The other day, my 5 year-old son Devin accidentally bumped his leg on a table corner. After a brief pause, I could see the grimace on his face and tears starting to well up in his eyes. I went over to him, asked him where it hurt, and after rubbing my hand over the area that he pointed to, I gave him a kiss on the forehead, and told him that everything will be OK. Within 5 seconds, he was smiling and running around again. This incident reminded me about the importance of relationships in any form of healing, as well as how we even define what health or healing is.
One of my most memorable courses in college was called “Paradigms of Health & Disease.” It was a fascinating course which explored how various cultures perceived and defined heath. Some cultures (such as ours) defines health as an absence of disease. Other cultures define health as a state of balance, in harmony with your natural environment, world or universe. I’m sure I’m missing dozens of other definitions, but what I want to convey here is that even within our Western, modernized culture, all of us have different perceptions and ideas on what it is to be “healthy.”
The famous 16th century French barber-surgeon Ambroise Paré said (paraphrased), “I place the dressing, and God heals the wound.” Whether or not you’re religious, Paré’s quote emphasizes the human body’s innate ability to heal, given the right conditions. If you have a cut, what we do as physicians is to facilitate the wound to heal, by cleaning the wound and placing a dressing. The body does the rest. Doctors get into trouble (especially surgeons) when they take credit for the almost miraculous recoveries after treatment with an antibiotic or after major surgery.
In this context, do doctors actually heal patients? Is the act of administering a medication or performing surgery the act of healing, or is the body actually doing the healing on it’s own, once the proper environment is laid in place? This health science issue is definitely up for debate, but one thing for sure is that the patients’ proper physical, emotional, and mental environment is critical for any kind of healing to take place. This is something that we as physicians tend to forget all too often.
Over the years, I’ve noticed that there are many terms used very loosely in the health-related medical fields, such as words like naturopathic, chiroprathic, osteopathic, and allopathic. Sometimes these words are used interchangeably, and other times they are used inappropriately. Hopefully, I can clear up some of the confusion surrounding these terms, as well as to give you some guidance as to who to go to when you have particular healthcare needs.
As I’ve mentioned in my other articles, I’ve come on a journey over the past 10 years in private practice, where I realized that to truly treat a simple ear infection or a sinus infection, you must address the entire person, including their diets, sleep habits, lifestyle and stress issues. Giving medications is only covering up the problem, a sort of a band-aid, until the problem comes back later on. It’s not surprising that it’s estimated that the vast majority of visits to the doctor’s offices are a direct or indirect result of diet, lifestyle, and stress-related issues.
Traditional Western, or allopathic medicine (supposedly) uses scientific reasoning, logic and methods to find the true cause of illnesses and attempts to leverage the latest technology towards achieving this goal. The term allopathy was originally used to describe a healing practice that used agents that are the opposite of what’s causing an illness (allo – against, pathy – disease). For example, an antibiotic is used for bacteria.
Homeopathy, on the other hand, uses substances that are similar to what’s actually causing the illness to treat the disease. An example of homeopathy is using very dilute concentrations of lead to treat lead poisoning. A basic foundation of homeopathy is that the substance or toxin in question must be diluted numerous times to the point where only a few (or less) molecules exist in the solution. Interestingly, Dr. Hannemann, the founder of homeopathy, originally coined the term allopathy and it was used in a derogatory manner. Modern allopaths like to think of allo- to mean all or inclusive.
Osteopathy is a form of medicine that focuses on proper bony alignment and it’s relations to the rest of the body. Modern osteopaths (Doctor of Osteopathy, or DOs) are the equivalent of MDs, with all the privileges rights, and responsibilities. In medical school, osteopaths take additional courses in spinal and bony manipulation and are more focused on addressing the whole person, rather than a body part or organ.
Chiropractic is similar to osteopathy, but focuses mainly on spinal and vertebral alignment and functioning. The inventor of chiropractic describes coming up with the concepts after a woman’s hearing loss went away after he resolved a bump behind her neck.
Naturopathy is a form of holistic healing that emphasizes the body’s innate ability to heal, using remedies such as light, water, food, herbs, and massage.
Last but not least, I should also mention Chinese medicine (with acupuncture) as well as Ayurvedic medicine. These ancient form of healing are thousands of years old and are still being actively used in many parts of the world.
To overcome all the shortcomings of each of the above mentioned disciplines, physicians have recently introduced terms such as alternative, complementary, integrative or holistic. Some of these words are sometimes used interchangeably, but it’s important to distinguish the true meanings of each of these terms. Admittedly, there are many definitions and variations for each of these terms, but I’m going to present the more commonly accepted definitions that I have come across.
Alternative medicine is any modality that is not traditional, allopathic medicine. In the US, due to the many problems associated with our current health care system, many people are either rejecting it altogether or looking for alternative ways of dealing with their health. This involves preventive and wellness options as well as treatment for acute or chronic conditions. Examples of alternative medicine (in the US—it may be different in other parts of the world) include Chinese medicine, naturopathic medicine, chiropractic, and Ayurvedic medicine. I’m sure I’m missing many dozens on others.
Integrative medicine is the practice of integrating or combining all the different forms of medicine, drawing from each field the most useful and effective methods of treating certain conditions. It gives equal weight to all the different fields. Some would criticize the fact that integrative practitioners sometimes use untested and unproven ways of therapy to treat certain conditions.
Complementary medicine is similar to integrative medicine, but from what I understand, uses essentially one main modality, but draws on the the beneficial aspects of other “alternative” areas when necessary.
Holistic medicine involves looking at the whole person—the physical, psychological, emotional, and spiritual. In theory, all physicians should be practicing holistic medicine, but very few end up doing so.
All of the above forms of medicine incorporate good nutrition and proper exercise as a basic foundation. Some may argue that Western, allopathic medicine has moved too far away from a “holistic” form of medicine where there used to be a much stronger doctor-patient relationship, to more of a technology-driven, algorithm-based, guided missile type of treatment. Due to obvious limited resources, time constraints, information overload, and medical-legal problems associated with our current medical system, the problems that we currently face are not surprising. Andy Kessler, in his book, The End of Medicine, predicts that with rapid advances in technology, doctors won’t have to rely on clinical judgement and experience. Rather, they can just order a test to make any diagnosis.
Another concept that needs clarification is timing. There is a major difference between treatment after an accident or infection, versus taking active steps to prevent an accident for infection from taking place at all. The former considers health as and absence of a disease (no more sinusitis), and the latter will take active steps to balance the body so that even if exposed to a cold or allergies, they won’t progress into a sinus infection. This is what differentiates someone that takes a reactionary approach to their health care issues, versus someone who takes an active or preventive approach so that illness is less likely to happen.
So ultimately, what is healing? Different modalities will have different definitions. An allopathic doctor will define it as total eradication of a bacterial infection from the body. A Chinese medical doctor will define health as a sense of balance in all the different forces, as well as between opposites. Can healing occur spontaneously, or is a second person needed for more optimal healing to occur?
If the patient feels significantly better, but the infection is not completely gone, has healing taken place? What if the infection is completely gone, but the patient doesn’t feel any better? Different medical paradigms will give different answers.
One interesting common feature amongst all the major healing arts, with the exception of traditional allopathic medicine, is that treatment always involve some sort of hands-on manipulation of skin, muscle or other body parts. Allopathic doctors will use manual techniques only briefly for diagnostic purposes, but rely mainly on tests to make the main diagnosis and resort to pills or surgery for any further treatment. In essence, we’ve abdicated the personal, relationship-driven healing arts in favor of technology and science.
I vaguely remember a study on newborn babies where one group had frequent manual touching, contact and stroking, whereas the other group did not. The group that were constantly touched had much faster rates of development, weight gain and other various measures. If babies need constant touching and reassuring to thrive and survive, why can’t adults benefit from “touch” therapy as well, no matter who lays on the hands?
This also explains why as a child, whenever my mother rubbed her hand on my belly for a tummy ache along with a soothing song, I always felt better. This goes to show that in a sense, whenever tactile relationships are involved, all of us are healers.