a good case against screening. The heading is very interesting to read: Do Epidemiologists cause Epidemics? I think they do! At the same wavelength is an editorial in the British Medical Journal entitled Screening Could Seriously Damage Your Health. I must congratulate the authors for their courage! They could not be more correct.



Why do we, then, advocate routine screening of health people?



I strongly feel, I may be wrong though, that is how the medi-business thrives. If the medical establishment were to tell the public the truth, the whole truth and nothing but the truth, then we should be content with treating the sick population only. There may be only a few million clients for the curative business at any given time. If on the other hand, we target the whole population there is a huge stock of six billion to draw from. The latter makes lot of business sense. Logically the latter is better business. The multibillion-dollar drug industry, equipment manufacturing industry and also the corporate hospital industry should thrive on this business and it makes sense that they target a larger clientele.



Well meaning NGOs and the governments of the poorer countries should read the writing on the wall that hi-tech top heavy modern medical interventions are not a panacea for man's ills but are a good quick fix for mending damaged organs. The long-term outcomes are anybody's guess. Doctors have been predicting the unpredictable! Let us put our heads together to see how best we could change the mode of living of man in the present world of cut throat competition.