an interview with Dr. William Carlyon

Dr. Bill Carlyon retired in 1987 as Director of the Department of Health Education at the American Medical Association. He sulked for several years and finally made a great lurch for wellness when he began offering curmudgeon services to all who would listen. His e-mail address is 104206.3601@compuserve.com Phone: 505-831-4042.

Don: Bill, you spoke at the Megaperformers Conference about your dismay with the language, particularly as used in the health care system. As I recall, your topic was “Doublespeak for Dummies.” What was that about?

Dr. Carlyon: As a writer who has observed doctors, health care administrators, and health promotion experts for several decades, I believe that too many people in the health biz talk way too much without saying anything. As a result, consumers are not empowered, they are befuddled. I guess sloppy language is as American as applehood and mother pie. But its deliberate corruption to mislead, distort, deceive, inflate, circumvent, or obfuscate is a plague for our times. It is a form of Doublespeak, which is itself an extension and elaboration of the Newspeak of Orwell’s 1984. According to coiner of the term, William Lutz, it is not a matter of subjects and verbs agreeing. It is a matter of words and facts agreeing. It is the incongruity between words and what they refer to.

Don: What is good communication? Why is it so lacking in the health care or medical system?

Dr. Carlyon: Good communication is active, clear, and concise. It conveys meaning crisply with the fewest possible words. In what is loosely referred to as “health care,” the corruption of language borders on lunacy. One might even imagine a plot in which administrators and others bamboozle patients with fuzzy prose that also serves to hide their own foolishness from criticism. After all if people can't understand what you are talking about, how can they criticize or, horror of horrors, demand reforms?

Don: Bill, can you give our Wellness Web visitors some examples of linguistic corruption in the health care system?

Dr. Carlyon: Of course. Let's start with the complete inversion of the term health from its original meaning. Health once meant a condition of soundness and wholeness. Now it is applied to just about anything that focuses on disease prevention, detection, or treatment. This surrealistic switch allows health care leaders to pretend they are doing things they are not. Since when has “health” care had anything to do with health? Tell me how so-called “health” maintenance organizations and their co-conniving “health” insurance companies address any aspect of human wholeness or soundness?

Don: You had some criticisms of health educators, too, as I recall.

Dr. Carlyon: You bet. Take the word “health,” add the word “education” and there appears a concept of mind-boggling density and ambiguity---“health education." One noted authority on that subject, in order to make it perfectly clear, defined health education as follows: "A process with intellectual, psychological, and social dimensions relating to activities which increase the ability of people to make improved decisions affecting their personal, family, and community well being and is based upon scientific principles that facilitate learning and behavioral changes in both health personnel and consumers, including children." Now, Don, you tell me: Is that perfectly clear?

Don: Point made. Any other examples?

Dr. Carlyon: Sure. How about the terms health promotion, lifestyle, and unhealthful lifestyle?

HEALTH PROMOTION... is a vague and soothing term that refers to any effort to praise, regain, improve, or maintain that weird condition called health. Standing alone it means nothing.

LIFESTYLE... is a word once used primarily by hippies to make folks over thirty nervous. Now, modifying it has become a near religious crusade, as we scour our lives in search of health sins that can be expiated only by giving up something we really like.

UNHEALTHFUL LIFESTYLE...are said to include such things as “self abuse” and “self pollution,” which sound to me like certain delightful and unspeakable sins of my boyhood.

PREVENTIVE MEDICINE … long considered to be a synonym for Public Health, has become muddled as its borders have expanded to include most of the other terms mentioned here. And finally, how about

PREVENTIVE HEALTH and PREVENTIVE HEALTH CARE? Such self-contradictory nonsense neologisms should be stricken from the language.

All of the terms just mentioned are thrown around glibly without understanding or to define each other as in, "Health education is good preventive medicine." We have built a tower of babble in health land.

Don: I've been waiting to hear what you are going to say about wellness.

Dr. Carlyon: Wellness sounds like just another feel-good Rorschach label with which to sell “health” products and services. Hijackers of the term have used and abused it so much that it has come to mean anything and consequently means nothing. You, Don, have persisted valiantly to clarify “wellness” in the face of its steady decay since its invention by Halbert Dunn. In fact, you have described it beautifully, over and over for many years, often to loud outbursts of indifference.

Don: Are we better off trying to save the term 'wellness' rather than resurrecting the term 'health'?

Dr. Carlyon: Unlike other vague terms already mentioned, the word wellness does not intend to confuse, deceive, or bamboozle. Unless, of course, it is used to beautify traditional disease prevention conferences or New Age healing blather. The real wellness offers a practical path to personal fulfillment and happiness. I once chided you, Don, for not having clear maps of the wellness territory, the territory beyond disease prevention. Without clear maps, how do we know where we are going and how will we know when we get there? That was 1984, about the time we first noticed that Orwell was right. Since then, Don, I think you have clearly mapped the road to Wellville. But, you wisely leave it up to us to decide when we have arrived. I think I have finally caught on.

Don: Parting comments, Bill?

Dr. Carlyon: I have always felt that wellness is not just the sum of its components--exercise, fitness, nutrition, critical thinking, relationship skills, humor, etc. Perhaps we miss the point if we preoccupy ourselves with trying to achieve the highest possible scores in those components...however worthy such an endeavor might be. I have always thought that wellness is what happens after all that. What’s all the multi-component, mega-achievement for? The point of it all, other than just feeling good? On the other hand, maybe the pursuit is the point. Cervantes said, "The road is better than the inn." Maybe getting there is what it's all about. We are born, we live, we die. It's the trip in between that counts. Pursuing wellness is life, so don't wait for rewards at the end. Maybe there aren't any. Maybe there is no there, there. Or maybe “there” is “here.”

On the third hand, perhaps there is a there, there. Perhaps wellness is a Utopian concept. Utopia is from the Greek, referring to a good place that is no place. It grew from the great expectations of the English Tudor period and Thomas Moore's book of the same name published in 1516. Most of the Utopian thought that ensued concerned itself with hope and human possibilities. The Utopians created imaginary societies, usually in far distant places. Societies obtainable through application of human intelligence, spirit, and effort. Most attempts to realize them have failed and Utopian ideals themselves have faded into pessimism and cynicism of the recent century. Like Orwell, our thoughts are drawn to dystopias, the inverse of those good places of which we once dreamt.

Perhaps it is time to bring back the Utopian ideal because we are in such desperate need of renewed hope and positive images of the future. Maybe it's time to see wellness as a Utopian destination. Maybe wellness needs a social agenda. A Utopian-like agenda that insists we look beyond the narcissism of conventional wellness and ask ourselves what the good person and the good society might look like. Perhaps it would be one that values people and ideas more than things and makes people, not goods, our most important national product. Now that's Utopian. Even revolutionary, and best left for another interview.

In closing I offer mysterious but enlightening words for all who would teach others how to live. Words from the Ultimate Master of all things educational and “healthical.” Namely, Mohan Singh, Guru of all things, including everything of which we spoke of at the conference.

"IF YOU WOULD CHANGE A MAN'S HABITS,
CONVINCE HIM THAT HIS VICE IS A VIRTUE.
FOR A MAN SHEDS VIRTUES AS THE
PYTHON SHEDS ITS SKIN.
IT IS EASY TO MAKE VIRTUE A VICE,
BUT NOT VICE VIRTUE"