Published on February 28, 2011, this article is even more pertinent today. I just got my lab results back. All but two results are within normal range. The two that are abnormal are just a little abnormal, hard to interpret and probably significant. I think my physician is stumped. I know I am!
Normal is a word I love. It’s great to call a patient and tell him his lab is normal, his chest x-ray is normal, his exam is normal. It feels good to reward someone for being healthy by telling him he is “normal.”
Normal is a word I hate. It is the spawn of the devil. It makes people feel bad because they aren’t normal. It scares people. It makes people do stupid things trying to be “normal.”
Last week I treated a perfectly healthy, delightful, intelligent and, quite literally, beautiful female patient who felt bad because her BMI (body mass index) was in the abnormal range. Her BMI, a measurement calculated from her weight and height, was in the obese range (according to recognized medical normalcy charts). She was not obese. She was not overweight. Her “normal” was simply different than the recognized norm. She was healthy until she found out what her BMI was and what it implied.
“Normal” is one of those concepts that can be hard get a handle on. In the laboratory, normal values are set by international organizations that set standards, by the laboratory equipment itself and by the population you are studying. If normal range is 80 –100 units and your value is 101, are you normal? It depends on whom you ask. When your doctor orders an EKG, there are excepted normal wave forms. If your EKG has an abnormal waveform, are you normal? Maybe! If you were born with it, it may be normal for you.
Tonight, I received a phone call from an anxious patient. Her MRI of her brain was interpreted by the radiologist as being abnormal. Her neurologist told her it was normal for her age. Who is right?
Normalcy is subjective. I have spent a great deal of time on this site discussing how remarkably different and unique my patients are. Because people are so individually distinct, each defines normal in a different way. Work at being happy within your own norm. As long as you are healthy and happy, try not to get overly invested in being like others.
When it comes to medical issues, work with your doctor to understand what each individual test means and how the results pertain to your health. Define how important it is to “normalize” your results. Set realistic goals. When it comes to a disease like diabetes, the closer you are to having normal blood sugars, the better off you will be. When dealing with your BMI, if you are healthy and have no weight related medical problems, relax!
Concentrate more on being healthy and less on being “normal.”
