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How becoming sick became a forbidden expression in the modern world

by Richard Meckien - published May 09, 2017 12:05 PM - - last modified May 11, 2017 11:28 AM
Rights: Original version in Portuguese by Sylvia Miguel.

Frederico Azevedo da Costa Pinto

Frederico Azevedo da Costa Pinto, one of IEA's sabbatical researchers in 2017

As natural as demonstrating joy and sadness is the expression of being sick. Among the vast repertoire of animal manifestations, "sick behavior" - as it is called among specialists - is the demonstration of discouragement, prostration, lack of appetite and the will to do nothing. These are clear signs that animals emit when they do not want social contact because they are sick. "It is the way to give the body time to recover and even preserve the social group from getting sick. But this behavior is being increasingly repressed in modern societies by the way workers' productivity is viewed," says Professor Frederico Azevedo da Costa Pinto, a specialist in experimental pathology and animal behavior, and participant in the IEA Sabbatical Year Program in 2017.

With the research project "Modern Man: An Animal Socially Deprived of the Right to Become Sick," the pathologist will go through the historical evolution of how the behaviors of sick individuals used to be viewed and how this behavior has been perceived in modern societies. In parallel, he will search for data in the related literature on the expression of this behavior among humans, relating them to the behavior of experimental animals.

The historical evaluation will allow to confront changes in the working day with the productivity expectations of the modern worker, he believes.

If in modern societies becoming ill becomes prohibitive, the counterpoint to "camouflage" disease is the increasingly common use of medicines. "Expressing unhealthy behavior would incur absences at work and therefore we are encouraged to take medication, often self-medication, in order to maintain the expected work day. Associated with this is the fact that the most prescribed and consumed classes of drugs in modern societies are precisely the palliative medicines for pains, colds and allergies, for example," he says.

The project will evaluate investments in research and dissemination of drugs aimed at the temporary relief of the malaise of certain diseases. "They are medicines that do not necessarily shorten the course of the disease; nor do they actually improve health conditions," says Costa Pinto.

"Let's not be purists. Taking medicine helps you getting through illness without suffering. But this does not prevent the individual from also staying in comfort at home. In reality, what we are trying to discuss is the fact that the individual takes medication to force themselves to continue working," he says.

In addition, there is the problem of excess and self-medication. In some countries, legislation allows drugs to be offered on gondolas, making access easier. But there are health systems, as in Canada, for example, where there is no excess or self-medication because there is no such facility of access, he compares.

Culture and legislation

Cultural differences also influence how the patient behaves. Even legislation can vary as a reflection of the cultural aspect, says the scientist. "Countries with more consistent social protection allow people to get sick, because the legislation provides for a longer sick leave. Even the longer maternity and paternity leave denote this kind of respect for the worker," he recalls.

On the contrary, countries that tend to work longer and with outsourced work place workers at increasingly absurd pressures, suppressing the individual's right to become ill, he says. "The right to get sick tends to become unacceptable in these societies, because they serve a logic that makes individuals expendable," he says.

But what is the problem in not allowing yourself to express the disease? "One of them, the most obvious one, is to take the disease to the social group, in the case of an individual who camouflages an infectious disease, for example," he says. Another problem in not manifesting the disease is the individual becoming increasingly subject to uncured diseases and that may have recurrences or become chronic. "We are talking about everyday diseases, not serious diseases. I have no doubt that not allowing yourself to fall ill will lead to a worse or incomplete recovery, since palliative medicines offer a momentary response to the symptoms of the disease," he says.

In addition, there are long-term emotional changes that seem to be associated with the fact that the person does not stop when they need to. "Not giving yourself this time can generate disorders, including psychological ones," says the pathologist.

All these cultural and legal aspects denote how much each society cares about the health of their citizens, he believes.

Similarities

We are more like animals than we imagine. Bizarre things that we assumed to be exclusive to humans have been observed among bugs. "For example, unplanned copulation, performed simply for the demonstration of power and hierarchical superiority. Hierarchy is key to understanding the behavior of getting sick. A senior executive and a doorman demonstrate different ways to get sick," he says.

The immune system has a lot to do with hierarchy, says the pathologist. "Some people do not demonstrate unhealthy behavior simply because they are more resilient, or because the hierarchical position in a company prevents it. They may not want to show vulnerability. Others do not express unhealthy behavior because they can not lose their jobs," he says.

Prurigo nodularis doença autoimune

Prurigo nodularis, an autoimmune disease of unknown cause

More and more research projects show that things that happen in the nervous system have physical connections. This includes the immune response, which is a protective response to infections. The same response that prepares the body for an immediate response, such as running away from a thug, is also the kind of response that modulates immunity, he compares. "Stress, for example, is an adaptive protective response described 80 years ago that works with this same mechanism," he says.

Subordination and immune response in animals have been studied to also evaluate how a "submissive" animal behaves in face of the disease. A research model, which injects bacteria to simulate disease in a rat pair, showed that the subordinate animal's pressures were different from the dominant's pressures, he says. "In this case, the dominant is allowed to demonstrate disease. The subordinate lends attention to the dominant and demonstrates to be socially submissive all the time, without being concerned with manifesting the unhealthy behavior", compares the scientist.

The most positive effects expected of his research is that it can subsidize public policies, says the researcher. "In a country with social, economic and political problems, it is utopian to think that these aspects of health are even considered. But in practice, I hope at the very least to raise a discussion about where industrial society is pushing the individual. It does not make sense to have an economy growing at the expense of the loss of individual freedom and the health of the individual. In fact, we need to rethink the culture of growth, industrialization, the consumer market, and profit. Growing up is a charge in all social groups and at all levels. But what grows without stopping is a tumor; is cancer," he says.

Images: Leonor Calasans; Michael Katotomichelakis, Dimitrios G Balatsouras, Konstantinos Bassioukas,
Nikolaos Kontogiannis, Konstantinos Simopoulos, Vassilios Danielides.