“When we try to choose something for itself, we find it tied to everything else in the universe.– John Muir
We live in an age that celebrates reductionism much more than holism. Reductionism is seeing an object or organism as nothing more than a sum of all its active parts. In a reductionist philosophy, we can understand everything about the object or organism by knowing everything about its individual parts. If one looks at current areas of research in “science”, we see that there is an almost obsessive drive to understand things exclusively on a quantum level. In fact, as I write this, it was confirmed today that Peter Higgs will receive the Nobel Prize for his discovery of, among other things, the Higgs boson particle, the God particle. Of course, there is a great need to understand things through the lens of reductionism. Many of the greatest discoveries in the formal sciences of chemistry and physics have led to countless life-saving advances, such as the use of penicillin, insulin, vaccines, and other drugs to treat or cure disease. Discoveries of elementary particles like the Higss boson, electrons, protons, and neutrinos have helped explain things like gravity and the Big Bang theory.
By understanding the intricate workings of a human’s immune system, we can better test how certain drugs might work in a laboratory. We would never have been able to advance medicine and the treatment of disease without the foundations of chemistry, physics, and biology. The scientific method, while not perfect, allows a researcher to say with some level of confidence that a treatment is effective when applied to the pathogen under study. Without reductionism, we could still be bleeding for all diseases.
What is holism then? Holism is often seen as the opposite of reductionism. Holism considers that the functioning of a system is related to all the parts that work together and as a result of the influence of other organisms, systems or environments. While a holistic approach to medicine would not have led to the discovery of certain proteins in a white blood cell that increase the risk of certain diseases, a holistic view will attempt to understand the influence of environment and lifestyle on disease expression. Even a reductionist approach to medicine cannot provide all the answers. Although the human genome has been mapped for more than 25,000 different genes, it is clear that possessing a gene for a specific disease in no way guarantees that the disease will be expressed. When one identical twin develops multiple sclerosis or diabetes and the other does not, we must ask what other (epigenetic) factors lead to disease expression. Was there anything different in the environment of one of the twins compared to the other? Holism allows for a broader view of the complex interplay of multiple variables that contribute to disease.
At the beginning of this article, I said that “We live in an era that celebrates reductionism much more than holism.” What should be obvious is that both reductionism and holism are necessary not only for medicine but for understanding all facets of science. The media can to some extent be blamed for celebrating reductionism. Reductionism makes headlines. Here’s an example of a fat loss news headline, “Polyphenols in Green Tea Fight Fat.” The medium takes a snippet from a study that showed people who drank green tea tended to weigh less. People love these headlines because it looks so simple. Just drink green tea and voila, you’re skinny. Of course, the media fails to mention the influence of other variables that might have led to the observation that lean people drink green tea. What about the possibility that people who drink green tea tend not to smoke, eat healthier and exercise more often? So, here’s the headline from Holism: “A healthy diet of between 1,800 and 2,000 calories when combined with intense exercise and resistance training for one hour a day, seven days a week, can result in modest weight loss.” . Which headline will sell more newspapers?
What we know for sure is that for chronic diseases such as obesity, heart disease, diabetes (type 2), most cancers, multiple sclerosis and many more, it is the interaction of genetic and epigenetic factors, such as the environment and lifestyle, which work together and lead to potential disease expression. In the subtitle of this article I asked if the cell is more important than the person. It should be obvious that both are important. While a reductionist viewpoint might find dysfunction in a cell in a Petri dish, how does that dysfunctional cell behave in a tissue like heart muscle and in an organ like the heart and in a system like the cardiovascular system and working with all the other systems in the human being that make the person as part of society in a complex environment is unknown.
We like the information we get from reductionism because it seems so simple. It’s easy to objectify and easier to fund research that finds a pathogen at the cellular level and then invents a patented drug at the cellular level to destroy the pathogen. It’s sexy and it’s profitable. It’s just not sexy or profitable to say, “We don’t know what causes most chronic disease, but lifestyle seems to be a big factor, so we recommend getting more exercise, reducing stress, and eating a healthier diet.” While it may not be attractive, if we don’t balance disease treatment with laboratory results and lifestyle and environmental modification, we will continue the trend of losing the battle against many chronic diseases.
The time has come to put the pieces of reductionism back together and view chronic illness through both lenses: holism and reductionism.
Brett