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by Donald B. Ardell, Ph. D.
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Wellness in the Headlines
(Don's Report to the World)

What's Missing from the International Classification of Diseases?

Friday January 5, 2001

The International Classification of Diseases (ICD) lists all imaginable reasons (like diseases and accidents) for morbidity and mortality -- except one. The one category that's missing is whatever term could be used for those who don't die for any particular reason or cause! The needed category would be for those who wear out and fade away, sort of like General Douglas McArthur's old soldier.

What name could we apply in such cases? How about one entitled "It was time to go?" or simply "Natural causes" or "Just died, that's all--his time was up?" If the deceased were a life-long smoker, sedentary, and given to drink with an attitude how about "Got what was coming to him" or "She blew it?"

The current ICD, now in its 9th edition, is used by Medicare, insurance, and other programs to classify the cause of every death for the purposes of reimbursement, resource management, and research. But perhaps the time has come to be more forthright. Let's recognize that everyone, no matter how healthy, has to die sometime and that a specific cause is not so important in such a case. Just note that "something had to give--the old vessel was just worn away" and let it go to that.

This idea brings to mind a stanza from Oliver Wendell Holmes' The Deacon's Masterpiece "Have you heard of the wonderful one-hoss shay, that was built in such a logical way it ran a hundred years to a day? It went to pieces all at once -- all at once, and nothing first, just as bubbles do when they burst."

Sounds like a good way to go in my opinion. What disease classification would they apply to that? There only can be one, a category that needs to be recognized: "Died at last from a long life of wellness."

Carpe diem. Look on the bright side and enjoy every day.

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