..."What does 'in good health' mean?
Has it ever been defined?
How might patients' and doctors' definition
of that phrase differ?
.... According to one of my medical dictionaries,
health is "a state of optimal physical, mental, and
social well-being, and not merely the absence of disease and infirmity." Another medical dictionary defines
health as "the condition of an organism with respect to the performance of its vital functions especially as evaluated
subjectively or nonprofessionally."
And a nonmedical dictionary says: ...
" freedom from disease, pain, or defect ..."
Consequently, health can be interpreted in a number of ways.
As I will attempt to show,
"in good health" is always and only an opinion.

Many of us have had patients who looked well, felt well,
acted well, and had absolutely no complaints.
Yet, by happenstance, we found them to
have a serious disease: for example, metastatic carcinoma
of lungs, colon, etc.
At the time of such discoveries, these patients
understandably believed that they were in good health,
and from their standpoint, they were.
And without further evaluation,
their doctors probably would have agreed
with them.
Now let us turn to another scenario.
A healthy-appearing, asymptomatic patient
comes to the office for a yearly check-up.
The routine physical examination
and basic lab studies yield normal findings, and
the patient leaves with a "clean bill of health."
On the way to the parking lot, however, the patient
drops dead of a myocardial infarction or
suffers a massive intracranial hemorrhage.
By all measures, the patient was truly in good health
seconds before the good health ended.
Sadly, ... we doctors have no way of predicting
with certainty when or how such events will occur.
We can, however, be circumspect
in using the phrase "in good health."

Finally, "in good health" is commonly a relative
rather than an absolute condition.
Take my case. At age 83, I am clearly not
as healthy as I was 40 years ago.
I currently have symptomatic varicose veins in both legs
and recurrent basal cell carcinomas of my skin.
In addition, my EKG shows complete right bundle branch
block, and my echocardiogram shows mild aortic stenosis.
By definition, therefore, I'm not free of disease or defect.
So in that light, I'm not in good health. ...
But at present I have no complaints, work 70 hours a week,
...and run 6 milies slowly every day.
Compared with other people my age,
I would say that I'm in good health.
But that is simply my opinion.

In conclusion, this mental exercise has changed
my view of "in good health."
Heretofore, I had taken the phrase for granted and
had never given it  meaningful thought.
I have learned, however, that at the very best,
it applies only to the moment at hand,
provides no guarantee,
risks giving a false sense of security,
and represents nothing more than an opinion,
professional or otherwise.
Therefore, from now on, I will use the phrase
cautiously and sparingly if at all.

"There is a limit to the best of health: disease is always a near neighbor."
 .... Aeschylus: Agamemnon, ca 490 BC