Fix the slow puncture: kill the chronic relationship

Coincident with the last piece extolling you to manage your health and avoid chronic conditions, the Guardian newspaper published the cost of chronic health care to the UK NHS (hat tip to Dr Paul Davies).

The data is sobering. Here are the facts;

  • 70% of the NHS budget of £110bn is consumed by people with at least one long-term condition. This includes heart disease, obesity, diabetes (90% is type II), and mental health conditions


  • The total number of patients in long-term care is expected to remain constant at 15 million per year, but the number with three or more long-term conditions is expected to rise from 1.9 million to 2.9 million by 2018.
  • England is now considered to be a world-leader in managing the consequences of type II diabetes e.g. amputation of limbs. An admirable but surely unwanted decoration

The trends are clear. 

1. Government pressure on spending will continue, and the chronically ill will receive more of the reduced resources than the acute, so avoid accidents if you can. Better still, avoid chronic disease. This is club to which you do not want membership. 

2. If you have one chronic disease, you are more susceptible to a second. If you have two, you are more susceptible to a third, and so on.  Again, avoid chronic disease in the first place! 

Chronic diseases are reversed by acute practices.

Of course, chronic disease is not limited to the physical. Chronic relationship and environments can be equally as damaging, and too often we focus on mollifying the symptoms instead of arresting the cause.

All of which is understandable, of course, for chronic diseases are only reversed by an acute action. And, after all, is the grief of confrontation worth the gain?

Yes it is.

I speak from direct experience and from the experience of others. Chronic relationships and environments deflate you like a slow puncture. You proceed, knowledgable about the problem but dismissive about the solution, until one day you can go no further. Now you’re by the side of the road, changing the wheel in the rain, while traffic clips past at high-speed.

Physically and emotionally we are built for short bursts of high-intensity activity interspersed with long periods of relaxed socialised play and development. We are not built to jog for endless hours on a treadmill.

If any of your relationships or environments feel like a marathon, or if you’re saying, metaphorically, in your meeting with John, Jim, Sally or Jane, “just one more mile,” it is time to make a change.

The table below may  focus your decision-making.