Most people assume that germs and genes cause disease. The germ theory has brought us a long way, and genetic theory promises to take us even further. But there is still a mystery surrounding why certain people get sick while others don’t. For example, studies show that if cold virus is placed directly into a person’s nose, the chance of getting a cold is about 1 in 8; being exposed to chill, damp, or a draft doesn’t increase these odds. Also, when the Black Death wiped out a third of Europe’s population in the 14th century, no one knows why the other two-thirds, who were certainly exposed, didn’t die.
Every day each of us inhales or ingests enough germs to cause a variety of diseases we never contract. Some sort of “control by the host” seems to be at work. This refers to the body’s ability to live with disease-causing agents without getting sick. Germs aren’t the only factor. Statistics show that severely ill people often wait until a significant date has passed, such as Christmas or their birthday, before suddenly dying. Studies going back to the Korean War showed that young soldiers in their early twenties had serious blockage of their coronary arteries, yet the disease doesn’t show up until middle age. Not everyone exposed to HIV contracts the virus, and in a few rare instances, those with AIDS have reversed their viral status from positive to negative.
Why, then, would you or I get sick when someone else equally at risk doesn’t?
The best way to get sick is to suffer from as many of the following conditions as possible:

• Unsanitary conditions: massive exposure to germs remains a major factor.
• Being poor: poverty degrades life on all fronts, including health.
• High stress: physical and psychological stress damage the immune system.
• Depression and anxiety: untreated psychological disorders weaken resistance to a wide range of diseases, perhaps even cancer
• Lack of coping mechanisms: stress by itself is a negative factor, but the inability to bounce back from it is more important.
• Lack of control, victimization: all stresses become much worse if you feel that you have no control over your own life.
• Inertia, sedentary lifestyle: if you are inactive and have no outside interests, your chance of getting sick rises sharply
• Feeling alone and unloved: emotional deprivation is as unhealthy as deprivation of good food.
• Sudden loss: the sudden loss of a job or spouse, a reversal in finances, or finding yourself in the midst of a war or natural disaster all constitute a state of loss and lead to higher risk of getting sick.
• Growing old: once considered a major cause of illness, aging is now known not to be a direct cause. Being healthy into your eighties should be your expectation, but if you neglect yourself in old age, the body becomes vastly more susceptible to disease.

None of these factors comes as a huge surprise, since public health officials have
drummed into us that most illness in modern society is a “lifestyle disease” born of stress, lack of exercise, and other factors external to germs. But I think most people still assume that being fat, for example, is worse for you than stress, which certainly isn’t the case. Outside of diabetes and joint problems, it’s hard to find a serious link between moderate overweight and any disorder, while stress and its offshoots are major risks and exaggerate the effect of aging. Yet in the absence of high blood pressure and artery disease, most people will live a very long time, probably in good health until they contract their final illness. (I’ve covered a dozen other common beliefs, both true and false, in earlier posts recently.)
But the mystery of who specifically gets sick remains unsolved, in part because there are subtle factors that few experts have adequately examined.

• Some people get sick because they expect to.
• Some people get sick, or sicker, after they are diagnosed with a disease.
• Disease brings certain benefits, known as “secondary gains,” that make it positive. The classic example is a child who pretends to be sick in order to get more love and attention, but adults find secondary gains of their own, such as not having to take responsibility for their lives or finding an escape from a situation they can’t cope with.
• Some people get sick because they want to give up, or even die.
• Some people have nothing better to do than to get sick.

In the next post I will cover how the healthiest people manage not to get sick, and again, the answers carry a few mysteries and surprises.

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