Meikirch modelThe ten complex interactions
Demands of life versus biologically given potential
The biologically given potential varies much among different persons. Some robust individuals may remain healthy even when challenged with very high demands. Examples are lives with physically strenuous work or with exposure to difficult environmental conditions, as they were prevalent in Swiss mountains in the past centuries. The biologically given potential may also be challenged by the natural environment, e.g. when pollen leads to severe asthma.
The physician deliberates: In a specific patient is it possible to reduce the demands of life to the level corresponding to her or his biologically given potential, or is it possible to strengthen the biologically given potential to the needed level?
Demands of life versus personally acquired potential
Life challenges each individual in various ways. There may be provoking developments such as diseases, difficult work situations, demanding climatic conditions and environmental poisons. The personally acquired potential is an important component to master these challenges. A well-developed personally acquired potential may lead an individual to adequate self-protection from overburdening and on the other hand to master the demands of life even under difficult conditions and thereby enable a healthy life. Yet, it is always necessary to ask the question, whether or not the challenges are commensurate to the personally acquired potential.
The physician deliberates: How does the personally acquired potential match the demands of life for this patient? If it does not match, what could be the reasons and what type of help could be offered? How could the patient be motivated to improve the personally acquired potential.
Biologically given potential versus personally acquired potential
This interaction is compared best to the relationship of a rider with his horse. The rider has to take care that the horse has all it needs, e.g. adequate fodder, sufficient water, physical activity, cleanliness, and a stable for weather protection. The rider has to cultivate the relationship with his horse and to adjust her or his demands to the capacities of the horse. The horse has to learn to adequately respond to the orders of the rider and must not assume leadership. The rider must always remain in control. This comparison comprises a fundamental truth.
The physician deliberates: When interacting with a patient the physician enquires about how this person deals with him- or herself.
Biologically given potential versus society
Persons with a disability need some sorts of relief. Many of them may lead a healthy life provided they receive commensurate support. Elderly people e.g. may no longer be able to manage stairs safely and should move to another apartment, etc.
The physician deliberates: What can be done for a patient in order to enable him or her to meet the physical demands to which she or he is exposed? How can the ambient living conditions be improved.
Personally acquired potential versus society
For the development of the personally acquired potential loving relationships within the family are indispensable. Social participation and good working conditions support the personally acquired potential and thereby promote health. Dishonesty, anxiety, craving, and abuse of power may overstrain the personally acquired potential of fellow men and coworkers and even impair the personally acquired potential of executives. In the professional life and in leisure time health may be promoted by devotion to activities that are related to a purposeful life.
The physician deliberates: How does a patient interact with his social environment? Is he or she in good hands, supported, dependent, avoided, criticized, etc.? How large and lively is the social network? Who comforts the patient and whom does he or she care for? What are her or his self-determined purposes in life?
Demands of life versus society
Most workplaces are organized by employers, i.e. members of the society, yet not infrequently without much consideration for the workers. Unfortunately some employees are exploited until they succumb to a burnout or to alcoholism. Thereafter they are dismissed and other parts of the society have to pay. This is not fair. The society as a whole has to carry the responsibility for working conditions.
The society takes care of the demands of life also in other ways, e.g. by supplying clean drinking water and by disposing of waste.
The physician deliberates: Which demands of life create difficulties for the patient.
Biologically given potential versus natural environment
An example: A gardener of 55 years has a physically demanding job. Will he be able to continue until he receives a pension? An amateur collects mushrooms in the forest and gets poisoned. A mountaineer gets skin cancer from his unprotected exposure to the sun and there are many other possibilities.
The physician deliberates: Does the patient know the necessary precautions and if not, why not?
Personally acquired potential versus natural environment
In spring pollen may induce allergies. Does the patient know, what needs to be done? In summer tick-borne diseases occur such as borelliosis and meningitis, but it is possible to protect oneself. How well-informed is the patient?
The physician deliberates: Is there awareness of the dangers by the natural environment? Is she or he informed about the risks of the natural environment? What is the vaccination status and which other measures had been taken or omitted?
Demands of life versus natural environment
The land available for nutrition and for recreation and the climatic conditions are examples. In Switzerland Iodine and fluoride deficiency were successfully counteracted by adding iodine to kitchen salt and fluoride to tooth pastes. In our climatic conditions we need warm clothing and heated housing to protect against cold winter weather. Unfortunately events of environmental pollution recur times and again. Therefore environmental protection also is health protection.
The physician deliberates: In what way might the patient suffer from environmental conditions he is exposed to? How could this be avoided?
Society versus natural environment
Not only physicians but the whole population observes how the society and specifically the politicians and the industry deal with the natural environment. The following questions arise: Will the atomic power plants be closed down soon? Can global warming be limited to two degrees? What is the quality of our atmosphere? Can green recreation areas be preserved? Why do we have to save fossil fuel in our homes and in the motorized traffic, while the airlines continuously increase the number of flights, even for intercontinental transport flowers?