Perspectives in Biology and Medicine

HEALTH AND FITNESS RICHARD B. GUNDERMAN* In every composite [thing] the good belongs, not to this or that part, but to the whole—and I say good according to the goodness that L· proper to the whole and its perfection. For parts are imperfect in comparison with the whole, as the parts of man are not man.—St. Thomas Aquinas However true it may be that the man who says his nightly prayers sleeps the betterfor it, nevertheless no one could say his nightly prayers with that in mind.—Josef Pieper Most of us recognize a healthy person when we see one, but to say what we mean by "health" is a challenge. Is it a bodily condition or a state of mind; a cultural construction or a natural condition; the mere absence of disease, or a positive state of well-being? Despite the difficulties, health is worth thinking about. It is a biological concept that includes both description and evaluation, both "fact" and "value." To know health would be to glimpse what human beings are and how we function, and also to perceive something about the good for us. In health, in other words, biology and ethics meet. Health is a kind of fitness, a fitness for love, for work, for play, for thought—in short, a fitness for life itself. In this essay, I sketch health from three different perspectives, related to different ideas of fitness. These fitnesses have both biological and ethical connotations. In our pursuit of health, for what kind of life do we aim to render ourselves fit? Physical Fitness "Physical fitness" of a sort is one perspective on health. By it I mean the view that health and longevity are the highest aims of human life, a * Lecturer in the Biological Sciences and New Collegiate Division and fellow, Department of Medicine, University of Chicago. Address: 5107 South Blackstone Ave., #1204, Chicago, Illinois 60615.© 1990 by The University of Chicago. All rights reserved. 003 1-5982/90/3304-0686$0 1 .00 Perspectives in Biology and Medicine, 33, 4 ¦ Summer 1990 \ 577 sentiment captured by the commercial saw, "When you have your health, you havejust about everything." It is no accident that this view of health became the advertising slogan for a brand of daily vitamin and mineral supplement. We encounter the physical fitness perspective when we pick up a magazine , look at a billboard, or turn on the television. We are saturated with pictures and descriptions of the youthful, perfectly proportioned, tanned and muscular human body. Health sells. Health clubs, health and fitness products, and health foods abound, as do health-oriented journals, newspaper articles, and radio and television programs. Rosy cheeks and a vibrant step are no longer the blessings of virtue, so Madison Avenue would have us believe, but the wages of consummate consumerism . I am less interested in the mercantile aspects of health, however, than in our appetite for health. As a society, we love health. In public opinion surveys, Americans commonly place health at the top of the list of things we feel are important in life. In one survey, health was cited by 70 percent of respondents as one of the items most important to them [I]. Thirty-nine percent chose peace of mind, 23 percent chose "seeing that my children get a good education," 16 percent chose living in a democratic society, and 14 percent chose having close friends. I am not saying that health is unimportant or that the pursuit of health is a base endeavor. I am saying that our interest in health is becoming excessive, perhaps even obsessive. The ascendancy of health in our own age is symptomatic ofa more serious disorder. The obsession with health reveals a misapprehension of what health is and of how it fits into the larger scheme of human ends. In our case, the pursuit of health is becoming pathological. What are the sequelae for persons, for families and friends, and for the community at large of an overly zealous pursuit of health? The personal implications of the obsession with health are captured in this piece from The Spectator, written byJoseph Addison in the year 1711 [2]: Sir, I am...