"Getting sick is a loss, but also an assignment"
ChroniquesDuVasteMonde WOMAN: Mr. Maio, you criticize in your new book "Business Model Health" that modern medicine fool us, a life without suffering and pain is possible. What is this related to it?
Giovanni Maio: None of us wants to suffer or feel pain. The problem is the internalized belief in feasibility. We think we only need the right method or the right doctor and can thus basically eliminate the suffering. This suggests that we can produce freedom from pain. That's a myth. The illusion of a life without suffering makes modern man unhappy: he assumes that if he does everything right, there will be no pain. That's why we are so intolerant of those who are bad. We silently expect him to learn to manage his suffering.
Why has this illusion become so powerful?
We have taken an economic view of life. Every day we are told that we should be entrepreneurs of ourselves. Following the motto: If I invest well in myself, I will reap success. The only goal today is winning a competition. We forget to be ourselves. Every man is more destiny than Machsal: We have been thrown into life. With the parents we did not choose. With the skills that were given to us. But we believe we could recreate the world.
was born in 1964 in San Fele, Italy. He studied medicine and philosophy in Freiburg. First, he practiced as a doctor at a clinic, later he began to write and teach. Today, Maio holds the Chair of Medical Ethics at the Albert-Ludwigs-University in Freiburg. His new book, Business Model Health, will be published in June. How the market abolishes the art of healing
(192 p., 8.99 euros, Suhrkamp)
In which moments do I have to respect fate?
In which I learn to realize that I can never start from scratch. I have strengths and weaknesses that I have to recognize as part of my self. But we want to coach them away. Because modern man believes that he does not have to make friends with anything anymore. He's like a customer wandering the supermarket: I'd like that for my life and that. But it's a mistake I can choose anything.
Why are we struggling so hard with our imperfection?
We believe that it prevents us from appearing powerful, interesting and therefore valuable. We are guided by marketable standards and conceal exactly what makes us different. But for what reason? We only have this one me. We would have to pay much more attention to what unique skills we have. Every human being is unique, unique and therefore fascinating. Instead, we bow to normalization. It has to be about new qualities such as creativity, sensitivity, empathy, but they are hard to measure.
A comforting thought: that we can do great things even in the diffuse. They criticize the fact that today's physicians are required to treat the patient like a vending machine, which simply has to be made functional again.
We are trained to be permanently capable. Therefore, every symptom that opposes this performance pressure appears as a catastrophe, as the supposed end of happiness. Because patients feel wrongly worthless in their illness, we need doctors who can convey us: even as a disabled person, I am valuable. A medicine that does not tell the patient: Even in a changed state is new life, I consider inhuman.
They wish again more intuition in medicine that we get away from the purely technically and economically effective craft.
We do not do justice to a sick person by objec- ting him and only working on his body: X-ray image, laboratory findings, surgery. Perhaps a tumor can even be reduced in size. But to stick only in a mechanistic way of thinking is too one-sided. Sickness plunges people into an existential crisis. The must necessarily be treated. Because every person has inner healing powers that a sensitive doctor can mobilize.
That sounds like a miracle healer.
I'm not saying that if the patient feels good, the tumor will be smaller. We are not talking about magic. The point is that man does not have to feel completely at the mercy of the disease when he recognizes his inner resources. There are chronically ill people who can lead a full life through their inner attitude.
It must cost a man enormous overcoming to look at illness so calmly.
Getting sick is a loss, but also an order. She urges me to reorient myself.Until yesterday, I thought I had decades left. Now I know, my radius is much smaller. But not all happiness is forfeited. Maybe I can not do long hikes anymore. But I can look, feel, read in the sky. Talk to my children, grandchildren, friends. When I think of myself as a fecundity, I do not find the wealth of life in the disease.
Nevertheless, a doctor who guides us to overcome or even live with a disease is not very popular. Instead, he should quickly "get rid of them". After all, we'd rather get the burnout syringe than ask about the meaning of a crisis.
Many patients, too, have internalized a mechanistic image of man, believing that mourning for the loss of a human being could simply be remedied through death or divorce. That such conditions take time to be mastered seems antiquated to us. In addition, our system encourages the physician to only measure the patient. If he relies on conversation and understanding, the health insurance says: done nothing.
Will there be another social revolution? That we again meet doctors with sense and we ourselves say goodbye to this enormous expectation?
I meet many young doctors - they want to help, they are not so economically motivated. They are terribly irritated when warned, "You did something out of turn, we can not get paid, you did not work fast enough, you talked too much." But there is resistance. It is rumbling in the system. Already we see that hospitals that attach importance to human contact receive much more support.
Then we also get away from ideology: I'll give you a pill, and you'll be happy?
The pill can never make you happy. Only the relationship between doctor and patient will make the effectiveness of the medication. I also have to believe in the drug. But I can only do that when I know there was one who was interested in me, who understands my need. That's why the situation in medicine is so dramatic. For the staff there, it is frustrating and meaningless to be so cut off from the opportunities of helping. The bedridden person needs a counterpart, who tells him: "You are not alone." Therefore, we must not accept that people die lonely.
In your book, you quote the neurologist Viktor Frankl, who found that man "does not destroy suffering but senseless suffering". What do you mean with that?
Frankl, a prisoner of conscience for many years, wrote at exactly this time: "My life is not meaningless." Although he expected to be murdered soon. He had an inner freedom. As long as we live, this is always possible. Even if we are in jail, in the prison of our illness. We have to recognize the light that is in us as long as we are. In the 18th century people spoke of the soul power of man. I still believe in that.
What is man beyond his capacity?
The fascinating thing about humans is their liveliness. The fact that he can not be ascertained, because every human is basically indefinable. Thus every encounter of people is always something completely new, a surprise. Even the person you're married to for 20 years can be a surprise if we just stay open enough for him.
Have we lost sight of that, the openness to surprise and liveliness?
Yes, because in the performance-oriented world we lash the self down to external quality characteristics. This deprives us of the inner being, our aura. Those who only make their own existence dependent on productivity program their unhappiness. Because he has to assume that this source will dry up one day.
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That makes us panic?
Yes. We are convinced that life is exhausted in what we make of it. We were never as unfree as today. Because social expectation imprisons us. She says: You are valuable only if you succeed. If not, you are to blame yourself. But we completely fail to realize that the very existence of one's own existence is the greatest gift we hold in our hands. You only have to imagine what would happen if I did not exist: then nothing would be. That's an unbearable idea. But if we do not think it, we will not grasp the core of life.
The source from which we can draw to the end of life would therefore be the being and the people we let in there?
We march through life as lone fighters and terribly frighten when we get to a point where we are in need. Without the integration of the own into a form of community one will not be able to prevent an inner emptiness. We find only about the you to the me. The connection with others makes life so precious. That which I am is the result of my encounters.
But the longing for the other, that is very big.
The longing is there. But we have forgotten how to indulge in one thing. Like passers-by who look at everything but do not commit themselves. Because decisions eliminate other options. For example, more and more women are freezing eggs. That's why such a big market, because couples today live in a state of provisionality: Everyone waits, if there is no better one.
Behind it is also the fixed idea that the best makes life glorious. A superlative that should enhance the gray areas of life.
Exactly. That is why dating agencies have such an attraction - nothing to chance, only to select according to their own criteria. But the best does not exist. He does not exist. What is left behind: I will not find out what it means to open myself to a person. The mode of provisionality prevents intensity. The tragic thing is: we have little time. Life is very short. We have to make decisions or we will live by.
Psychiatrist Arthur Barsky discovered in the late 1980s that the healthier a society, the sicker people feel. In fact, because of minor illnesses, we run to the specialist or make us diseases, such as lactose intolerance. Why is that?
We have fallen into the belief that is on many glossy brochures: Health is not everything, but without health, everything is nothing. We are convinced that life is only perfect if everything goes well. This is a broken relationship to our own limits: we want to live forever, to abolish death altogether. We perceive our body as a mass to be modeled. That's why we panic for possible symptoms that need to be eliminated. Modern man sometimes has no other content than the functioning of his body.
At the same time we banish anything that could harm your health. The glass of wine, the cigarette, the pleasurable meal ...
You can only live a good life if you keep your balance. Between worrying about possible risks and allowing life. We need to open more to the things that give life depth and spice. We should never be radical. The excessive taking care of the health prevents life and in the end also the health.
That we are constantly optimizing ourselves makes us unhappy, as you say. But when do I know when to stop improving? After all, we understand ourselves as beings who are constantly evolving.
I think that's not difficult at all. It's about the simple question: Who do you want to be? We do not have to reinvent ourselves, but rediscover ourselves. Without contradiction from outside. We have to leave much more room for our identity.
