I might as well begin by being blunt. There is no love lost between the medicine I was taught in medical school and the kind I practice now, which used to travel under the name of mind-body medicine. The relationship between conventional and alternative medicine is like a bad marriage, only in reverse. It began with a divorce, has moved to the stage of wary mediation, and holds some prospects of reaching a shy courtship some day in the future. The grounds for the divorce are bitter. Conventional medicine is offended that alternative medicine even exists. For the average physician, to hear that an allergy patient is taking extract of nettle to treat his symptoms or that a breast cancer patient is being treated with coffee enemas and a macrobiotic diet arouses scorn. Yet at bottom no one could really object to the aims of alternative medicine, which are to bring relief to the whole patient. If millions of them have been seeking holistic treatments instead of the two-pronged approach of conventional medicine - drugs and surgery - their motivation isn't irrational.
Foreign As To Be Entirely Alien
Twenty-five years ago the possible efficacy of traditional healing modalities, herbs, Eastern therapies like acupuncture, and even mind-body medicine was so foreign as to be entirely alien. Today there are still die-hard sceptics, of course. But in a mood of expanded tolerance, a medical doctor (MD) can look at the research on neurotransmitters, cell membrane receptors, and brain physiology, which has made enormous strides in recent decades. Taken as a whole, this research describes the body as an integrated system that exchanges information continuously between the mind, via the brain, and every cell in the body. One party in the divorce can no longer claim to be the only one supported by evidence, research, and blind trials.
Growing Reconciliation
One sign of growing reconciliation comes in the form of softened terminology. Instead of calling it alternative or holistic medicine, as I've been doing, the more acceptable term is complementary and alternative medicine (CAM), which sends the signal, "See? I am not your foe. We can cooperate. We're complementary." Which is true. The public has been told for decades now that the primary causes of suffering are no longer infectious disease, epidemics, and lack of proper sanitation. Those have been replaced by lifestyle disorders, which are largely preventable.
Drugs and Surgery
The problem is that an MD's practice is badly set up to promote prevention. Visits are too short. Doctors aren't adequately trained beyond their specializations. Their habits are focused almost entirely on drugs and surgery as treatment modalities. Prevention is considered too "soft," and yet, if you shift the burden of prevention to the patient (which most MDs are more than happy to do), there is enormous resistance. The public has been given countless warnings about smoking, poor diet, and lack of exercise, yet we have by no means eradicated lung cancer, obesity, coronary artery disease, and type II diabetes. Lifestyle disorders prove intractable when people cling to bad lifestyle habits and resist adopting good ones.
This is where CAM makes significant inroads, because one of its main themes is the return of power to the patient. MDs should welcome the whole trend to self-treatment instead of taking the scornful attitude that nothing works but the modalities taught in medical school. The inconvenient truth that "you can heal yourself" has always been the foundation of medicine. The body is the locus of the healing system; physicians assist this complex, little-understood system. They do not actually do the healing. If this feels threatening to MDs, there is much more room for pride to take a fall.
Expanded Medicine
I look instead toward the next phase of this reverse marriage, which is shy courtship. If both sides stopped being defensive, they would see that they share core values: treating the whole patient, reducing suffering, closing the gap between healer and healed, and doing the least harm while bringing the greatest good. Speaking personally, I stand for alternative medicine while remaining a board-certified endocrinologist, and the reason I straddle two worlds is that I envision expanded medicine in the future, not alternative or mainstream medicine as divergent choices or warring camps.
If we combine wisdom and science, tradition and research, mind and body, there is every hope that the mystery will reveal its secrets more and more fully. The experiences of joy, compassion, and meditative quiescence could be powerful tools to restore homeostasis and strengthen our self-repair mechanisms. Expanded medicine is the answer, I am sure of that. The only question is how long and crooked a path it will take to get there.
An abridged version of an article originally published in Virtual Mentor, American Medical Association Journal of Ethics.
Originally published on Jun 28, 2011
