1.2 Talking about health

Hello. I'm Helen King, professor of Classical Studies at the Open University. And I'm joined today by Mathijs Lucassen, who is a lecturer in the School of Health, Wellbeing, and Social Care. Welcome.

Thank you.

It's really good to have you here, because what we want to talk about today is health. What do we mean by health? How has that changed over time? And also we want to have a little look at a particular disease, which was known in the ancient world and which I don't think is known today-- lovesickness. So that's quite a lot to get through. And I want to start by thinking about those words-- health and wellbeing. So you're in a school that's got both words in the title. How do you understand the difference between health and wellbeing now?

I think health, people will have more of a focus on physical health and a lesser focus on things like mental health. And wellbeing, I think, sort of encompasses so many different things, which includes health but it can be about environment as well as individuals and practitioners.

Right. So from an ancient perspective, that's interesting because for the ancient world really health is about everything. It's about your environment as well as yourself. So it's also about how you function in that environment. But socially and institutionally, of course, it's arranged very differently. We don't have hospitals in the ancient world.

Yeah.

Whereas now, in terms of what you do if you're ill, your first port of call would be doctor, then a hospital.

And also there is even compartmentalising within the hospital. So we have separate departments. So if you've got a problem that's related to something that has to have surgery, then you're on a surgical ward. If you've had a stroke, say, you might have to go to a rehabilitation ward, which would be separate again. So even within the hospital it's compartmentalised.

Whereas in the ancient world a doctor just does everything. Some might be better than others at particular things, but surgery as well would be done by the same person as far as we can tell. So in the past, what you're most likely to die of is an infectious disease. Something that's just going to be acute, short disease that's going to kill you rapidly. And there's not much you can do about it. Very different approach today in terms of what's going to get you.

Yeah, completely. I think we've done a lot in terms of managing infections and acute health issues, because of vaccines and modern medication. But it's the chronic issues now that people are facing. Things like cancer, cardiac issues, diabetes, dementia. It's those things are the real difficulties that people are facing.

So in terms of what's going to kill you, but also in terms of how you're going to live, these are the important ones. You're not going to feel that healthy over a long period of time, rather than just having a short burst of being very unhealthy and then dying. Yeah, it's very different.

What about the division between physical and mental now? I mean, how does that work?

Well, we have completely different funding for-- you know, we've got the funding that's going to be for health services, and we split that up into different chunks. And then we have separate funding for mental health services. And if you present to a general practitioner in primary health care, and it looks like your main concern is around mental health issues, then you will have quite a different care pathway, quite a different experience than you would if you were presented with a physical health issue. You'll get treatment that's completely different, mostly from practitioners, that are completely different as well.

So you may end up being someone who's got both physical and mental health problems, but they're dealt with separately. You have to be defined.

Yeah. And we get a lot of people falling through the cracks, because they don't neatly fit into these different care pathways.

Whereas in the ancient world, it's all about balance. And if your bodily fluids are in balance, then you'll be healthy physically and you'll be healthy mentally. So there isn't such a problem.

So what about the way that we-- how do we decide? How do we decide if we're healthy? There's a big thing about numbers, I know. I mean, you've got various things in the magazines there about the different numbers we use. What sort of numbers are important?

Well, we measure all sorts of things in terms of a person's health. So it can be from birth it's birth weight and height as children grow. And then for adults, it's things as varied as cholesterol levels, blood pressure. There's all sorts of ways in which we measure health and wellbeing. And I think in some ways we could become quite fixated on that.

We've certainly got lots of equipment to measure these things. I mean, we've got the blood pressure monitor here. So take one of these home, you don't have to go to the doctor. You just stick this thing on your arm. You can press the magic buttons. And if you look to see what the last member of the family to use it had. We can see that little picture of a heart comes up, which is very cute. Just like a sort of heart you use in love, actually. And there you go-- 140 over 84 for blood pressure, pulse of 62. So you know your numbers, and you can adjust your life accordingly. But in the ancient world, numbers really don't play a part.

Let's think about lovesickness, because in that, as you'll see in this week's work, we do have some use of the pulse, but not a number attached to it. Lovesickness is a disease which people thought they had if they felt a bit sort of faint and pathetic and felt dizzy and sweating, and a sort of pulsing sensation, a noise in the ears-- might mean that they were in love. Is love ever a sickness now, or is it always a healthy thing?

I think we don't pathologize love at all now. But we do think about certain aspects of love as being possibly problematic. So we do have services and clinics for people that are seen as being addicted to sex. So that, I think, is connected to a love. But you wouldn't say-- you know, if you went to see a health professional, they wouldn't say this is a lovesickness. That would be really unusual now, I think.

So if you think about that overall, then, in terms of health we have some ideas that are very different now, particularly the fixation on numbers and getting it right. We have a division between physical and mental, which they didn't really have in the ancient world. But love is no longer a sickness. It's OK to be in love. Thank you very much.