In this perspective article from NEJM (link below) entitled Time after Time-Health Policy Implications of a Three Generation Case Study, Sayer and Lee share an intriguing example of how a family’s social patterns of interaction can produce recurrent deleterious health effects. Enter Exodus 20:5 which shares an ancient perspective on the same issue. Without an intervening and foundational social (spiritual) change, many are left to suffer in the fallout of generational behavior patterns. The NEJM article concludes by saying “many of those activities [which may help break generational pathology like developing “systems” of educational and social care and support within the context of medical practice] lie outside the traditional health care system”.
This is an important insight. There is only so much that a medical system can do to reach into one’s personal life and effect change even if (and that is a big if) the individual wants that “outreach”. While it is very important to build strong medical systems of support for disease prevention, intervention and improving health behavior, ultimately the effecting of change needs to originate from within and not from without. Smoking cessation is a perfect example. We can offer education on the health benefits of smoking cessation and challenge people to quit, but any medical “system” intervention in the cessation process is only supportive of an individual decision to quit.
So how can we encourage “individual change”? At least one way is acknowledged by the truths in Exodus 20:5. Deleterious behavior patterns can change when a true spiritual source and new faith life and world view is embraced as change’s foundation. The medical “system” is not equipped for this. Relational medicine in the context of an open and mutually respectful doctor/medical home/patient relationship can be.