As long as there has been life there has been illness, and as long as we have experienced illness, one question dominates: why?

Why is why so powerful, so persistent?

There are many reasons.  One has to do with simple curiosity.  When bad medical events strike, the first question is why because we want to know how it happened, we are curious.

We also want to know why because we want to know how to fight the attack.  Knowing why a medical problem occurs is essential to knowing how to cure it, to solve the challenge.

We also want to know why medical problems happen in general, because that’s the best path to crafting approaches that might prevent such problems from happening in the first place.

For many years the dominant explanation, the reason why we get sick, has been the concept of a harmonious body being disrupted.  The deepest understanding of our bodies we now follow is that when left to its best ways, the body is a symphony of beautiful harmony.  And in this understanding, disease and serious medical conditions are the result of events that disrupt this harmony.

Organs, Functions, and Harmony

A recent book by the incisive writer Barbara Erhenreich,  Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer raises the possibility that our bodies are not symphonies of harmony, but a far less predictable, more chaotic collection of independent actors who often are in conflict, not harmony.

Ehrenreich writes beautifully about our long-held perspective that the cells of our body our organized for a unified purpose.  Nerve cells gather into sets of neural networks that create the brain, spinal cord, and other organs that together form the nervous system that has the unified purpose of sensing, processing, and executing tasks based on information.   Or that other cells gather into organs such as the stomach, intestine, pancreas, and liver to form the digestive system which is united in its purpose to deliver nutrient from food to our bodies.  Or that other cells gather into organs such as the bone marrow, spleen, lymph nodes, and masses of roving cells to create the immune system which a system united in its defense of our body against threats such as infection or cancer.

Of course, this view of the structure and function of our body is true at a very deep level.  We do in fact have well-known systems- nervous, digestive, skeletal, circulatory, respiratory, endocrine, immune, and other systems.  Their excellent functioning is a basic fact of life, essential and necessary for life itself to exist and continue.

This view is the foundation of the popular notion of holistic being, health, medicine.  Holistic philosophies are based on the notion that the body is an complex web of trillions of cells, but each of these cells serves an integrated purpose.  Cells gather to form tissues, tissues organs, organs systems, and systems the organism that lives.  Holistic perspectives see that the body is a whole, that one cannot really talk about just bones, or lungs, or brains, that the reality lies in all these organs and systems serving one whole purpose, namely healthy life.  A harm to one cell or one system is a harm to life and health.

Holistic philosophy is also true at a very deep level.  The knee bone really is connected to the hip bone.  Their are no cells, tissues, organs, or systems in the body that are not deeply connected, influenced, even defined, by the others.  What hurts one part, hurts all parts.  And what helps maintain the health of one part, helps all parts.

And so, in the very real sense that the body is one whole, that it is united in one purpose, medical disease and dangerous conditions can indeed be seen as disruptions of an otherwise unified set of systems that normally are together in creating life and maintaining health.  This view of disease sees disease as an outside attack on an innocent body.   The familiar story of an infection fits this model.  Our bodies seek to operate as a very effective, united, healthy whole, and along comes the evil germ to attack the good body and try to destroy it.   Again, there is much truth to this concept.  Today I may feel great, my body is humming along in perfect harmony, and then tomorrow a cold virus lands in my nose and suddenly I am under attack, my nose runs, my throat hurts, my chest coughs, I feel miserable and suffer fevers and aches.  All this is true, and happens all the time.

The Power and Intelligence of the Cell

In Natural Causes, Ms. Ehrenreich shares compelling recent insights from human biology that expands this picture of our body and how it works.  Note that I say expands, there is no argument that our body does contain astounding harmonies of purpose, but it turns out that’s not the whole story.

The story she presents looks at the cell.  We tend to take cells for granted, after all there are 10 trillion of them in each of our bodies.  It is impossible to give thought to all 10 trillion, so much easier to think of groups of billions, like a lung or heart, as noted above.  And when compared to the glories of the great functions of the body, how the brain works, or how the endocrine system works, the cell seems so small and humble.

But Ms. Ehrenreich reminds us that the cell is the unit of life.  There is no life without cells. Viruses, if living entities, need cells to live, and are the only possible living entity that is not a cell itself.

So what is a cell?  The word itself comes from the Latin word for a chamber, or a room.  It is quite literally one room of life.  From my perspective, a cell is a small chamber that sharply defines itself as having an inside and an outside.  That boundary allows for special events to take place on the inside.  If the inside and outside are not kept strictly separate, these special functions cannot happen.  The special functions include a dazzling array of chemical reactions that allow energy to be concentrated, for various actions to take place with that energy including maintenance of each cell’s genetic code and its expression, movement in the world, responses to the world, taking in nutrient, expelling waste, sending signals to other cells.   In bodies with lots of cells, cells decide on whether to cooperate or attack cells it comes across.

If the Body is a Beautiful Harmony, how Can the Fault Lie with Our Body?

This list of structures and functions makes clear that the intelligence we associate with life starts right there in each and every single cell.  And it’s true.

Every cell strives to survive, takes actions to increase its chances of living and avoids demise.   That is the heart of intelligence, and every cell is loaded with it.

Of course, what that means is that cells as individuals will, at times, find that their reaching for life bumps into other cells quest for life, and that they will be in conflict.  That urge to life for each cell can also be seen at the level of groups of cells, in tissues, and organs, and even systems.

The most dramatic example Ms. Ehrenreich offers is of the macrophage.  The macrophage is a type of cell in our bodies, one that Ms. Ehrenreich specialized in studying when a student.   The word macrophage is derived from the Greek words for big (macro) and eat (phage), so it means big eater.  And it is.  Macrophages are white blood cells that leave the bloodstream to take up their posts in tissues across the body.  They grow large, and basically identify enemy cells and eat and destroy them.  A microscope’s photo of one devouring a tuberculosis germ makes this whole idea very clear:

Here, the macrophage is the flowing drape-like brownish set of folds devouring a bunch of TB germs which are colored bright green in this photo.

Notice how huge this cell is compared to bacteria, and how complex its folds and structures.

This makes the macrophage a formidable cell in the human body.  It can roam anywhere in the body, and has the ability to engulf and destroy any other cell.  We cheer when our macrophages destroy invading germs, or encounter an emerging cancer cell and nip a developing cancer from occurring.

But it also turns out that, as part of its usual functions, for unknown reasons, the macrophage is now known to play a role in some cancers actually taking hold and spreading.  Normal macrophages have been found to actually hide cancer cells in their folds to protect the cancer from detection and destruction, of helping such cells move in and out of blood vessels as an essential step towards metastasis, and even of promoting blood vessel formation to a tumor, another essential step in the creation of a serious cancer.

The point here is that when we think of the body as a harmonious whole, with every cell and organ playing a good role and function, then disease represents a failure or a mistake.  Something that should have done something right failed to do so, or a terrible accident occurred allowing an enemy inside our harmonious whole.

The story of the macrophage opens up the story quite dramatically.  Now we know that a major player in our immune system, while functioning as it usually functions, actually ends up hurting us sometimes, hurting us quite seriously.  The cancer cell that spreads and grows only with the help of a normal macrophage demonstrates that disease can be the result of normal functions of our body, not from errors.

The idea of a harmonious body suggests disease is the result of our disruptions.  Events that we expose ourselves to, that upset the quiet harmony of the intact body.

But again, the actual normal behavior of the macrophage tells us that the body is not always a harmonious whole, but a wildly complex arena where 10 trillion of our human cells each play a role with their own intelligence, and sometimes the role these healthy cells pursue can cause a serious problem.

Many mechanisms of aging fall into this pattern of normal body functions causing disease or chronic conditions.

BOTTOM LINES

1. Current fashion, as well as much science, suggests that the 10 trillion cells of our body want to live together in piece.  That the various collections of cells, namely tissues, organs, and systems, operate under normal conditions under holistic harmonies, with each cell and tissue performing an orderly function.
2. This holistic sense of body function then understands disease as a state where otherwise normal cells are now abnormal, usually as a result of a poor diet, too much stress, an infection.  Something has to go wrong for disease to occur.
3. Recent findings in the world of biology give us a far more complex picture, starting with the cell.   Some very healthy, normal cells, in our bodies, can at times act very harmfully.  For example, the white cell that can weave in and out of blood vessels to live in any tissue, can turn on the body without being abnormal in any way.

We should all continue our vigilance in avoiding triggers for cells going bad, including the triggers of smoking and obesity, of drug addiction, and other behaviors that can hurt our health.

But at the same time, it may be time to see the movement of holistic medicine as a harsh perspective, one in which all disease is unnatural.  Many diseases will be turning out to be the result of the complexity inherent in our bodies.

This perspective allows us, oddly, to relax a bit, enjoy life, knowing that the really astounding fact is that we are alive.  And given that this astounding collection of 10 trillion cells, our body, may one day turn on us, gets off the hook, at least a bit from pretending we can avoid all troubles by behaving and eating well.

And so, the fault sometimes is not in our stars, but in our cells, in life itself.

To your health,
Dr. Arthur Lavin