In 2001 I was hit by a train. Okay, not a real train but it might as well have been! My train was a heart attack. When it happened I thought to myself, "why me", "why now", "why here?" I thought I was in good health. I had followed the advice of many doctors, but still the train hit me. As I worked through my crisis, I started thinking about the many factors that could have contributed to my heart attack and wondered why I had not had better warning?
Having worked in and around healthcare for many years I had learned a great deal about how to avoid a heart attack. You know, the usual things: avoid risks, live a healthy lifestyle, control my weight, choose better food and drink, don't smoke, reduce stress ... all excellent advice to a reasonable person.
Like many of you, however, I had provided a lot of personal information to all my healthcare providers over many years, such as family history, medication history, surgical history, disease history, allergy history, social history and of course my lifestyle inventory. I now wondered why none of that information had actually helped avoid the roaring train bearing down on me.
I soon began to discover that there were many different reasons why I may have been hit by that train. In addition to all the usual suspects, high blood pressure, high cholesterol, stress, genetics, I discovered that many environmental conditions and exposures could greatly increase my risk for a heart attack. Things like air quality and exposures to pollutants -- some that I did not even know existed in the communities where I lived. As I began to research the places (aka geographies) where I had lived -- both as a child and an adult -- I began to discover disturbing information on what I (and my doctors) could have already known about the quality of my various environments and what the impact might be on my future health.
My search was not easy, even on the Internet. Large volumes of health information spread across many governmental and health related websites of varying quality. While I cannot prove that any one of my specific environments caused my health attack, there was plenty of evidence that some of the contaminants I had been exposed to in places where I had lived, were well known precursors to circulatory and respiratory disease -- and yes heart attacks. It was at this moment that I realized that a physician looking at my health history, in the absence of any specific information about my unique environmental exposures (geographically), would be less likely to warn me, let alone guide me away from the oncoming train wreck. The problem, as I have come to see it, is that none of my physicians had a useful or easy way of translating all that rich environmental health research into something that would benefit me directly. Why was it so difficult for me and my doctors to connect the dots?
Every place I have ever lived and will live is part of my medical history. The impact of breathing bad air in many of the places I have lived will surely follow me where ever I go, and therefore, my medical record should be automatically informed about new research findings of relevant health risks.
Unfortunately today, my medical record and probably yours as well, is already a vast collection of clinical facts, observations, test results and diagnostic conclusions but remains silent about the accumulation of environmental health impacts and risks. As a patient as well as a good health-seeking consumer, I need to be better served by the great wealth of environmental health research that is available. I also need to do what I can to increase the capacities of physicians to consume and use this information in smarter ways.
I invite you to think about the places you've lived, or where you live today, and learn more about the impacts of your environments on your own health. I've worked with my colleagues to share a new online app (free and anonymous) that can help give you some ideas on how you might approach your own health discovery process as I have done. There is much to learn about geomedicine and understanding how it can become a valuable tool in clinical practice. I hope that I can begin to help readers of this blog to learn more about the subject of personal geomedicine and discover ways to stay healthier longer. If you're new to this discussion perhaps watching my TedMed talk and reading Alana Kornfeld's blog on that event will help.