Earlier this year, my sister and I went to San Francisco’s marvelous art museum, the Palace of the Legion of Honor. We had a great time, but my sister lives with a chronic autoimmune disorder and can only stand and walk for so long. So after about an hour, we headed for the lounge area and made ourselves comfortable, until it became clear that we were not welcome in that space.
One of the symptoms of her condition is lung congestion, which leads to periodic bouts of coughing. One struck just as we sat down. To some of those near us, her spasms were clearly an affront.
At first, it was just judgmental sidelong glances. Then a couple of people began to fidget as they glared, wordlessly signaling their exasperation. Finally, after my sister had been hacking away for three minutes or so, one man stood, stared, anger evident on his face, and stomped away. To be ill in public was disgraceful, an affront.
We read the room and fled.
That one afternoon’s momentary shame soon faded, but the belief that to be sick is a personal failure has much broader consequences. When Health and Human Services Secretary Robert F. Kennedy Jr. states that “it’s very, very difficult for measles to kill a healthy person” (misleading at best), what many people hear is that those who do suffer bad outcomes have themselves to blame. “We see a correlation between people who get hurt by measles,” he said, “and people who don’t have good nutrition or who don’t have a good exercise regimen.”
There’s nothing new in the idea that we are each responsible for our own well-being. Illness has long been seen as a measure of our character, even of our moral values. But when Kennedy implied that exercising and avoiding junk food will save someone from the worst that measles can do, that unfairly places blame on those who do get seriously ill. It also suggests that each of us is the captain of our fate, and that eating right and exercising is just about all it takes to avoid illness.
Of course, Kennedy didn’t invent the idea that health is the testament to a well-lived life. The belief that those with good habits can shrug off disease runs through the history of medicine. In 1721, London and Boston faced twin outbreaks of smallpox. A handful of pioneers responded with variolation: scratching material from sores of those already afflicted into the limbs of volunteers who had not yet suffered the disease. Such proto-vaccination was far from risk-free, but for the majority of recipients, it worked.
To its opponents, though, this effort reflected a fundamental misunderstanding of why one fell ill. The Reverend Edmond Massey, preaching in the midst of London’s outbreak, captured the essence of such objections. Massey told his flock that smallpox was God’s way of forcing sinners to “examine themselves for what cause this evil is come upon them.”
A case of smallpox was a window on one’s soul; sin had brought the disease upon each sufferer, which meant that any hope for recovery required repentance. Boston’s city leaders believed this to be true and, in late June, called for a town-wide observance of a day of penitence and fasting.
Unsurprisingly, the smallpox virus was unmoved by such piety. In Boston, about 300 people were willing to try the new procedure. All but six survived the epidemic. But more than half the town’s population—roughly 5,900 people—bypassed variolation and fell sick. At least 850 of them died.
For the next two centuries, though, even though explicit appeals to religious faith became less common, the underlying belief remained: health was a moral choice, secured by choosing the right habits. Of course, that meant that if illness did come, it was a reflection of failure. Take, for example, what a most unlikely wellness influencer, Walt Whitman, had to say in his 1858 series on “Manly Health and Training.”
Whitman offered plenty of idiosyncratic advice: avoid catsup; eat rare beef, maintain “a cheerful and gay temper during and immediately after meals,” and so on. But he anticipated current health influencers on the crucial question. “The cause of disease,” he wrote, “is bad blood, often hereditary, more often from persistence in bad habits.” No need to bother with conventional medicine, then, with “the great requisites of health being good air, proper food, and appropriate exercise.”
Henry Lindlahr, one of the most influential naturopathic writers of the early 20th century, claimed that vaccinations made “the human body a swill pot for the collection of all sorts of disease taints and poisonous antiseptics and germicides.” By contrast, good health could be achieved through natural prescriptions and “by cultivating the right mental attitude.”
Trusting that good health is simply a matter of will has always been a seductive act of faith, offering the hope that our fate is under our control. But it’s an illusion. No amount of positive thinking or healthy eating will keep an illness from doing potentially lethal harm.