Antifragility In Medicine

The following is an essay of mine that was recently published in NSU-KPCOM's student newsletter, SGA Rounds. You can access the full newsletter edition here. With permission from the publisher, the full essay can be read below.

At times, many of us might naturally tend to avoid challenges or other stressors in order to decrease our stress. However, it’s important to recognize that there are both good and bad types of stressors (i.e., eustress and distress), as well as positive responses to negative stressors (e.g., hormesis). Although we don’t typically enjoy feeling stressed in the moment, often the stress can result in benefit rather than harm if one can persist through the discomfort.

I find this concept and its potential application in medicine fascinating. However, in search of an angle for a related research topic I was unable to find a term that encompasses this idea as it applies broadly to various aspects of health. By divine intervention (or whatever you want to call it), I stumbled across Nassim Nicholas Taleb’s book, Antifragile, in which Taleb argues how many systems, including economics, finance, and medicine, have a natural tendency to improve as a result of volatility and disorder (i.e., stress) rather than deteriorate.

Taleb coined antifragile — the term that encapsulates what I had been pondering myself but had no words for — and redefined a couple of other terms, which are relevant to this essay. According to Taleb’s definitions, something that is “fragile” breaks with stress. Imagine a glass bulb packaged tightly in bubble wrap within a cardboard box as it’s sent through the mail. Something that is “robust”’ is resistant to stress, and thus, it is neither harmed nor benefited. Something that is “antifragile'' grows with stress. The most relatable example is how muscle cells grow after the injury caused by strenuous exercise.

I believe that the concept of antifragility can be applied to other aspects of health and wellness as well. Allow me to extrapolate with just a few examples:

• Stretching: Like strength training, we become more flexible with repeated bouts of stretching as we progressively and painstakingly push our muscles beyond the sarcomeres’ resting length.
• Immune Response: While the body is fighting a novel infection, we often experience symptoms such as malaise, fever, and fatigue. Upon convalescence, our immune cells remember the immunogen and prevent future infection by destroying it sooner in the disease process, ultimately making us healthier and more resilient.
• Meditation & Mindfulness: Even a relatively simple meditation such as focusing on one’s breath for any length of time is quite difficult, as our minds have a strong tendency to wander. However, by returning one’s attention back to the breath again and again, a regular meditation practice can improve one’s ability to remain focused (amongst other things).

I hope that through this short essay I’ve been able to convey the importance of challenges and stress as they pertain to health and wellness. It is my belief that if one alters the lens through which they perceive challenges by choosing to accept them as opportunities for growth, then they too will notice their benefits in life beyond just medicine.