Why Are Doctors Needlessly Restricting Their Healing Potential?
The secret to the care of the patient is in caring for the patient.
As long as we think of western medicine as, above all, a science, we will focus on clinical trials and the drugs they are designed to promote. Certainly, this is what I was taught in medical school. My experience, however, as an endocrinologist intent on resolving my patients’ issues, was that there is so much more to healing. Over the course of my career, I went from being bookish to mindful to heartfelt. I learned that medicine is not just the implementation of scientific precepts and the administration of drugs. It is, above all, a profound process of connecting the part with the whole.
Francisco Varela said it well: “If a living system is suffering from ill health, the remedy is found by connecting with more of itself.” Such a redefinition of goals radically widens the field of medicine. This potential can be addressed on three fronts in particular: integrating alternative medicine and lifestyle choices, cultivating the profound connection between doctor and patient, and harnessing the power of mind and spirit.
Healing By Invasion Vs. Summoning The Healers
Allopathic medicine does not concern itself with stresses that throw the body out of balance. Usually, it waits for the full-blown disease to manifest in order to then treat it with medication and surgery. While it recognizes that stress kills because of dysregulation in the body, western medicine does not recruit the body’s natural ways of promoting well-being, but instead imposes external treatments. The treatment of disease with drugs is, however, just one approach to medicine, shaped by a well-defined paradigm whose mantra is war on the invaders. A completely different approach is to embrace the positive forces of healing to summon the body’s own inner resources and bring the system as a whole back into balance.
Consider the difference between antibiotics and vaccines. While antibiotics seek and destroy microbes by warfare, vaccines enhance the organism’s immune system to prevent or nullify the action of invasive infectious agents. There is no war, just containment and disposal of unwanted intruders. The noxious substance is surrounded and made impotent and then eliminated naturally.
Naturopathy, while it does have similarities to allopathy, is of a more holistic bent, emphasizing natural medicines with less potency and fewer side effects, as well as diet modification. Herbs are used, often in combination, to recruit the healing powers of the body to bring it back into balance. Adaptogens, for example, are herbal products meant to alleviate the stressed body from chemical, physical, or biological insult, and thus adapted, return the body to homoeostasis. Ginseng for immune support and stress reduction, and ashwagandha for regulating metabolism and calming the brain are two examples of such adaptogens.
While herbal preparations are becoming more accepted by conventional medicine, they are still considered a secondary treatment option. The buzzword these days is evidence-based medicine, and the best evidence-based medicine is produced by the randomized clinical trials mentioned earlier. Big Pharma has the resources to launch RCTs, allegedly proving the efficacy of their drugs, but these studies are often imperfect.
However, there are few financial resources for the study of herbs. In addition, many healing modalities cannot even be proven via scientific study, such as homeopathy and hands-on treatment by acupuncturists, chiropractors, body workers, and massage therapists, and for this reason they are dismissed. These cannot be properly evaluated by evidence-based studies, which means clinical studies, in general, cannot be the sole basis for evaluating health benefits. Patients’ own experience of the alleviation of symptoms and of healing counts, too.
For millennia, diet has been recognized as critical to maintaining health and treating diseases in cultures around the world. However, where diet is concerned, RCTs are difficult to design, and no one is likely to finance them for individual foods. Who will pay for the rigorous study of garlic, for example? On the other hand, certain food groups can be marketed with health claims that mischaracterize and mislead. For decades, the sugar industry funded distinguished scientists’ work downplaying the role of sugar in heart disease while making meat the villain.
Putting The Care Into Cure
Physicians play an important role in working with their patients towards individualized programs of health and wellness that include diet and lifestyle, but that is only the beginning. A doctor’s personal relationship with his or her patients has a critical effect on their well-being. It is an aspect of healing that goes largely acknowledged, though it has been known since prehistoric times. The first healers may well have been the shamans that lived in the Neolithic era. In modern times, shamanism is practiced in select communities, and has at its heart the close relationship between healer and patient.
Certain doctors in the modern western tradition also recognize the importance of this connection. “The secret to the care of the patient is in caring for the patient,” wrote Dr. Francis Peabody at the beginning of the twentieth century. More recently, Dr. Vivek Murthy, Surgeon General under Presidents Obama and Biden, argued that friendship is critical to promoting good health outcomes. Dr. Bernie Siegel, a pediatric surgeon at Yale, makes the same argument in his amazing book, Love, Medicine and Miracles. “When we commit ourselves to egoless, unconditional love, true healing begins.” These are the words of a skilled surgeon who fully understood the importance of serious medical intervention. But even as he administered chemotherapy with harsh side effects, Dr. Siegel advised his patients to perceive the chemicals not as toxins to be feared, but as beneficial agents to be embraced. He saw love operating on every front.
Trust and authentic communication are critical to the successful outcome of a visit. Time and again I saw how my deep engagement was often the lifeline that helped a patient get through an illness. It is easy for doctors to underestimate the impact of connecting with their patients. But, in the words of Margaret Wheatley, “When we seek for connection, we restore the world to wholeness. Our seemingly separate lives become meaningful as we discover how truly necessary we are to each other.”
The healthcare system asks doctors to focus on the disease — to label the problem and then cure it so it no longer exists. However, this is only part of the doctor’s role, and it largely ignores the person who is suffering from the affliction. I have found the following distinction, made by Buddhist practitioners, very useful: Pain is an affliction of the body while suffering is an affliction of the self. Even when doctors cannot cure the body, there’s still much they can do to alleviate their patients’ suffering.
As doctors, we can realize that we are in a truly privileged position to help a patient to be with their affliction. This may seem counter to our goal of eliminating the affliction, but the two are not contradictory, and if we focus too narrowly on the cure, we forget this most important aspect of our patients’ well-being. The truth is, while the doctor is focused on cures, the patient is looking for care. This is perhaps most obvious at the end of a patient’s life. It is natural that doctors should focus on prolonging their patients’ lives, but approaching death requires a different mentality, and the more mindful doctors are of what is needed, the more sacred the transition can become for everyone involved. I personally have had the great privilege of participating in a number of such transitions, and they have left me feeling full of awe and reverence.
The Healing Team
While the one-on-one relationship of doctors with their patients is central, no doctor works in a vacuum. Practicing the art of medicine requires the support of a team as well as the cultivation of relationships within the greater community. Support groups of various kinds with different modes of operation are recognized as essential to healing. Practitioners of medicine must acknowledge the effect of community on the health of our patients and do all they can to connect their patients with communities of support.
Unfortunately, Western medicine has never fully appreciated the role of spiritual and emotional support. Nor does it recognize the tremendous power of the mind in affecting physical health. There are numerous studies that show the importance of psychosocial factors in influencing cognitive as well as physical functioning. There are the benefits of belief, for example. As a doctor, I always took care to choose my words carefully, knowing their power to affect my patients’ beliefs and therefore their health.
Actively engaging the mind to control the body also has great potential in the realm of pain management. These days, limiting the use of opioids is a priority. In a study on pain management in a burn unit, relaxation techniques were shown to decrease pain, with added benefits when imagery was included. Modern technology can now supercharge imagery by creating completely immersive virtual realities.
The power of the mind to affect the body is well-known in the case of placebos. There is, however, a great deal of paranoia about the placebo effect. Pharmaceutical companies try to minimize or even eliminate this effect in scientifically controlled trials believing that the efficacy of a medication or procedure cannot otherwise be demonstrated.
It is true that, within the context of a clinical trial, clear conclusions can be muddied by the confounding influence of extra factors. In general, however, the placebo effect is an extraordinary phenomenon that should be exploited for its healing potential. By denying or ignoring it, we arbitrarily restrict the practice of medicine. I would like to coin a new phrase — therapeutic interventional potential or TIP — to draw attention to the mind’s tremendous capacity to heal. Let us harness the powers of the mind-body connection and consider it a vital aspect of our delivery of care.
Science can be reductionistic, fragmenting the body into parts and examining how the parts fit together. The disease is isolated and elimination is the goal. But what if the system as a whole becomes the focus? Then our view of medicine, and the tools our doctors make use of, expands dramatically. Drugs and surgery play an important role, but so do many other healing factors. If medicine is to advance and doctors are to reach their full potential, we must ask them to integrate the full range of approaches available to them.
Allen Sussman is a board-certified endocrinologist who was in private practice for 34 years, and also served as director of Alternative Medical Services at Valley Medical Center in WA. As cofounder and president of Rainier Clinical Research Center, Dr. Sussman was involved in hundreds of evidence-based studies and the development of ground-breaking technology for the treatment of diabetes. This article is based on his newly published book Saving the Art of Medicine: Observations of a Practitioner.
