The Fifth Vital Sign: Moral Health Pt. 1 Moral Health

The Sackler family - a name that resonates through the chilling caverns of the opioid crisis, their legacy a symbol of the suffering that has descended upon countless lives. But in this bleak tableau, they inadvertently unveiled a critical paradigm we'd previously overlooked in healthcare: the role of pain as the fifth vital sign.
Now, let's reclaim this revelation. Instead of quantifying the fifth vital sign as physical pain, let's assess something that the Sacklers seemed to have tragically mislaid: a moral compass. Welcome to an era where 'vital signs' take on a deeper, more profound significance. In this world, your encounter with healthcare takes on an entirely new dimension.
Imagine, for a moment, stepping into the hushed tranquility of a clinical space. The routine melody of health checks ensues. Blood pressure - check. Pulse - check. Oxygen saturation, respiratory rate - check, check. But then, a shift in the cadence, an unexpected note. An exploration into your moral health.
Embark on this thought experiment with me. Questions, not of physical wellness but of ethical vitality, begin to unfurl: "Do your daily actions echo the rhythm of your core values? Does your family life breed tranquility or unleash tempests? Do your social interactions ignite fulfillment or spark disquiet? Does the ethos of your workplace align with your moral compass or veer off course? In your interactions with nature, do you feel an exultant connection, indifference, or a pang of guilt? Are the decisions of your government, the laws and policies that orchestrate your life, harmonious with your beliefs or do they strike a dissonant chord?"
This is not a rhetorical exercise; you're prompted to chart these facets on a scale from one to ten. Each number, a reflection of your moral equilibrium within the grand tapestry of life. Your moral health, thus, revealed not as an abstract notion, but as a tangible, measurable entity, ripe for introspection and growth.
Could the way we make moral decisions, how we interpret and act upon what we perceive as right and wrong, be intrinsically linked to our health? This thought might appear to be hanging by a thread at first, but give it a chance, let it steep in your mind for a moment.
The concept of 'moral injury' might help tie these seemingly disparate domains together. To break it down, moral injury is the damage done to our conscience, our moral compass, when we commit, witness, or fail to prevent acts that transgress our deeply held moral beliefs. Now think about the unease, the restlessness that lingers when we go against our core values. We might try to numb it, drown it under indulgences - food, leisure, shopping, alcohol, or drugs. But in the quiet moments, it seeps out, a gnawing discomfort that refuses to be silenced.
This isn't merely a philosophical musing. What if this moral discomfort, this nagging 'injury,' plays a significant role in our overall mental and physical health?
A Lawyer's Struggle with Morality and Addiction
With this backdrop, allow me to introduce you to Greg. A wonderful human I met while working at an ultra-high-net-worth rehab in New York City. He isn't just a man grappling with the complexity of life, but a soul wounded by the profound betrayal of his moral beliefs by a system he trusted. His personal tragedy paints a vivid picture of how societal corruption, and individual choices, infiltrate our being, deeply influencing our emotional, mental, and physical health.
In the tranquility of the upmarket rehab, Greg and I found ourselves nestled on plush armchairs, splitting a tub of Ooey Gooey Butter Cake ice cream as the Statue of Liberty twinkled outside the panoramic windows. The ambiance of the room echoed a quiet yet luxurious solitude.
"Greg," I said gently, "Would you feel comfortable sharing with me the point in your life where you felt alcohol started to take a greater hold over your life?"
His spoon stilled mid-air, and for a moment, he was somewhere far away. Then,