The Grammar of Healthiness

Image by Vassia Atanassova, Spiritia, via Wikimedia

Over lunch this past weekend, my father and I were talking about a friend of mine who always seems to have multiple ailments, some diagnosed and some not. My father noted, “At least some are real health issues.” I replied, “Yes, but we know that mental states matter too, and he doesn’t seem to be trying to help himself be, or seem, any more well.”

My father paused. “More well?” he asked skeptically.

I am not sure I have ever tried to make a comparative out of the adjective well (referring to health) in exactly that way before. And it did present a bit of a grammatical conundrum.

We know well can be an adjective meaning “healthy” or “in good health” as well as “cured or healed.” The American Heritage Dictionary of the English Language provides better and best as the comparative and superlative forms respectively for all meanings of well as an adjective.

Here’s the thing, though: I think that when we’re talking about health, better and more well are not synonymous. To me (and I’m curious to hear others’ thoughts on this), better implies that someone is cured or recovered/recovering: Someone was not well and now they are feeling better than that, which doesn’t necessarily mean that they are well — they are just not as bad as they were. (Yes, I am using singular generic they to refer to someone.)

So what if we want to talk about people on the continuum of wellness? For instance, it’s not that I’m not well; it just seems like I could be more well if I ate more kale. Or perhaps I could seem or be more well if I didn’t dwell on my aches and pains.

I recognize that we may not have a need to talk about this specific spectrum of wellness all that often, but in case I ever need to again, I would like to get the grammar straightened out.

I checked the Corpus of Contemporary American English (COCA) to see how others are handling the issue. Of the 63 instances of more well, only one of them is about health; the others are about being more well known, more well informed, more well fed, more well off, etc. (and occasionally about drilling one more well). Whether or not these should be, for example, better known as opposed to more well known has been addressed on Language Log, and I’ll leave that be for now.

The one instance of more well in reference to health appears in an interview with C. Everett Koop, published in the magazine Christian Century (1994):

There are considerably more hospital beds consumed proportionally by the public in Boston than in New Haven, yet there is no indication that the people in Boston are sicker before they go in the hospital or more well when they come out.

Exactly. It is assumed that these people are well when they leave the hospital, but we don’t know if they are more well.

If we are willing to say that the adjective well also has a regular comparative, as opposed to the irregular better, what about weller? I can’t say I like the sound of it, but I did find one seemingly playful instance of it in an article by Robert Sapolsky in Popular Science (2005):

The rich get richer. Do the well get better than weller?

I’m opting for more well over weller to talk about the continuum of wellness (and my spell checker is not happy about weller at all). And clearly if one can be more well, then one can also be less well. COCA provides one instance from 1997 in the journal Hospital Topics to back me up:

Bias may have occurred as a result of the 35% nonconsent rate (particularly from patients who were less well) and from the filtering effect of the treating physicians’ nonconsent rate.

It wouldn’t make especially good sense here to say worse because the comparison is murky. Worse at filling out the form? Worse than they were before? To describe the patients as “less well” clarifies the reference to a continuum of healthiness.

It appears we rarely need to talk about wellness this way. As a result, I think better is assumed to be standard for the adjective well in all comparative contexts. But I think there is a footnote to be added about the occasions when more well works better and means something different from better.