Wednesday, January 16, 2008

What Heals and Ails in Healing System !

What heals the patient: treatment,doctors,regimens or patient him/herself or all of them ?

Most commonly practiced healing system to day is of course the so called Allopathy or the Western Medicine. On the one end, there are people,like Dr.B.M.Hegde,a Fellow of the Royal Society, who say that the system is harmful and in fact, as he quotes from the report in a Medical Journal, there were lesser deaths in the Hospital when the doctors went on strike for days than when they were treating! At the other end it is said that it is the only scientific and by far the most successful system available today especially through the highly advanced surgical procedures ,and drugs, a most necessary evil!.More than 80% of Indians can not afford this medical system is a different matter! Most believe that there is hardly any better alternative to this system. The so called alternative medical system such as Ayurveda,Sidda,Unani,Yoga, Homeopathy,Acupressure and so on, are woefully short of scientific respectability as there is hardly any new research,discovery and expansion going on in those systems and they rely mostly on ancient treatises only as authority, even when some researches are undertaken, it is very poor in experimental control(no 'double blind' technique used,for instance) having essentially pre and post measures only while drawing conclusion. The counter from the Alternative Medicine Practitioner has not been very strong,it is based mostly on accusing the opponent's system rather than revealing justifications from their own system! For instance, the Alternative Practitioner argue that the Allopathic treatment is based on their experimentation with animals and thereby tend to neglect the effect of uniquely human factors in the origin,development and therapy of the disorders;the drugs they are using, though may have positive effect, it is short lived, have deleterious side effects and in the long term destroys the body reserves and capabilities.It appears to be a very valid criticism.Consciousness/awareness,one of the unique features of humans, is one of the important variable in most of the alternative medical system,especially in Yoga,you can not expect the Western model of science (such as 'double blind') to fit in here.It also appears that there is a lot of vested interest operating in the medical research and its outcome to day. I am one of those who believe that there can not be any Western or Eastern, Allopathy or Homeopathy; anything that works better must be taken from whatever the system and there should be only one System of Medical Education.

These warring Systems apart, I am often besieged by certain elements that aids the healing process common to any or all systems of medical practice and it is often most neglected by all systems.Observe the most popular doctors,in the sense that in them people have great trust and with whom patients are known to get better soon,safe and with lesser cost.I have observed some of them-all of them were called "good" doctors- and struck by some similarities in all of them which I think can be a pointer to any system of medical practice.

HOLISTIC : Body functions as a whole, disturbances in any one system,say cardiovascular system, will affect not only all other system of the body, but also get affected by all other systems of the body in origin,development and healing of disease processes.Yet, we do not recognise it often,partly because of super specialisation where specialist of one system rarely attends and monitor the other systems and partly because of our system of education itself which has been very divisive in knowledge construction. Furthermore,not only the systems within the body functions as a whole but also the body itself a part of of a total system such as family,sociocultural environment and atmosphere and all of them affect each other continuously; this is even more rarely recognised by the medical practitioners.I know one of those"good" doctor who actively probed patients to find out the background,present preoccupations, family environment and the place of living ,and his dispensation,-be it in diagnosis,understanding pathology or in planning treatment,-reflected the 'global' situation of the patient. His success in accurate diagnosis and treatment may be attributed to these skills of the doctor. I also know of a doctor,a neurophysician,who goes only by symptoms ,never asks about anything else and prescribed one drug for each of the symptoms.It was some two decades ago. The patient was a 65 year old lady,had giddiness, peripheral neuritis,lower abdominal pain,headache and ringing in the ear and mild and prolonged fever.He prescribed seven drugs and told us that each drug is for each of those symptoms and the extra is for possible complications! She developed additional problems, when doctor was contacted, he neither reduced or altered but introduced some more drugs for additional problems! We gave up,consulted one of those"good" General Practitioner,she was free from all the symptoms in just six weeks.

PATIENT CENTERED : Often, the doctors today are tools and technique centered,diagnosis centered,systems and hospital/clinic procedure centered rather than patient centered.The heavy cost of modern treatment is mostly due to these practices. The scans and imaging techniques is to sort out the problems of doctors in diagnosing the disease,it is none of the business of the patient, but the patient is made to pay for it! Many doctors hardly speak to the patient,listen to him fully and patiently,give respect and regard; within minutes they get to know the symptoms and send the patient for umpteen number of lab tests,scans and x-rays and so on even without any explanation to the patient, let alone justifying it.Doctors do that way because they want to sort out their problem first,not the patient. Patient feels lost and helpless,take negative attitude and that will definitely affect the healing process and may contribute to delay and deviation in treatment effect. It happened more than two decades ago.I had gone to drop my daughter to the school. The Head Mistress of the school invited me profusely to her chamber and started eulogies about a doctor who according to her such a nice and competent fellow that I should consult him for all the health problems of my family.I believed her,it was later I discovered that it is big network racket.I took a relation of mine,an aged lady, to that doctor for her problem of uterus collapse.The doctor spoke to us hardly for few minutes,suddenly invited me alone in front of the lady to a chamber inside and tells me that it could be a cancer and needs several investigation and that I could go and get it done in the lab which he would advice as it is most trustworthy.I said good bye to the doctor asking time to consider his advice but never returned.The patient got completely cured of the ailment in just three months by an alternative medicine practitioner! Another friend of mine,when I was studying in NIMHANS in the 1960's,had an ear infection and the doctor prescribed chloromycetin capsules.The patient told the doctor he never took capsules,it so big that he can not swallow,is it all right if he remove the cover and swallow the powder only.Doctor said "Yes Yes". My friend suffered from allergic reaction for the next six months. Doctor said that he only joked,patient should not have taken that way! Finally, one of those "good" allopathic doctor only advised him for an alternative medicine practitioner and the cure was achieved in just six weeks. For that "good" allopathic doctor patient was more important than the system or self indulgence like the other two doctors!

SELF-RELIANT PATIENT : There appears to be a sort of 'disease-doctor nexus' operating in our lives of today! We have illness, go to doctor and get treated and again we have illness,most of the time similar illness, again go and get treated by the doctor, and it goes on. Patient has become doctor dependant and he likes it,and doctors expects that kind of dependency of patients on them! Is it healing and health promoting?Doctors should aim at preventing diseases in their patients too.Moreover, a notion has been created in which we are made to feel that medical science is so advanced to day that we have an answer for almost all the disorders and even for some where we do not have an answer, we are likely to find it soon. Public simply believes that as it is convenient for them and remain as they are, for, they have nothing to worry,if illness comes, the modern doctors are there to take care of,cost notwithstanding to those many.Take my own case for instance.I am an ENT case,as they say.I had an ear discharge since childhood. My tonsils used to get infected frequently with high fever until I got it operated.I used to have frequent cold. What is more, since several decades, I used to get once every year during the months of November/December a sort of 'Flu",with cold ,high fever,body aches and pain and the condition used to last for three to four weeks with treatment, of course .This is the doctor-patient dependence I am talking about.Once, I woke up to a suggestion of my non-medical family member,took up seriously some minor life style changes and practice of exercises including deep breathing. Now, I am totally free of my annual November visitor since the last five years, and, not just that, I am free of any illness since five years too. I begin to feel for the first time some truth in what a sage has been telling for long that one need not get ill and health is our birth right.A very late realisation for me indeed that too for a person whose research specialisation is Psychophysiology and has been teaching that subject for three decades to my students and make them wonder about the wisdom of the body.The wisdom begin to dawn in myself so late around the age of 65! If only doctors has indulged in making the patient self dependant than doctor dependant we need not suffer that much.

HEALING AS SERVICE : ' Health Practice has become a money making business' many have observed.If money making is the aim, it is better they choose some other profession where they can amass wealth much at a faster rate and legally too than medical profession. Health,Education and Judiciary are the fields where corruption and moneymaking business is lethal and criminal.It is playing with the lives of the people,betraying the trust deposed on them and would leave an un-healing scar on client's lives by the malpractices of those professionals.Those who opt for these profession should dedicate themselves to the work with a spirit of service that is unselfish, bereft of greed and totally client centered.By doing so they reap rich dividend in terms of their well being and human stature. By not doing so, they would suffer untold miseries in their families,in their health and in their relationship with the society-all of course in the long run,there may be temporary,short term benefit, but by the time they realise the catch,it would have been too late: studies have shown this. I know of a Family Doctor who would never take a consultation fee from anybody and the medicine/mixtures he prepares were ridiculously cheap(Rs.two!).He would visit the family when needed at any time of the day and in his own vehicle which was in the 1950's bicycle, later on a two wheeler and finally a car! His selfless service is unparalleled and he was respected and regarded by everyone with such high esteem. He died a very peaceful death.

It is time that we inculcate the above crucial healing factors in educating practitioners of any medical system.


Raj said...

I am suffering for last 10 years.
I have had bypass surgery 8 tears ago. I am told I my heart is in good condition. The pressure in my eye are good. I get checked by ny endocrinologist,and ophthalmologists, and cardiologist in addition to my primary care physician. I have been to psychologist, sleep disorder specialist and neurologist. I am almost out of all specialists. I used to be a software specialist but had to give up because of travel. I own few business to keep me occupied. I am married to a wonderful wife ( a physician), and a beautiful well settled daughter.
Financially we are well off and very social in our community and society.

I am diabetic, sugar is controlled with medicine Glucophage 1000mg 2 times day.

I also take vytorin. My fasting sugar is in the 90.

I am tired after 10am in the morning. I take a 2-3 mile walk at 8am.

I can not focus, my eyesight to read after 10am. I have checked eyesight; they can not find any problem.

I have idiopathic sleep disorder; I can sleep 7-8 hours in the night and sleep at any time of day for 2-3 hours.

My weight is steady for last 40 years at 142lbs. No alcohol, no smoking, Lacto vegetarian. Occasional cup of coffee.

i have seen neurologist and endocrine doc. all test are negative for thyroid and mysthenia gravis.

The weakness is making routine work difficult.

Need help!!!!!!

Prof.M.S.Thimmappa said...

You have taken good care and have a fairly healthy life style too,congratulations.For your problems you may try Meditation for about half an hour once in the morning and once in the evening on a relatively empty stomach; it offers deep relaxation of the body and mind. On medical advice,that is if they OK it, you may try deep breathing exercises-pranayama. Both stabilises and balances the different component of the nervous system.

ajay.rao said...

Most of our doctors tend to forget the Hippocratic oath they take to practice ethical medicine. one can not blame the doctors alone. The amount they have to spend to become a doctor, forces them to do so.
being a life saver profession, our government would have given maximum possible subsidy to the students who want to become a doctor. The admission should have been purely on the merit basis.
We still don't have enough doctors compared to the population. Most of the doctors who practice from the clinics will be available for a max of 3 hours in the clinic. Rest of the time they will be visiting some private nursing home.
on a busy day a doctor can give hardly 3 min per patient. Do you think the 3 min is enough to study the case history of a patient?
all he/she does is to treat to the symptoms.
This might be the reason for doctor and patent nexus.
please tell me how many doctors store a patient's medical history at least in a file?
When our basic infrastructure is not up to the mark this debate will go on.