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This paper was never published but was the subject of a talk I gave in Wexford on 11 June 1979. It was around this time that I first encountered the work of the two Chilean biologists, Umberto Maturana and Francisco Varela, and their concept of autopoiesis, which is fundamental to the understanding of human group organization. THE first thing I want to say is that, in my opinion, we are moving away from, not towards, a healthy society. This at least as I see it is the position at the present time, that there is a fairly rapid movement away from anything that could be called sane or healthy in our society. In this paper I would like to say why I believe this to be so, and also to express my hope that this may be only a temporary situation, that we are in fact seeing the last days of an era in western society, indeed that we are already seeing the beginnings of a very radical change that is going to alter the very basis of all that we thought most stable and permanent in our western world. My purpose in raising this subject is not to get involved in an anti-technological medicine debate; the knocking of orthodox medicine and psychiatry has been a little overdone of late. Indeed in recent years I have found myself developing a growing respect for the achievements of modern medicine: the foot of a deformed child which can be turned around by a paediatric surgeon so that the child can grow up healthy and strong like other children; the harelip which can be repaired so as to leave no traces; the young father of a family who, by receiving a kidney from a relative, can once again lead a normal life and be a father to his young children; the bringing under control of infections that would certainly be fatal with antibiotics therapy; the ability of a modern personality to blossom out and lead a full creative life. Many of these everyday events in contemporary medicine would seem like miracles to our forefathers. This is 141 12. Towards a Healthy Society The Writings of Ivor Browne 142 not to mention the achievements of public health and preventive medicine, which have virtually eliminated a whole range of infectious diseases which took the lives of millions before they reached adult life, so that it was only the lucky person who got beyond twenty or thirty years of age. No, I think it is quite wrong to make little of these advances and the skills which we now possess. There is nothing to decry in these achievements in themselves; more than enough knocking of orthodox medicine has been done by Illich and others. What is wrong is not the existence of modern technological medicine, but the way in which we as a society order our priorities, where we place our primary emphasis. Modern medicine can treat any illness or at least greatly enhance the human body’s ability to deal with them, but it has little to say to the development of, or maintenance of, health. Let us go right back to the beginning. What do we actually mean in ordinary terms when we say someone is healthy? When we say to someone, ‘You’re looking very well’? One thing it cannot mean is that that person is free from disease. Such a statement might be true of a healthy child, but, once we pass even twenty years of age, our bodies usually show the ravages of various disease processes, our teeth are decayed, our lungs, cardiovascular system and other organs are almost inevitably showing signs of damage. We frequently see even more obvious evidence of disability, such as a missing eye, a damaged limb or impaired respiratory function, but such a person is often going contentedly about their daily life and, if asked, would described themselves as healthy. So what do we mean? It seems to me that we mean something that is essentially simple, that in operational terms, in everyday life, we say we are healthy and experience ourselves as healthy when we are able to manage ourselves, and are able to cope with ordinary life as it comes to us. We may or may not have disease of some kind or another present within us. For all we know we may within a week have had a heart attack or a brain hemorrhage , so that some disease process may already be...

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