Health and Well-being - Part 2 - The Table of Contents to Your Owner's Manual
"To write a great book, you must first become the book." - Naval Ravikant
[NB: The Health and Well-being series of articles are reworked and updated from a similar series that first appeared on The Stoic Agilist. My goal for this series of articles is to serve as an example of how anyone might go about improving and sustaining their health and well-being.]
phenotype /ˈfēnəˌtīp/ noun
the observable characteristics or traits of an organism that are produced by the interaction of the genotype and the environment : the physical expression of one or more genes
The phrase "being comfortable in our own skin" expresses a desire that stirs within everyone. It suggests a state of easy and satisfying confidence in who we believe we are without the need for external validation or obsessive comparison with others. It's a self-acceptance grounded in a deep understanding of one's self and what it means to be human: Imperfect and a work in progress.
Being comfortable in our own skin isn't about pure bliss and harmony, 24/7. It's everything but that. Being comfortable and confident with who we are has to be a true superpower. The Stoics and Buddhists have sussed this out far better than any other faith or philosophy. Each in their own way teach a form of self-reliance that acknowledges the boundaries - the skin - between our selves and the world, between what we can control and what we can't, and the value of accepting the things we can't control while fighting like hell to keep agency over the things we can. The task of maintaining this slender boundary isn't easy, but if left up to others the consequences can be disastrous.
Not everyone I've met has a clear sense of who they are and what it's like to be living in their own skin, in the metaphorical sense. Their words often belie the mental image of who they believe they are, held together by the duct tape and bailing wire of cognitive biases, motivated reasoning, inherited values, and virally transmitted beliefs. Yet having a clear and unbiased understanding of who you are is a phenomenally liberating combination, a prison, or somewhere in between. Getting to the level of "clear and unbiased"...that's not easy. I've written about this elsewhere on this site.
In my view, the literal barrier of skin has many of the same qualitative attributes. (If you wish to throw yourself down a galaxy sized rabbit hole, head on down the path of mind-body research.) In the beginning, the vast majority of elements that make up who we are inside our literal skin is determined by genetics. Any number of molecular level things could go wrong that end our lives, perhaps before they even start. The early years of life are for the most part sustained by a zillion automatic instructions encoded in our DNA. But a not-insignificant percentage of our physical self is determined by our environment - the capabilities and resources of our parents and where we live, to name a couple. As we age and gain experiences, this percentage increases in response to decisions we make - smoke cigarettes or not, eat processed food or not, exercise or not. With greater agency the number of levers within our control that can be used to influence our health increase. In the parlance of classical science, this is known as our phenotype - the physical manifestation that uniquely defines each of us.
Almost as a rule, most people have an insouciant sense of who they are in their literal skin. An yet, it's this magnificent biochemical machine that supports the mental/emotional sense of who we believe we are inside our metaphorical skin. There may be many elements of your phenotype that are shared with everyone on the planet - hemoglobin, for example. But with little effort, it is possible to close in on a phenotype that is unique to you.
Everyone on the planet has red blood cells, but there are different types. Knowing your blood type can prove critical in an emergency where you've lost a lot of blood. A transfusion of the wrong type can be fatal. If your type is "O-," in general about 7% of the US population, than you can only receive "O-" blood. Suddenly, the potential pool of blood donors has been reduced 97%. In a room of 100 people, only six of them are in a position to give you a life saving transfusion. Feeling a little more special now?
Determining all the unique nuances of your individual phenotype is like working your way up a tree, looking for the leaf that defines you. When you get there, you would have sorted through a whole host of genetic and environmental determinants that clarify who you are physically - sex, height, eye color, finger prints, food allergies, the shape of your hand, speech accent, and on and on and on.
You don't need to know all the unique elements to your individual phenotype. That's probably not even possible. It's certainly not necessary if your objective is better health. Understanding key elements unique to how you are could, however, prove critical in determining the best course of action you need to take to regain or keep your health. The hard truth is no one is going to figure this out for you.
Throughout history, the practice of medicine has worked in terms of generalizations. Over the years, with the help of empirical science, the generalizations have become more and more applicable and therefore useful to each of us for maintaining our health. Modern medicine can get us pretty close to defining our own phenotype for health and well-being, but the absolutely critical last mile is up to us to figure out if we don't want to put ourselves at the mercy of expert guesswork.
Essentially, our unique phenotype is a collection of known phenotypes with many of them adapted to better reflect our changing situations as we travel through life. How each phenotype interacts with others begins to alter the composition and definition of our overall health phenotype. The more we adapt these phenotypes the more we move away from what modern medicine likes to consider "normal."
For example, an aspect of my phenotype is that I'm tall. Very tall, actually. This has consequence for determining what my resting blood pressure should be. Taking twice daily blood pressure readings on two separate devices for years has shown that I feel best with a pressure around 125/85. During times when my blood pressure has dropped to 115/70, I have to be careful how fast I stand up if I want to avoid feeling light-headed. Q, on the other hand, being a 5'6" woman, rarely sees a blood pressures above 110/70 and moves about in the world with plenty of energy. And this illustrates the inclusion of yet another phenotype into the mix: height, blood pressure, and sex. Add to this age.
Other places where "normal" doesn't apply to me are spirometry values (my height is almost never included on any of the normalized charts) and BMI. That hasn't stopped a few "experts" from making decisions based on flawed generalizations. I'll be revisiting this in a future installment in this series when I cover how to interpret test data.
Hopefully, you're getting the picture of how complex this can get. And that gets me to a nuanced piece of determining your overall health phenotype. If you have a particular health goal in mind, it's just as important to exclude certain phenotypes as it is to include them. Eye color, for example, probably has zero contribution for determining a reasonable resting blood pressure. But the determination might not always be so straight forward. Does gut health play a role in blood pressure? Maybe. Probably. But to what extent and in what way?
In Part 1, I stated the overarching objective for this series of articles was to establish an example of how to identify a specific phenotype for health. The example being mine. That objective needs a little unpacking. As stated, it sounds like a goal with a definitive end. It isn't. What I have as of today is just the latest phenotype from an ever lengthening trail of phenotypes that together tell the story of "Gregory Engel." Who I was at age 1 day - strengths, weaknesses, capabilities, capacities, nutritional needs...all of it - is vastly different from who I was at 20 years and again who I am today at 64 years. And yet, there is an undeniable and verifiable connection between every single minute from the beginning until now. It exists on a spectrum for all of us. You might say it's a record of our days, a physiological story unique to each of us.
The thing is, for most of my life I was largely unconscious of the unique elements of my constantly emerging phenotype. Largely taken for granted, I moved through life with the unquestioned assumption that most physical things would take care of themselves. I would breathe without effort, my heart would faithfully beat out it's rhythm, I would heal when needed, and my stomach would extract whatever the body needed regardless of what I ate.
This pretty much describes everybody. And it isn't necessarily a bad thing. When we're young we have our ambitions and dreams to attend to and to realize our potential we rely on the flawless participation of Nature's miracles. Where it becomes a problem is when the ongoing evolution of our individual phenotype is challenged by Fate or - quite literally - hijacked by people and companies who have their own interests in mind. Having been turned to their service, it's years later, if at all, when we realize we're trapped in a wrecked spaceship. No long of use to anyone, we are left to drift out the rest of our lives.
No matter when this realization hits, it doesn't have to be that way. There is a lot you can to do regain control of the pilot's seat, reset your body's engine, plot a new course. It takes effort, but consider the alternatives.
It's also an iterative and unending quest for information and understanding. Every time I fill in a few missing pieces of the puzzle, a few other pieces - outdated or inaccurate pieces - are discarded. The picture is constantly in flux due to events, experiences, and the unrelenting process of aging. All this and more converge on my person and change what I need to do to remain healthy. My health phenotype isn't a thing, it's a reflection of this process.
What's different from five years ago is that back then I had what in hindsight could only be described as a loose intuitive sense of what I needed to do to remain healthy. After much research and work, it's clear that some of that intuition was luckily correct, but much of it was ill-informed or inaccurate. What I have today is a much clearer understanding based on empirical evidence of how my body works and what my body is telling me it needs.
What has emerged after all this work is something that resembles the table of contents to an owner's manual for my personal health and well-being. The clarifying result from this constant refinement has deepened my appreciation for the miracle I share with every human being on the planet as well as the unique characteristics that define who I am. My hope is that anyone who decides to transcribe their own owner's manual will also appreciate there are unique and defining characteristics of everyone they encounter throughout the day. There's no need to acknowledge or even accommodate these differences. Simply to recognize them makes a world of difference toward building cooperation and genuine tolerance.
With a working copy of my phenotype for health in hand, it's time to apply what I've learned and start tuning the system for better health.
Disclaimer
The author is not a licensed practitioner of medicine or psychotherapy and nothing presented on this website claims or should be construed to provide medical or psychotherapeutic advice. This series of article is presented as a personal reflection by the author on work he's done to improve his health and as such is relevant to the author and no one else. The author makes no recommendations as to any course of action the reader may chose to follow other than to encourage the reader to work closely with qualified health professionals when making healthcare decisions relevant to their personal lives.
← Health and Well-being - Part 1 - Setting the Frame
"Health and Well-being - Part 2 - The Table of Contents to Your Owner's Manual" last updated on 2025.08.01.
Health and Well-being - Part 3 - Goals →
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