The results are in, and I’m appallingly average.
I’ve been applying for long-term care insurance, and the process involves a physical, including the usual blood and urine samples in addition to an EKG and a few more unusual measurements.
“Please stand up from your chair without using your hands to assist you, walk to the sliding glass door, turn, come back and sit down.” Hardly a challenge for someone who does yoga and walks about five miles a day.
“Here are 10 words. I’m going to say them, show them to you on a flashcard, and ask you to repeat them and make a sentence with each of them.” (Foot, door, yellow, rain, bicycle, magazine etc.—nothing too unusual.)
“Now we’ll put them aside and revisit them later.”
Ten minutes later, the nurse asked me to recall as many of the words as I could. I made it to eight. My overachiever self panicked.
“That’s actually excellent—most people get to six or so.”
So yes, I did quite well. And like I said—the final conclusion is: appallingly average.
Why “appallingly?” All the usual numbers (cholesterol, HDL, LDL, triglycerides, A1C, etc.) fell within the normal ranges. That’s great, right?
That range, I’ve learned, is not necessarily, well, “normal.” It’s really a “reference interval,” a range based on statistical analyses of the results of tests on a large number of individuals in what’s called a “reference population.” (And it often is determined by “reference man.”)
Want to know what that means?
A reference interval is the interval between, and including, two reference limits, which are values derived from the distribution of results obtained from a sample of the reference population. The reference population is a hypothetical entity including an unknown number of reference individuals. A reference individual is a person selected for testing on the basis of well-defined criteria; in the case of health related reference intervals (also called physiological or biological reference intervals), the selection criteria are designed to exclude the most usual pathological conditions known to affect the concentration values of the analyte under investigation. It is essential to notice that the reference limits are defined through various statistical methods so that a stated fraction (usually 2.5%) of the reference values is less than or equal, or more than or equal, to the respective upper and lower limits. Another important observation is that selecting a different sample of reference individuals from the reference population would give slightly different limits.
So presumably, the insurance company is comparing my numbers to a range that has been determined to contain—at a minimum—people in my age range. So “normal” is really an average of all these other people’s numbers.
normal vs. average
Let that sink in. What we consider “normal” is really average. Which means we really, really need to be concerned about who the other people in the reference population are.
It reminds me of the conversation about what “normal” perimenopause looks like. You’ll hear many women (and their health practitioners!) refer to hot flashes, emotional dysregulation, sleep disruption, dry skin, etc. as “normal.”
A better word would be “common.” Just because the majority of women experience it that way doesn’t make it normal—it’s common. It may even (terrifying thought!) be average.
And yet, there are shining examples of women who breeze through that stage of life. Individuals who stay mentally and physically fit until a ripe old age. Others who heal from devastating injuries and illnesses.
The human body really is a miracle. As Deepak Chopra says, we’re made of stardust—literally. And our normal state is one of true health, not average mediocrity.
It seems a bit criminal to expect so little of ourselves and deny our bodies the opportunity to be amazing—not just average.
It is clear that this term [normal] is not scientific because, as [E.A.] Murphy stated many years ago , “try as we may, we cannot come up with anything like an absolute definition of normal from the scientific viewpoint.”
I love that the NIH makes this admission, buried as it is within an attempt to do just that: explain what normal test results are.
I’ve been health coaching for close to 10 years now, and it seems that most patients and healthcare practitioners are stopping short of achieving optimal health by aiming for average.
Average is a great place to start if you’re truly unwell. Let’s get to a place where we can stop taking innumerable medications with even more innumerable (is that a thing?) side effects, where we can perform our daily tasks without aches and pains, where our chronic diseases no longer rule our lives.
Being in pain, sleeping poorly, taking medications to manage everything from our pains to our moods to our relationships with food—all those aren’t normal. They are common. They are, sadly, average in our society.
make the connection
One of the primary tenets of Integrative Nutrition® health coaching is bio-individuality, the idea that every one of us is a unique-orn: nobody else on the planet is exactly like you. It’s fine to measure yourself against others—and being average is a starting point, not the end game. The food and lifestyle choices that make us optimally healthy vary from one individual to another: if you want to discover the combination that works for you, let’s talk! (Pssssst. They don’t have to be costly or time-consuming.)