Do You Need a Spa Day or Accessible Healthcare?

I was born in the United States and lived there for the first 24 years of my life. Double-majoring in History and Latin American Studies in college stripped away the subtly pervasive U.S. exceptionalism that I was surrounded by growing up. While I never sang the praises of the healthcare system that had largely ignored my chronic pain as a child, I wasn’t aware of the extent of the expensive, poor quality, and traumatizing nature of medical care in the U.S. until my health rapidly deteriorated at age 21, due to the undiagnosed genetic condition that my childhood doctors had gaslit me into believing was “growing pains.”

The term “holistic health” has been largely co-opted by the wellness industry in the United States, reduced to yoga retreats, massages, detox diets and supplements, and other luxuries that are not only far out of reach for people trying to make ends meet, but also are often not effective for the conditions claimed to be treated. Many people in the U.S. turn to forms of “alternative” healthcare (a label given to anything outside conventional Western medicine) in an attempt to regain some sense of control over their bodies. When basic healthcare—emergency or preventative—is out of reach, it can feel more empowering to turn to home remedies than to face the painful reality of not being able to see a doctor.

When I moved to Brazil in 2020, I began to understand what holistic health means — not the U.S. consumerist version, but the true definition — the well-being of the whole person. Here, holistic health emerges from political and sociocultural systems designed to meet people’s physical, mental, emotional, social, and spiritual needs.

This means…

• Having the right to take time off for recovery from surgery without missing out on income or worse, risking losing your job.
• If you’re struggling with burnout, a psychiatrist can write a letter for a mental health leave, and your workplace must respect it.
• If you are diagnosed with cancer, you are bumped to the front of the line to see specialists to ensure timely treatment.
• If your doctor prescribes you a high-cost medication, the government is required to pay for it, or they can be sued.
• When you leave the clinic or hospital, you do not pay for the clinician you saw, the medical tests, procedures, or treatments that were done, and you are given your prescribed medications, for free.
• When I ask how many sick days people get (thinking from the U.S. perspective of sick days being an employee benefit), I am met with a confused look, and the only rational response of: “as many days as they are sick.”

Before anyone jumps to any Utopian conclusions, I have lived in five countries across three continents, and I will be the first to admit that no healthcare system is perfect. Brazil’s public system, Sistema Único de Saúde (SUS), has serious flaws, from long wait times for specialists to underfunded hospitals, and with over 70% of the population relying exclusively on SUS for their healthcare needs, these flaws deeply affect access and quality of care. But the very existence of a public healthcare system speaks to the fundamental value beneath its function: Healthcare is a human right, guaranteed by the 1988 Brazilian constitution.

This sharply contrasts the U.S., where healthcare is currently a private benefit reserved for those who can afford it, rather than a collective responsibility. It means that care is built into daily life, supported by political systems and sociocultural values, seen as a right, not a luxury.

Since moving to Brazil, I have been able to access holistic care for my complex chronic health conditions. I have a team of a dozen specialists (something that was impossible in the U.S., where I had expensive private health insurance and still paid $300 copays for every specialist appointment). While my diagnosis of Ehlers Danlos Syndrome (EDS) doesn’t have a cure or approved treatment (anywhere in the world), here, I am a part of ABRASED, an organization advocating for legal rights, research, and improvements in quality of life for people with EDS in Brazil. Even though there is still a long journey ahead, I feel capable of dreaming of possibilities of advocating for collective care that felt impossibly unimaginable in the U.S. After all, if healthcare isn’t considered to be a human right and health insurance isn’t legally required to cover anything, what hope is there for someone with a rare genetic condition of unknown cause with no approved treatment?

To me, holistic health is found in valuing the connections between the physical, mental, spiritual, and cultural dimensions of life at every scale: among friends and family, within the city and state where I live, and extending within the vast and beautiful country of Brazil and beyond. In the U.S., within such a different political and cultural context, I was numb to the depth and vibrancy of these overlapping networks, even when they were present. Among so many invaluable life lessons, Brazil has taught me that healing cannot be a burden carried on any one individual, but is instead found deeply rooted within the collective.

About the author

Elinor Ackerman is a disabled entrepreneur and writer, living in Curitiba, Brazil.

This story was published in Interconnections in Health. Our September edition features stories about Holistic Health. Submit yours below!

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Holistic Health: What the Wellness Industry Doesn’t Want You to Know was originally published in Interconnections in Health on Medium, where people are continuing the conversation by highlighting and responding to this story.