What Is Health?
Table of Contents
At RiverRock, health actually means freedom. Or if you like the fancier, more precise word, it means autonomy.
Just like having money in the bank means you have the freedom to make choices, you also have a health bank.
Health actually means freedom.People talk about your "financial health" because there's an intuitive understanding of this concept - that health is autonomy. Health is the "money in the bank" that allows you to make decisions about your life.
If you have 10 million dollars in your financial bank account, you have a lot of freedom to go buy things, or do things with that money.
By contrast, if you weigh 500lbs, or you have heart failure, or you're just not fit enough, then your depleted "health bank account" will limit what things you can choose to experience, no matter how much money you have. You can't go snowboarding. You can't go climb Machu Picchu. Those dreams cannot become reality, because you don't have enough freedom to make that choice.
But, if you become healthier, then suddenly those choices are open; those dreams become viable options. Your health has increased, and now you can choose to make those dreams real; because that's what health is - The power to choose which dreams you want to make real.
That's what health is — The power to choose which dreams you want to make real.And that's what RiverRock is really about, what medicine as a whole should be about - helping you to define which dreams are important to you, and finding a path that allows you to choose to make them real.
Severe illness has few options
Take a guy in an ICU coma. He has zero choices. He is physically and autonomously “bankrupt” - no freedom, no choices.
If he gets just healthy enough to regain consciousness, he earns back exactly one choice: the power to tell his doctors to stop, or to choose to keep going.
Get him healthy enough to get out of the ICU, and he gains a few more options. He can choose to work with physical therapy. He can choose his food. He can choose what to watch on TV. But he still can’t choose to walk out the front door. He doesn’t have enough health in the bank to “buy” that option yet.
This is what healing actually looks like. It isn’t just about symptoms fading away; it’s about dreams becoming viable choices.
As he gets stronger, the world expands. The viable dreams multiply. Suddenly, walking to the cafeteria is a real choice. Then, going home is a real choice. Eventually, holding down a job or building a relationship becomes an option. His health, his autonomy, is growing.
And that's one of the key insights that started RiverRock - this patient isn't just getting rid of illness ... he's gaining health. We know he's gaining health because more dreams are becoming viable choices.
That insight, that health is the freedom that makes dreams into choices, is what lies at the root of RiverRock's approach.
Standard medicine doesn't consider this at all
The issue with regular medicine, even regular concierge medicine, is that once you meet some arbitrary standard, once you don't have any overt symptom that's obviously abnormal, once you have moved out of the "ill" territory, modern medicine basically gives up and says there's nothing more we can do. We've moved you from the crappy end of the bell curve to the middle, and that’s all we do.
When Dr. Z works in the hospital, that’s what he does. It’s great work. It has honor and true magic. We pull people out of the fire and back to safety, and we do it well, at great personal cost.
But … once you have moved out of the "ill" territory, modern medicine basically gives up and says there's nothing more we can do.
Nobody in standard healthcare is talking about giving you more freedom than that. We even have a name for it - ADLs, or “Activities of Daily Life”. Once you’ve hit that level, standard medicine is done with you. As long as you can sit on the couch, watch TV, go to your job, and come back home, eat and drink and go to the bathroom, that's basically where traditional medicine stops.
And that's where RiverRock is different. Because that is not good enough. We want to go beyond that.
But in order to go beyond that, it's difficult, because now you have to have some deeper meaning in mind.
Why do I need some 'Deeper Meaning' to get healthier?
Most people want to be able to have relationships, to be able to go to the bathroom on their own. Those are basic functions. Those “dreams” are so ingrained that regular doctors can work with them, without needing to discuss them at all.
But beyond that level, the meaning you are pursuing creates a different vision, a different definition of health. A woman who wants to become a mother can define health in terms of having the basic physical strength, along with the mental, emotional, relational, and social structures that will support her in that goal. A different woman, who wants to become an olympic boxer and win gold, has a totally different vision of health. Her concept of physical, mental, and emotional fitness will be defined by her meaningful goal. The first woman might tolerate more bullshit from her mother-in-law, as long as she comes over to help clean diapers; the second might cut out anyone from her life that distracts her from her training.
In order to pursue physical, mental, emotional, relational, social, and spiritual health … a goal must be defined. In both the examples above, the path each woman’s goal requires dedication, discomfort, pain, suffering, and yet each woman would consider all of it “worth it”. That’s meaning. That’s a dream. And those dreams define who we are.
Health is the ability to meet the demands of our dreams. Without the dream, there is not only no motivation for health, there is no real definition of health. Health itself becomes an empty platitude - some amalgam of comfort, painlessness, warm fuzzy feelings, and the pointless narcotic of “fun”. These can be (and often are) achieved with alcohol, drugs, or doom scrolling. When you have no meaningful dream, no purpose worth sacrificing for, your internal drive toward health becomes corrupted toward mere comfort.
"Or have you only comfort, and the lust for comfort, that stealthy thing that enters the house a guest, and then becomes a host, and then a master?
Ay, and it becomes a tamer, and with hook and scourge makes puppets of your larger desires.
Though its hands are silken, its heart is of iron.
It lulls you to sleep only to stand by your bed and jeer at the dignity of the flesh.
It makes mock of your sound senses, and lays them in thistledown like fragile vessels.
Verily the lust for comfort murders the passion of the soul, and then walks grinning in the funeral."
— Kahlil Gibran
But, when you have a dream worth pursuing, then your drive toward health manifests as motivation to become the person who can achieve that dream. You forge an identity from those dreams. You build character in order to achieve them, and you develop consistent values to prevent self-destructiveness.
And when you can feel yourself making good progress toward your dreams? That’s what we call “wellbeing”. Wellbeing is the subjective sensation of making adequate progress toward a meaningful goal. That’s the real feeling that people don’t realize they are chasing when they pursue comfort, pleasure, or fun. It’s the thing that drugs and doomscrolling promise, but never deliver.
And that’s why RiverRock starts with dreams. We use many different interrelated terms - dreams, purpose, meaning, fulfillment, wisdom. Each of them relates to the overall concept differently. But these are the concepts that define your unique instantiation of health, and that allow your unconscious to measure your wellbeing. Without them, you are cast adrift, merely seeking pleasure.
At RiverRock, we understand that choosing to accept the burden of meaningful engagement is the core of these dreams, and these dreams define health and wellbeing in a way that is unique to each patient. As a result, that is where we begin - by helping you define and articulate the things that your heart and soul find meaningful. These dreams then drive everything we do. Dream-driven healthcare is a great marketing tagline; but we mean every fucking word.
Go Deeper
This page discussed RiverRock's view of the concept of health. For those who want to explore further:
- Watch the lecture series – Dr. Z has recorded extensive discussions on longevity skepticism, Bayesian medicine, and MeaningSpan philosophy. Topics include:
- Why homocysteine optimization is a biomarker bamboozle
- Why testosterone supplementation doesn't improve longevity
- Why full-body MRI screening generates more harm than benefit
- Why massive lab panels on healthy people are "quantified quackery"
- Read related essays – For more on the philosophy behind RiverRock:
“Don’t be pushed by your problems. Be led by your dreams.”
— Ralph Waldo Emerson