If the risk of cancer, heart disease or another debilitating disease became real tomorrow, I ask patients what they wish they would had done today

We can learn to recognize warning signs before they become emergencies. For my patients, it means walking through what high cholesterol today could mean years from now. That could be a stroke that takes away their ability to speak.

Years ago, as a young internal-medicine doctor at Massachusetts General Hospital, I was called to answer a "code blue." In the room, I found a man in his 70s, whose heart had stopped.

For 20 minutes, we pressed on his chest and pushed medicines, but despite our best efforts, we could not revive him. I later learned from his daughter that he had struggled with controlling high cholesterol, high blood pressure and Type 2 diabetes - all conditions which he had been diagnosed with years earlier but for which he had not sought ongoing medical care.

Most of us have learned to wait for our bodies to tell us something is seriously wrong. A pain in the chest. A lump in the breast. Only then do we go to the doctor. But disease does not begin when symptoms appear. Heart disease builds silently for years before anything announces itself. Alzheimer's disease begins decades before memory fades. Cancer takes root long before a tumor is visible. And by the time the symptom surfaces, the damage is often irreversible.

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The truth is that our uniquely American healthcare system is designed around the same idea - wait until we are sick, then act. That is expensive for all of us. About half of American adults live with at least one chronic disease, like heart disease, diabetes or cancer, and about 85% of healthcare dollars go toward caring for these illnesses. We all feel it in our growing health-insurance premiums, deductibles and out-of-pocket bills, and we pay significantly more than residents of our peer countries who have more universal systems.

As we approach the midterm elections, nearly every healthcare proposal on the table is some version of paying less, covering less or waiting longer. But we cannot cut healthcare costs without cutting healthcare - unless we get ahead of disease.

As a physician, I've seen how difficult it can be to act on a threat that doesn't hurt yet. Psychologists call this normalcy bias, which is our mind's assumption that things will continue as they always have. When something frightening develops gradually, we explain away warning signs because they don't fit the world we already know.

I saw the same pattern while leading the official response to public-health emergencies in the White House Situation Room, where I watched normalcy bias blind experienced officials to the next pandemic in the quiet years between outbreaks. In the clinic, I could tell a patient their cholesterol put them at risk someday, but I could not show them the disease. It was invisible to them and to me.

We can't eliminate normalcy bias, but we can learn to recognize warning signs before they become emergencies. Studies have found that visualization - being prompted to consider vivid and emotionally meaningful images - can clarify how we perceive risk and prepare for it. For my patients, it means walking through what high cholesterol today could mean years from now. That could be a stroke that takes away their ability to speak or a cancer that keeps them from attending their grandchild's high-school graduation.

New tools are starting to make invisible risk visible in ways I never could. While I want to caution against putting our unquestioned trust and faith in any shiny new "magic bullet," it is clear that, within certain parameters, specialized AI programs can detect early signs of disease. Stanford University researchers trained an AI model, which from a single night's sleep, can flag a person's risk for roughly 130 diseases, including heart attack, stroke, kidney failure and dementia, years before diagnosis. In cancer, blood tests can be used to read circulating tumor DNA, helping us spot the disease when it is still microscopic. Some of these tools are already cleared by the FDA and in use by doctors and patients, including Guardant Health's (GH) Shield test, which screens for colorectal cancer.

But you don't need to wait for the next breakthrough. Start by knowing your numbers, like your blood pressure, cholesterol and blood sugar. Ask your doctor to clarify beyond whether they are "abnormal" or not, but what they mean for you. Learn your family history. A parent's early heart attack or a sibling's cancer can change which screenings you need and when. Ask your doctor which screenings you're due for. Before your next checkup, ask yourself a simple question: If the risk of cancer, heart disease or another debilitating disease became real for me tomorrow, what would I wish I had done today?

That question moves us from worry to action. It's the difference between acting on a small problem before it becomes an uncontrollable crisis.

Most of us don't just want to live longer lives. We want to live longer and healthier lives. That depends not only on what medicine can do after disease arrives but also on how early we see it coming, and what we do to keep ourselves safe once we know.

The greatest victories in healthcare are when we avoid suffering altogether. AI-enabled tools to see disease coming and stop it are emerging. Using them, asking for them, is how we turn that promise into longer, healthier lives, and into a system that costs less because it waits less.

Raj Panjabi is a physician at Mass General Brigham; a lecturer on medicine at Harvard Medical School; senior partner at Flagship Pioneering; and author of the new book "Safer: A Playbook - Turning Fear into Action and Crisis into Community."

-Raj Panjabi