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There are people who have lived much longer, or much healthier, than their medical prognoses would have predicted. Well, first of all, blame has nothing to do with it, so let’s take that out of the equation.

I hope that health professionals will also find this information valuable in providing better and more comprehensive care. Are you actually saying that I’ve created the conditions for my own disease? As I’ve written above, blame is a useless commodity in trying to understand or deal with a complex problem, whether one blames oneself or something/someone else (one’s parents, one’s genes, etc.) It’s common to confuse blame with responsibility, which I am advocating and which has nothing to do with blame. It’s very tricky to speak about something like “cause” without sounding like I’m personalizing the issue, or pointing the finger – “you brought this on yourself.” That’s not at all what I’m saying.

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These premonitions can also be stored in the unconscious; take my ALS patient who, after a lifetime of recurring nightmares of being buried alive, walked into a doctor’s office following her diagnosis to see a poster that said “ALS is like being buried alive.” Since the mind and body are inseparable, it’s perhaps not surprising that these premonitory metaphors can grow into concrete physical realities, but it’s still striking – and a reminder of the importance in medical care of really listening to people’s stories, their experiences, their very language, for clues about how they experience the world.

They first emerge as responses to stress, but in the long run they themselves are incredibly stressful to body and mind (which are inseparable, as I discuss in the book.) So yes, in a sense I am saying you created the conditions for your disease, but only with two crucial asterisks attached to the words “you” and “created”.

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