Today i want to write about something that i have been thinking about for a while. Mainly how genetics and PM&R ( physical medicine and rehabilitation )compare. What their practice seems to symbolise of the human psyche.
Genetics is the search for perfection, the nirvana we have been dreaming about since the beginning of time. The complete solution to all health problems. Fixing at the cellular level many health problems that are inborn like cystic fibrosis, and sickle cell anemia by manipulating genes. Such genetic diseases also terrify and irk us all the more because there is no magic elixir that we can drink and recover. No pills, no medicine and no therapy in fact offers the complete solution held out by genetics to conditions you are stuck with. Genetics plays on fear, like insurance companies when it extends to cover risks. Certain genes are associated with heart disease, with cancer, with diabetes, with hypertension. You can get fixed, you can protect your children or you can resign yourself to a bleak future. That seems like admitting defeat, doesn’t it? What about the fighting it? Beating it?
PM&R is the other side of the coin. That is, the main concern of PM&R is salvaging from the wreck as much as you possibly can. To function at the optimal level with the limitations of disease. It is not the vision of a starry eyed utopist but contact with the harshest reality. What could go wrong, has gone wrong, beyond reversal. It is the life after being beaten, being defeated. But it is for those who are not broken. Amputations, neuromuscular diseases, spinal cord injuries, chronic pain management; all the trauma people don’t think will ever happen to them. PM&R is accepting it , and living with it.
Genetics is a sprint race, it demands more and more speed. There is always a new horizon, a new goal. No one is satisfied for long with one result. There are a dozen more intolerable things to work on. And always the perfection tantalizes us. Custom made babies with the height, hair color, eye color of your choice. Intelligence, long life, talents, less sickness are all desirable.
PM&R is an endurance marathon. It is too busy just trying to finish the race to worry about might have beens. It is an exercise of will to get up again and keep going with the end seldom in sight. And it is along this harder path that people are truly made. Some drag happiness out of the struggle, some discover new wells of strength and broader vision of themselves and the world. And some are hopelessly lost in repining and bitterness.
There is cynicism and awe in PM&R because you cannot guard against tragedy, humiliation or defeat. These patients are proof of the delicate and in exorable nature of life. A vivid painting of how life goes on always bringing new dawns even after stormy nights. It is about accepting limitations, compromising on your desires and always making up your mind to stay happy without any conditions. Just as helen keller blind and deaf was happy, she said “i have found life so beautiful.”
There is an illusion of control and a fairytale-ish dream ending in genetics.
That of having an edge over the rest of humanity, of avoiding misfortune like disease, of greed for admiration and or just acceptance in an unforgiving world. Between hopes and desires reality becomes a little vague. Perhaps that is the secret of the popularity of genetics. The amount of research on aging is evidence that man still dreams of conquering death which really shows how unwillingly we accept oblivion of our dreams, existence and importance. A competition that you get so caught up in that you have little time for anything else. And such a lot of conditions before living life in every facet.