Travels by Michael Crichton Page A

reflected our mental state, was to say something else.
    It was to say mental states caused disease.
    And if you accepted that concept for infectious disease, where did you draw the line? Did mental states also cause cancer? Did mental states cause heart attacks? Did mental states cause arthritis? What about diseases of old age? Did mental states cause Alzheimer’s? What about children? Did mental states cause leukemia in young children? What about birth defects? Did mental states cause mongolism at birth? If so, whose mental state—the mother’s or the child’s? Or both?
    It became clear that at the farther reaches of this idea, you came uncomfortably close to medieval notions that a pregnant woman who suffered a fright would later produce a deformed child. And any consideration of mental states automatically raised the idea of blame. If you caused your illness, weren’t you also to blame? Much medical attention had been devoted to removing ideas of blame from disease. Only a few illnesses, such as alcoholism and other addictions, still had notions of blame attached.
    So this idea that mental processes caused disease seemed to have retrogressive aspects. No wonder doctors hesitated to pursue it. I myself backed away from it for many years.
    It was Dr. Gardner’s view that both the physical and the mental aspects were important. Even if you imagined the heart attack had a psychological origin, once the cardiac muscle was damaged it needed to be treated as a physical injury. Thus the medical care we were giving was appropriate.
    I wasn’t so sure about this. Because, if you imagined that the mental process had injured the heart, then couldn’t the mental process also heal the heart? Shouldn’t we be encouraging people to invoke their inner resources to deal with the injury? We certainly weren’t doing that. We were doing the opposite: we were constantly telling people to lie down, to take it easy, to give over their treatment to us. We were reinforcing the idea that they were helpless and weak, that there was nothing theycould do, and they’d better be careful even going to the bathroom because the least strain and—poof!—you were dead. That was how weak you were.
    This didn’t seem like a good instruction from an authority figure to a patient’s unconscious mental process. It seemed as if we might actually be delaying the cure by our behavior. But, on the other hand, some patients who refused to listen to their doctors, who jumped out of bed, would die suddenly while having a bowel movement. And who wanted to take responsibility for that?
    Many years passed, and I had long since left medicine, before I arrived at a view of disease that seemed to make sense to me. The view is this:
    We cause our diseases. We are directly responsible for any illness that happens to us.
    In some cases, we understand this perfectly well. We knew we should have not gotten run-down and caught a cold. In the case of more catastrophic illnesses, the mechanism is not so clear to us. But whether we can see a mechanism or not—whether there is a mechanism or not—it is healthier to assume responsibility for our lives, and for everything that happens to us.
    Of course it isn’t helpful to blame ourselves for an illness. That much is clear. (It’s rarely helpful to blame anybody for anything.) But that doesn’t mean we should abdicate all responsibility as well. To give up responsibility for our lives is not healthy.
    In other words, given the choice of saying to ourselves, “I am sick but it has nothing to do with me,” or saying, “I am sick because I caused the sickness,” we are better off thinking and behaving as if we did it to ourselves. I believe we are more likely to recover if we take that responsibility.
    For one thing, when we take responsibility for a situation, we also take control of it. We are less frightened and more practical. We are better able to focus on what we can do now to ameliorate the illness, and to