Homeostasis, flat seas, and diseases of modernity

Much of modern life is a bet on calm seas and homeostasis. Just because you weren’t previously aware you were making that bet, doesn’t mean you haven’t been making that bet your whole life, picking up pennies in front of infrequent, often invisible, but very, very large bulldozers, relying on some force pushing things back to normal afterward, even if the worst happens,

In biology. this tendency for systems to return to normal is generally called homeostasis. When human bodies—complex systems—are pushed away for where they prefer to operate, the body has a strong, innate tendency to return to where it was before, a condition that we generally call normal, whether it’s body temperature, weight, biomarkers, or anything else.

We have similar homeostasis systems in society. Things, when pushed suddenly away from where they were before, tend to return to the prior position. Whether or not we recognize it explicitly, it gives us implicit comfort to know that there is a normal, and that things tend to return there over time (which is, of course, one of the reasons things return to normal: our collective desire to make that happen, makes it happen).

You can see how deeply our homeostasis worldview is embedded by scanning a site like IsItNormal, where people ask whether something is normal and others jump in with answers and data. Reduced to atomic levels of normality questions—is it normal that my cat licks my toes? is it normal to love something that makes you sad?—you can see how our worldview gets built, one comforting piece of normality at a time. 

We want to believe the abnormal is normal. Sure, most mortality is caused by only a few rare events, but, hey, that’s normal. It comforts us to discover that seemingly freakish infrequent events happen frequently enough that we can take comfort in their infrequent frequency. It’s normal.

This is, I think, one of the reasons for the medicalization of everything. By medicalizing things—treating human conditions and problems as medical conditions, and thus prime for medical study, diagnosis, prevention, or treatment—we get to declare it normal. Further, the medicalization of the human condition offers the hope that “it” can be fixed, whatever “it” is that we’ve turned from something inherent in being human today to being something with diagnostics and treatments and specialists with billing codes.

We sometimes call a subset of these things that we’ve medicalized and declared normal “diseases of modernity”. One example is depression, which was only declared a diagnosable and treatable disease in the last hundred years. But there are other examples, where something about modernity makes people sick, and rather than treating the cause, we treat the symptoms.  Obesity, diabetes, lung disease, and heart disease are all disorders caused in large part by modernity, by polluted, obesogenic, car-bound environments. 

In that spirit, you can argue that the current Covid-19 outbreak is a new disease of modernity, one created by the conditions of modern life: Its crossover was caused by density, its spread by tight linkages and interconnections, its mortality goosed by aging societies, obesity, diabetes, heart disease, and air quality. While most of the coverage is of the innumerate, ambulance-chasing sort, you can also detect an undercurrent of nervous and desperate people questing to be reassured that this too is … normal. 

Biology & Medicine

Science & Technology

Finance, Economics, & Sociology

Blood Oxygenation is the New Heart Rate

Remarkable the fervor with which people are hunting down and buying pulse oximeters. While some smart watches detect levels of blood oxygenation, the feature is by no means widespread. Nevertheless, the soaring prices and limited availability of dedicated consumer pulse ox products has to be good for the upcoming Apple Watch, as well as for Garmin and Fitibit products that already detect it.

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Things That Don’t Help

A lot of my conversations lately with medical, financial, and statistics types feel like thumb-sucking, with people mostly proferring pointless advice, disconnected from reality. It reminds me of this classic scene from HHGTTG:

You really think the world’s going to end?
(Ford nods)
Shouldn’t we lie down or put a bag over
our heads or something?

If you want.

Will it help?

Not really.

He gives everyone in the bar a friendly salute, exits.

– Hitchhiker’s Guide to the Galaxy, original script

Fun with Medical Statistics

A new CDC study shows that 80% of  ICU cases in the US in the current outbreak have pre-existing conditions. That sounds worth knowing, until you realize that as many as 50% of non-elderly Americans have pre-existing conditions, and more than 90% of elderly Americans do. So this headline becomes a little like saying: So far all we are seeing in American ICUs are bipedal American apes — no talking cats, etc.