A Harvard Medical School graduate explains how traditional Western medicine can coexist and thrive with acupuncture, herbs, hypnosis and other therapies.
My father was a general surgeon. The medicine he practiced seemed marvelous and terrifying to me. In the bright light of his treatment room, gleaning scissors were lined up on white towels; scalpel blades, grainy glass syringes and fierce needles emerged from the steaming sterilizer.
I remember asking at age three or four, how “instruments” that looked hurtful could also help. The scalpel, he explained, cuts away what doesn’t belong. The needles inject medicine that makes sick people feel better.
The medicine he practiced was based on a view of illness often called the biomedical model. It conceives of illness as a formidable enemy and uses a language of pathology and conflict. The physician is a detached scientist-strategist who rationally and objectively assesses the patient’s symptoms; diagnoses the diseases from which she is suffering; and selects from and applies those therapies “magic bullets” that are most likely to subdue the invading bacterial pathogen or rectify the offending abnormality.
Harvard Medical School
By the time I entered Harvard Medical School in 1962, science was probing far deeper levels and more complex pathways of biological causation, and developing even more precise pharmacological treatments. But even as we learned to appreciate the immense power, range and elegance of this medicine, I was feeling uneasy about it. The focus on the pathological processes in our patients, and the search for accurate diagnoses, identifiable causes and precise remedies for their diseases, tended to overwhelm our concern for them as people.
I decided to specialize in psychiatry. There I would be able to focus on what moved and interested me most, the rich complexity of people’s lives and our relationship with one another and the world in which we live. All that changed one morning 22 years ago. I was doing the plow, an upside-down yoga posture in which the weight is on the shoulders and the feet are extended over the head, toes touching the floor when I felt a terrible pain in the lower part of my back. It shot from the slope of my lumbar curve, down to the left, sending fire into my left buttock and calf and finally into the foot, where pins and needles sprouted. I wanted to stand but couldn’t.
When I turned to the Bethesda Naval Hospital for help, orthopedic surgeons prescribed muscle relaxants and painkillers, two weeks of bed rest and a heating pad, and deferred their final diagnosis. The pain abated when I was still, but it never really left me. A portion of my mind was held hostage. My concentration and my patience were short. I had the sense that the body that had always served me willingly might well betray me.
Two months later, I was desperate. If I took muscle relaxants, I would grow sleepy. If I didn’t, I was in agony. My attention span was short. Ordinarily fairly even-tempered, I lived on the edge of anger, ready to shout at anyone who crossed me. In constant pain, still stiff and bent over, I felt three times my age. The orthopedists were talking, a little gleefully, I thought, of doing a myelogram, an MRI after an injection of dye into my spinal column, and surgery.
Finally, in desperation, I called Shyam Singha, D.O., in London. I had first heard about him a year before from an old friend in England. Richard, laconic and skeptical, had been unashamedly enthusiastic about this “mad Indian.” Dr. Singha had put him on a grape fast for 60 days and stuck acupuncture needles in him, and Richard, once deaf, had begun to hear. Now at the end of my therapeutic rope, I was reaching out to Singha for help over the telephone.
“Stop the medication,” he said. “Take hot baths with Epsom salts and then cold showers. Eat three pineapples a day for a week and nothing else.” I thought the transatlantic phone had gone bad. He repeated his prescription while I stood with my mouth open.
“It won’t make sense to you.”
“Why?” I demanded.
“Remember what Hippocrates, the father of your medicine, said.”
I could only say,” What?”
“Let food be your medicine and medicine your food.” “Yes, yes. But pineapple!” I was getting impatient. “Pineapple has malic acid.”
‘Yes, I understand that.” I was even more impatient.
“Malic acid affects the lung and colon.” He was fast losing credibility. “In Chinese medicine the lung and colon are the mother of the kidney and the bladder.” The mother?”And the bladder and the kidney are connected to the back”
He was right, it made no sense to me. But I didn’t want a myelogram, and I knew I didn’t want surgery. Nothing else had worked, and none of my doctors had anything else to offer. Something about Singha, an authority I did not understand, moved me.! decided to do what he said.
After three days, I called Singha in London. “My mouth,” I reported, in a pained voice,”is full of sores. I have a 103-degree fever and my back hurts as badly as the day! injured it.”
For the sores, he replied, “coat your pineapple with honey. So far as the rest of it goes, it’s very good. In Chinese medicine, we have to make a chronic disease acute before it can be healed. We call this a healing crisis.” I felt like a character in a comic strip when the light bulb goes on over his head. Just as a depressed person sometimes has to feel rage or experience despair before she can be healed, so, perhaps, physical symptoms need to be heightened before they can be relieved.
When, at the end of seven days, I called Singha, I told him that my back was 80 to 90 percent better. I was, I added, 12 pounds lighter and far clearer in my mind. Neither my back, nor my medical practice, nor indeed my view of the world, has been the same since.
A year after I recovered from my back problem, Singha came to the United States. Listening to him speak about the ancient laws of Chinese and Indian healing, I could feel his words working and surging in me. The first time he put acupuncture needles in my body, waves of pleasure swept from my feet toward my head. On the same table three days later, without warning, my arms and legs began to shake so hard that the trays of instruments across the room clattered. He looked in on me, impassive, and nodded. “Good, good.” Meanwhile my head was vibrating and my teeth were chattering.
“That is what the Chinese call qi,” Singha explained half an hour later. “The Indians call it prana, Henri Bergson said it was elan vital, and Wilhelm Reich, your Western psychoanalyst, named it none energy. It is the life force. The acupuncturist’s job is to move and balance the qi. Everything else bliss, shaking and tears arises as the being moves toward balance.”
A Medical Odyssey
Singha became my guide through the world of “other medicines”. I experimented with using foods therapeutically garlic and onions for colds, ginger tea for an upset stomach, fasts of lemon juice, cayenne pepper and maple syrup. I began to read about and experiment with the tiny doses of homeopathic remedies designed to relieve the symptoms that, in large doses, they would cause.
I also started studying Chinese medicine. Soon I began to appreciate how this system always addresses both mind and body and carefully individualizes its treatments. The shape of the pulses at the radial arteries there are 12 in Chinese medicine, Singha assured me and even the time of day at which the treatment is given are all taken into account. There is no standard treatment for congestive heart failure or even pneumococcal pneumonia but many different ones, different combinations of herbs and acupuncture points, physical exercise and psychological advice, each designed for that particular person.
I had begun as a psychiatrist, but soon I was treating physical as well as emotional problems and using the other medicines food, herbs, acupuncture, homeopathy and the manipulative techniques of osteopathy and chiropractic in combination with what I had learned in medical school.
Merging East and West, Mind and Body
when someone calls my practice holistic, I agree, but I also nod when asked if I work with alternative medicine or complementary medicine. When the time came for me to create a nonprofit institution, I called it the Center for Mind-Body Medicine. Yes, I say, I primarily use techniques that are other than those I learned in Harvard Medical School, techniques that may work where more conventional practices have fallen short.
I call my center Mind-Body because so much of what we do is concerned with bringing mind and body into harmony. But what I’m really interested in is helping to create a new medicine, a more respectful and responsive health care, a larger synthesis that transcends categories and any attempts to categorize it.
Even though its practice is highly individualized, the new medicine has certain consistent and recognizable features. All of us who practice it take seriously Hippocrates’ injunction ‘First do no harm.” We understand and help our patients to understand that each of us is a unique and whole persona biological, psychological and spiritual being in a total social and ecological environment. We recognize that each of these dimensions of our lives can be both a source of our distress and an arena for relieving it.
The heart of this healing practice is self-care, those approaches that a person undertakes for herself: self-awareness, relaxation, meditation, diet and exercise. Next in line are methods and techniques that usually require professional assistance and stimulate the body’s own healing processes manipulation, massage, acupuncture, hypnosis and homeopathic and herbal prescribing among them. Finally, reserved for special and specially demanding or threatening situations, and for people whose defenses are overwhelmed, are potent pharmacological remedies and powerful surgical interventions.
Those of us who practice this way spend a great deal of time taking a history. We don’t, as too many, physicians do, touch only lightly on “family history,” simply record a patient’s job title or ignore her spiritual life. We regard all of these aspects of life as being of fundamental importance. We ask not just what our patient’s parents died from or what their health was like but what they were like.
We want to know where and with whom our patients live, whom they love, and what the joys and tensions of those relationships are. We are interested in how they eat and exercise and, especially, in what gives their lives meaning. How do you like your work? What makes it worthwhile to get out of bed in the morning, and why do you think you’re here on this planet?
Just because an illness manifests in a physical way does not mean that its origin is or its treatment ought to be exclusively or even predominantly physical. Virtually every chronic illness has a powerful psychological component, and almost always, the work of untangling the fears, resentments and misconceptions that prevent emotional and intellectual change is a necessary precondition for physical healing. Similarly, emotional problems are often susceptible to nonpharmacological, physical solutions. For example, I have found that physical exercise and meditation techniques carefully individualized for each person’s needs are the most effective way of helping people cope with, learn from and go beyond anxiety and depression.
The New Medicine Manifesto
In the future, I hope and expect that we will create a system of medical care based on this comprehensive understanding. We would, of course, use drugs and surgery when necessary, but only when necessary. For the most part, our system would be based on interventions that foster the body’s own healing powers and on self-care, with the physician’s role being one of teacher rather than treater.
For example, we will insist on manipulation, acupuncture, massage and baths for an injured … back prior to even considering long-term use of anti-inflammatories or surgery. Homeopathy, dietary changes and herbal remedies not antibiotics, antihistamines or decongestants will be the initial treatment for such common ailments as sinus and middle ear infections, diarrhea, hay fever and other allergies. For asthma, we would no longer routinely prescribe inhalers, bronchiodialators and steroids substances that do combat the inflammation and constriction of the bronchi but create dependence and also do not significantly alter the course of the illness or address its causes. These have their place but as last resorts, not as primary treatments. Instead, we would preferentially, and wherever possible, begin therapy with acupuncture and herbs, as well as family discussions, self-awareness and relaxation techniques, breathing exercises, dietary and environmental change, and yoga. And we would always work to instill hope, which has proven to have positive biological effects on immunity and healing in our patients.
The medicine of the future will help all of us to understand why we have become ill and will put in our hands most of the tools we need to help ourselves stay well. It will help us see that illness is a part of, and not apart from, life, that learning to understand and heal ourselves and maintain our health is a great spiritual teacher.
Adapted from Manifesto for a New Medicine, by james S. Gordon, M.D. Copyright 0 1996 by James S. Gordon, M.D., director of the Center for Mind-Body Medicine in Washington, DC. Reprinted by permission of Addison-Wesley