Doctors Say I'm Unhealthy; I Disagree

On a recent Monday morning, I underwent a routine liver biopsy. I changed into one of those awful hospital gowns, signed away a slew of legal rights should anything go amiss, withstood an IV-line placement and arranged myself into the prescribed position: lying on my back, my right arm high above my head.

Over the years, I've become inured to hospitals, needles, ambulance rides and promises of doom and gloom. Twenty years ago, when I was 15, I was diagnosed with autoimmune hepatitis. At 22, I underwent a liver transplant. By 24 I had developed ulcerative colitis and two years later I had my large intestine removed. These two early diseases then begat a third: primary sclerosing cholangitis. PSC, a liver disease, prompted a second liver transplant when I was 28.

But I don't feel put upon or see myself as some sort of "other," representing all that can go wrong. In fact, I've come to think of myself as the picture of health. Is this delusional? Perhaps. But I don't believe I'm the sum total of every unfortunate medical crisis I've ever come up against. Yes, there have been diagnoses that have complicated my young life, but where there's been disease there has also been triumph.

When I explained this to the nurse assisting with the biopsy, after he referred to me as very unhealthy, he balked at the idea. I guess I could understand his hesitation. Maybe I'd had brief, healthy intervals, but did I really consider myself healthy? What healthy person knows to ask for a less painful butterfly needle, and instinctively knows that in order "to get a good vein" for a blood draw, it's best to dangle your arms over the side of the chair? Besides, if I were the picture of health, I wouldn't be on a first-name basis with many of the emergency-room valets. Yet, it's precisely because of my experiences and routines that I think I'm healthy.

It's too elemental to define being healthy as merely the absence of illness, frailties and failings, the chance to count yourself among those who have never been on the receiving end of a frightening diagnosis. Maybe a healthy person is someone who's in constant pursuit of it, someone who's lost it and fought hard to regain it, someone who appreciates that being healthy isn't merely an abstract state of being to which some are blessed and others are deprived. Under this premise I'm fit, hard fought and hard won.

I cannot help that doctors will always see me in terms relative to a set of finite radiology or pathology reports, or that neighbors will always refer to me as L.J. and Deborah's daughter, the wan one, or even that most others will see me in terms of where one surgical scar ends and another begins. This is not all that I am. I see a body that heals quickly after trauma, one that mercifully forgets the pain of biopsies, surgeries and colonoscopies, one that remembers its strengths. When I'm in the throes of a spinal tap, or when friends and family are present for the insertion of a second or third urine catheter, this confidence admittedly wanes. But it doesn't stay gone for long.

Perhaps it's time to redefine what it means to be healthy. In an era of great medical advances when doctors have the ability to diagnose once unidentifiable ailments and when genetic testing is becoming more acceptable, maybe the definition of what is and isn't healthy needs to be amended. Are you healthy if you can jog a mile? Are you considered well if your body has been put to some dire test from which you have emerged victorious? And how do you classify those of us who face numerous tests, but still jog two miles a day, work full time and lead otherwise "normal" lives?

I visit the doctor's office monthly, sometimes weekly. For me, annual doctor's exams are a quaint notion akin to 5 o'clock Sunday dinners. My health is monitored by a team of specialists always striving to improve upon the last set of results. Bone-density tests are scheduled between social events. Professional obligations yield to doctor's appointments, CT scans and X-rays. On any given day I can recite my most recent cholesterol, creatinine and potassium levels.

I understand many will not see me as healthy, that they'll continue to punctuate every inquiry with condolences. I'm not even sure how best to redefine the concept of what is and isn't healthy, but I hope any such definition will underscore that the presence of illness isn't nearly as important as one's ability to overcome it.