Canguilhem: The Margin of Tolerance

There is no such thing as perfect health, because almost everybody you know will be living with something. A thyroid condition that needs a daily pill. A back that needs massaging. A stomach you need to plan your week's dieting around. And usually nobody talks about these things, and yet they are the most normal abnormality there is. In 1943, the philosopher Georges Canguilhem wrote The Normal and the Pathological, where he argued that we have misunderstood both the words normal and healthy. Canguilhem defined health not as perfect function or as silence, but as slack. It's a margin of tolerance, as he puts it, to the world's misfortunes. And to be healthy is to fall ill and to get back up again. The opposite of health doesn't mean having nothing wrong with you — it's when you have the power to live with your something. Imagine there's somebody called Ruth who's just been diagnosed with type 1 diabetes. And so now she has to check her levels, she has to count what she eats, and she adjusts her lifestyle to accommodate exercise, stress, travel and so on. But she hasn't been into any hospital for years, and nobody at work knows about it. On the old definition, Ruth stopped being healthy the moment she was diagnosed. But for Canguilhem, what matters is how much she can absorb — and it's a great deal. This doesn't mean that abnormal or healthy stop existing as categories, because some conditions do take away your margin, and some people need help, constant intervention and revised medication. But it does change what normal and healthy mean, because all of us eventually will have to learn to live with something. That is just life. But the healthy person, the normal person, is the one who works out how to squeeze the most out of life with what they have.