on the cascade of interventions

The cascade of interventions is an idea I first came upon in midwifery.  Midwifery itself is shorthand for "how I learned to be pregnant and give birth in a way that promotes the health of the baby, the mother, and the family".  Although interventions in pregnancy and other areas can so often be sidestepped entirely by eating well.  And not being fat.  And not smoking.  And working physically hard.

Those are the four pillars, in no particular order.  Your genes are a crap shoot but there is always epigenetics and if that can go in a negative way (which is the direction in which it has been studied), then it can go in a positive, adaptive, functional, healthy direction too.

Smaller things likely get in there, like don't live in Flint sorts of things, but that's going to exist in high end places perhaps even worse with the lawn chemicals. So anyway. 

In midwifery the cascade of interventions generally starts during the process of birth if it hasn't begun before:  Go into labor, have them attach fetal monitors which requires some time on your back which leads to the perception of fetal distress so they "enhance" labor to speed it up which causes more pain which results in epidural which slows labor . . . and pretty soon you have yourself a c-section and being told by your doctor or perhaps other perhaps well-meaning people that you just could not have a baby vaginally.  Bullshit.  It does happen but it is rare.  You have millennia of successful birthing women standing right behind you. Also:  Birth; as safe as life gets.

None of that means that you are to "blame" if you have a c-section. But it may mean that you didn't know better.  And it may mean that you didn't believe better, like the plethora of people I've known who don't believe that diet can prevent pre-eclampsia now generally called PIH.  If you didn't follow the diet however, if you didn't get enough protein, if you didn't support blood volume expansion, then it doesn't matter if you "believe" it or not, you could have at least tried to prevent it and you didn't.  You didn't, as Maya Angelou said, "When you knew better, you did better."  It isn't blame, it is responsibility.  And responsibility moves.  With information.  There is very little cut and dried anywhere.

I have always felt rather strongly against diagnoses.  Here's a box, get in it, stay put.  Life just isn't like that.  Yeah, maybe once your pancreas stops working, then you are an insulin dependent diabetic, but even so much of that "after the diagnosis" depends on diet and that ubiquitous "lifestyle".  The folks who argue for a chemical basis for mental illness conveniently neglect the fact that while when you change the chemistry you sometimes change the thought, when you change the thought, you do change the chemistry.  The best (that is, most clinically effective) anti-depressant is exercise.  Better than exercise is work to exhaustion with an accomplishment at the end (not a treatmill but a garden, say -- and oh look, then you get to eat food that is chemically and spiritually more healthful, and also then the whole community is stronger and the things that need to not be supported aren't supported, etc.).  People who fart too much after eating beans generally just need to eat beans more often to support the correct gut flora to digest them -- and of course realize that farting is healthy.

I mean, it is not really all that different from cancer.  Cancer is terrible, I'm not saying it isn't, but when talking about a need for a "cure" for cancer, why when people absolutely completely ignore what we know about preventing cancer:  eat widely, work hard, don't be fat, don't smoke.  Sometimes our genes or just the luck of the draw gets us anyway, and almost certainly age itself will get us (the idea that if we don't die of something else, we will die of cancer, eventually), but that doesn't change what we know about prevention.

And then there's the "don't stress" roof over the pillars of health: physical, mental, spiritual.

And so far this whole thing has been about the cascade of health instead of the cascade of interventions but again, what got me thinking about that was the cascade of diagnoses.  The first and most obvious to me example was a good friend to the husband who randomly got screened and had prostate cancer.  In getting "healthcare" for that, he got "healthcare" for a whole lot of other things, I don't even remember now what all but I know it included cholesterol.  Within a couple years he was so very very sick.  Not of prostate cancer, which may have killed him eventually, if given enough time.  After he died his wife told us that he had said to her, "I'm on too much medicine.  It is killing me."  It did.

Years before that a man I knew was in the hospital dying and there was nothing medicine could do for him.  He said, take me off the medicine and let me be.  He got better.  For years.

Some 25 years ago another man we knew took some medicine for a mild condition, a one time medicine, and it shut down his gut and he was far enough gone that he got his affairs in order and stopped all medication except he still took the TPN.  He's 80 now and a fantastic old fart, my favorite old fart.

So those are persons I know/knew and life/death.  But there is also the woman we knew from a homesteading list way back in the day.  I always doubted her "homesteading" because she was exceedingly fat.  You just can't do that much work and be fat.  She has, through the nearly 20 years we've "known" her (virtually -- she blogs now), had every "diagnosis" in the world, including Munchausen's which was likely the only accurate one.  Every doctor who doesn't diagnose her is a quack.  Nothing is ever enough.

But I suppose at least hers are physical diagnoses.  Now I come to the mental ones:  the ones who believe they have ADHD, then autism, then bipolar, until maybe you finally get all the way up to the schizophrenia spectrum.

My point is that just exactly like there is a cascade of interventions possible in childbirth (and likely in medicalized birth), there is likely a cascade of diagnoses and going through that cascade is quixotically enticing and treacherous.

And a particularly ineffective way to be a special snowflake.  Why not admire health instead of unhealth? Strength instead of weakness?  Function instead of disfunction?  Wealth of skill instead of wealth of debt?  That whole sort of thing.   There are a whole lot fewer of those snowflakes.