Norm and normal

Medicine bases its definition of the normal on population studies. A normal heart rate is defined as an average heart rate in a healthy population, which is 80/min.  Since heart rates vary, the normal is defined over a  range of values which extend  up to three standard deviations from the mean. However the heart rate of some healthy individuals like athletes or Buddhists is much lower.  Their normal differs from the population normal. We ought therefore to distinguish between two kinds of normal, a population normal which will  be called here a norm, and individual normal. In most people both are congruent while in a minority they differ.  How may this discrepancy be avoided?

In the case of the heart rate this difficulty is easily resolved. The population is divided into different groups, one includes inactive individuals, the other  athletes, and so on. In each group the norm will equal the normal. However  this method fails when defining the norm of   biochemical variables.   Normal blood glucose, or normoglycemia is estimated  in a healthy population, and a departure greater than three standard deviations from the mean is abnormal.  Considering  the heart rate example one may expect that some healthy individuals will have an elevated  blood glucose and their normal will differ from the norm. Since this inconsistency cannot be resolved by grouping  they are regarded as abnormal (hyperglycemic). 

The Normal and the Pathological

Medicine regards  the normal as health and the abnormal as disease, and  the healthy hyperglycemic is regarded as sick or pre-diabetic. Medicine imposes the collective norm on the individual normal, which endangers many healthy people whom medicine labels as abnormal and sick.  This conceptual dilemma was analyzed from the philosophical perspective by  the French philosopher Georges Canguilhem in his treatise: ‘Le normal et le pathologique.’ Here it is postulated that only the individual normal which is determined by WOB is correct. The norm is only an approximation of the normal.

Diabetes mellitus

This double meaning of the normal has far reaching implications on the interpretation of disease which was examined in a separate chapter .  In diabetes mellitus, the average blood sugar of a healthy population is taken as a normal reference, and diabetes mellitus is regarded as a  progressive hyperglycemia.    However this view ignores the possibility that  some diabetic individuals may require an elevated blood sugar. In other words, since only WOB knows what the optimal blood sugar ought to be, it elevates the blood sugar to levels required by the organism at each stage of the disease, and  diabetes mellitus ought to be regarded  as an evolving normoglycemia.

The two kinds of the normal  and have  far  reaching implications on therapy. Should the blood glucose be reduced to the collective norm of the healthy collective? Or should medicine be concerned also with the individual normal which is set by WOB?

The central motto of this site is that only WOB determines what  should be regarded as normal.   There is no use in   distinguishing between the normal and abnormal since  all WOB manifestations are essentially normal. Actually both, the normal and abnormal are meaningless and should avoided.   In mathematics this state of affairs  is obvious. Consider the integers which extend from minus infinity to plus infinity. Would anybody suggest that some are normal and other not? The same logic applies to the spectrum of WOB manifestations.   Disease is not an abnormal state. It is defined as follows:

1. Subjective definition: 
  1.1 A WOB signal informing the mind that it needs assistance, like thirst when it lacks water, or dis-ease, when it fails to  handle some processes by itself. This signal initiates a WOB disease state.
  1.2 A signal initiated by the mind, like suffering, or a sense of misery, while WOB remains silent. This signal initiates a mind disease state. 

2. Objective definition: Any agent which reduces tolerance.

Tolerance

Is a measure of WOB reserves (resources)  and its capacity to sustain life. It is an objective description of   the patient’s state. WOB has no way of assessing its tolerances  and  from its perspective tolerance is meaningless. It has a wisdom to maintain life at any tolerance level, or better, it optimizes  tolerance (resources) utilization.   When tolerance is exhausted  the organism dies. In order to get resources (tolerance) WOB depends on the  assistance of the mind. By itself WOB cannot get resources.  Like in the newborn baby, which is a pure WOB. When it  lacks resources it cries and so signals  its mother to supply its needs.

Vitality

Vitality is an epidemiological definition of tolerance. The probability of an individual to die is called hazard rate,  or the force of mortality. Vitality  is defined as  (1. – hazard rate). In the adult, vitality continually declines and vanishes at death. While tolerance is an attribute of the individual, vitality is an attribute of the population, or its norm.

Additional reading: Vitality and Health

WOB and mind signals

Any agent which reduces tolerance may initiate a disease state.  As long as WOB is silent tolerance reduction is not regarded as disease but as a health deterioration. For instance healthy aging is manifested by a continual tolerance deterioration and is not regarded as a disease.  In order to be regarded as WOB disease, a declining tolerance   has to be accompanied by a WOB signal. We may thus distinguish between two kinds of WOB disease signals:

1. WOB signals which the mind can resolve by itself, like thirst or hunger.
2. WOB signals which are handled medically, like dis-ease.

There are two kinds of mind signals:

1. Mind signals that can be handled by the individual, e.g., in order to handle his misery he decides to change his life style.
2. Mind signals which call  for medical assistance. 

Mathematical considerations

The  state of an individual is represented by two components (signal, tolerance). Actually we speak of a signal set which may originate in WOB or mind, defined respectively as signal[WOB], and signal[mind].

WOB disease = (signal[WOB] = on; signal[mind] = off).
Mind disease = (signal[WOB] = off; signal[mind] = on).

Most diseases are mixed, and  disease = (signal[WOB] = on; signal[mind] = on). Although tolerance is required to describe the state of an individual, it is not required for the definition of disease. Take for instance a cripple who is regarded by medicine as abnormal since differing from the collective norm of healthy individuals.  From the present perspective, if he feels good, which means that WOB and mind are silent, he is healthy and remains so despite his low tolerance.  

Disease is driven by a tolerance reducing agent

Any  tolerance reducing agent, called here a driver,   may initiate a disease, which  proceeds through two phases:
1. Pre-clinical phase, a symptom-less tolerance decline, when WOB and mind are silent.  
2. Clinical phase, when tolerance decline is accompanied by WOB and mind signals.

Some diseases are driven by well defined agents, like infections, or vitamin deficiencies. In most chronic diseases, like cancer or diabetes mellitus, the driver is unknown.

Will as a disease driver

Some diseases are initiated by a conflict between WOB and mind. One morning you watch your poor physique and enroll  in a fitness club. WOB dislikes weight lifting and signals the mind, fatigue, and muscle ache. You suffer from a mind induced disease. Despite rising tolerance WOB objects  and you suffer, which illustrates again that tolerance gain or loss does not indicate a disease state.  Generally our will is transmitted to WOB as an image which signals WOB to execute our will.  When deciding to exercise WOB is required to reshuffle processes  and adapt them to our new demand  to which it objects. It would prefer to put us in bed.  Whenever you decide  to  perform a new task the mind has to endure WOB objections for some time. The will induced disease state ends when WOB regains control over the new situation and stops complaining.

Further reading Astronaut disease

Mind disease which is driven by culture

Mind is an interface between WOB and the outer world (non-self). It provides WOB with   resources and transmits to it cultural norms which may be in conflict with WOB demands. WOB is generally regarded as the beastly  and some of its demands are forbidden. This conflict between mind and WOB initiates a mind disease. Like in the case of a male WOB which signals the mind that it is in love with another male, a situation which is described elsewhere. If culture objects to homosexuality, mind will refuse to look for a male partner and the conflict initiates a mind disease.   If unresolved it may drive  the individual into   a psychiatric ward. However many homosexuals channeled their WOB urges into creative tasks like arts, resolving the conflict and eliminating their mind disease.  

Mind disease initiators

Culture nurtures beliefs and norms which may initiate  mind diseases, like religion whose contribution to mind disease is described elsewhere in this site. Medical sciences trigger   many mind diseases since   their philosophies are unhealthy, as the following examples illustrate:

1. Genetic pre-determinism  whose motto is:  “It’s all in your genes”.  Sophisticated tests detect bad genes  in otherwise healthy individuals.  A young healthy female discovers that she carries her own self destruction  known as BRCA  gene. This dreadful  revelation initiates a mind disease, or mind cancer.   In order to avoid her terrible fate    she even volunteers to remove her breasts aggravating her mind disease even more.

2. The tyranny of the collective normal is discussed above. Medicine, imposes the collective norm  on the individual. During one of your periodic checkups, your doctor studies the computer printout of   150 lab tests  and reveals to you that your calcium is abnormal  since it deviates from the population norm. True, nothing can be done about it, yet you leave the doctor’s office with an incipient mind-calcium disease.  

3. Molecular fatalism  You might be lucky and all your genes are intact, and then one day a gene mutates and a normal cell becomes a tumor.  It is a random event which may affect anyone.  From now on your fate rests in the hand of doctors since according to their view your organism is helpless to cure your cancer. Randomness dominates medical reasoning and its consequences are all sorts of mind diseases.

The common denominator of these examples is that medicine attempts to impose the population norm on your individual normal and the conflict may end in a mind disease.

Cancer  starts as a mind cancer

Officially cancer starts as a random mutation in a normal cell which becomes malignant. Yet this story is utterly irrelevant when cancer is diagnosed because all the knowledge on cancer progression during its pre-clinical phase lacks  therapeutic implications.  Suppose that you know the etiology of a particular cancer since the  patient consumed a carcinogenic poison. When cancer is diagnosed this information is meaningless since the mutation cannot be undone.  Generally in all chronic diseases etiology does not contribute to therapy.

From the therapeutic perspective  cancer starts when the patient realizes that she carries an evil and fatal disease. Diagnosis initiates in  her a  mind cancer. At this stage the tumor is generally painless, which means that WOB is silent  and  healthy. Her ordeal is nurtured by the obvious questions: Why did you smoke? Or what kept you so long? Whereupon mind cancer becomes wrapped  in guilt.

Their cancer is different from mine

She will be rescued from her misery when realizing that: “Their cancer is different from mine” which is her first effort to free herself from the tyranny of the collective norm. From now on her mission is to become a Cancer-Yogi who cherishes her individual normal.  

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