LINE ZERO: Redefining the Start of Healthcare

Background: Healthcare systems are organized around traditional levels of care (primary, secondary, tertiary), activated only when a patient enters the formal system. Translational medicine typically moves from bench to bedside. Here we propose a reverse translational step: patient-led self-management as a pre-clinical level of care – LINE ZERO. Objective: To introduce and test LINE ZERO – self-management, prevention, and self-care – as an extension of the traditional care model. Methods: An 11-month longitudinal self-experiment (n=1) in a 55-65 year old man with adjustment disorder. Interventions included breathing exercises, light therapy, music therapy, gentle stretching, moderate dietary changes, and self-monitoring of blood pressure, deep sleep, and blood glucose. Results: Deep sleep increased 3-fold (p < 0.001). Blood pressure stabilized. Glycemic variability decreased after an acute stress-related peak. A subsequent work stress episode caused a 30% drop in deep sleep, followed by rapid recovery within 48 hours. Conclusion: LINE ZERO extends the traditional care model by adding a pre-clinical self-management space. It aligns with Future Medicine (predictive, preventive, personalized, participatory) and represents a reverse translational contribution – from patient observation to a conceptual framework applicable to health systems.