Written by Coeur d’Alene Healing Arts founder, Dr. Todd A. Schlapfer , NMD
It took only a few moments to recognize why this young man had been diagnosed with ulcerative colitis. In the course of our visit he excused himself several times to rush to the bathroom. His diarrhea was urgent and painful with bouts of bloody, mucusy discharge. This had been chronic for many months in spite of strong medic at ions which managed to dampen some of the symptoms but did not return him to health. Weight loss and weakness prevailed along with a dark despair for recovery.
The diagnosis was correct. Every exam and investigative procedure confirmed the malady. The standard of care was applied, but his health was failing. Fortunately, he is well now and thriving. It turned out that the etiology of his inflammatory bowel disease was an incessant fear and anxiety with respect to his work as a professional. That, along with a chronic intolerance to certain common foods and a mounting disruption of his microbiome. The real failure was the delivery of short-sighted health care, limiting treatment to the diagnosis rather than the person with the diagnosis. The cause had gone unaddressed.
As a fledgling physician, I had long been inspired by the proverbial principles of Tolle Causam and Tolle Totum, the essence of which was provided by the counsel of Hippocrates when he wrote, "It is more important to know what sort of person has a disease than to know what sort of disease a person has." Examining and unraveling my own life' makes this ring all the more true. However, most of my patients were in pursuit of symptom relief and considered themselves healthy if free of symptoms. I grew increasingly discontent with a rising awareness that symptom relief is not equivalent to health. Yet it is the paradigm of ma inline. standardized health care. The eradication of illness and disease is the footing upon which our model of health care stands. I was conflicted. I stood at a crossroads. Was my success as a physician to be anchored by how well I was able to relieve symptoms and annihilate illness and disease? While illness and health may appear as opposites, I could see that the connection between them was inseparable and essential to healing and our well- being.
Thirty years later I’m still practicing, but unlike how I began. The arduous journey through my own fallibilities, the vast treasury of clinic cases and the emerging revelations have altered my considerations of health care. When symptoms are regarded as the harbinger of illness, it's easy to justify modalities that suppress or quell the symptoms. But, if symptoms are recognized as the emblematic expression of the body's effort to heal itself, then I must be careful to conscientiously select methods that compliment this intrinsic intelligence. Not until the symptoms of the young man with severe ulcerative colitis were linked to his life experience and bio-psyche was he able to reverse the disease and retrieve his health.
Let me quickly clarify. I’m not saying symptoms are unimportant. Quite the contrary. Symptoms can be an exquisite guide to understanding the root causes of suffering. But to treat suffering and health as opposites would amount to removing a vital and essential part of our in-born intelligence like removing our eyes because of what we don't want to see. The invention and pursuit of health as the absence of symptoms and disease may actually be getting us into deep trouble.
Disease and suffering is no stranger to being human. This has always been true and belongs to our fundamental nature, regardless of the mental and spiritual constructs to the contrary. Suffering seems to be built into the nature of life, whatever it's form. When we diagnose and treat illness and disease as an error of our nature by suppressing symptoms, we may be doing more harm than good. We may actually be initiating the development of chronic disease, diminishing our vital nature and bio-intelligence, albeit in the pursuit of health.
Transcendence of health care as symptom relief requires reconfiguration of what we mean by health. As a nation we have developed a health care paradigm that discourages the practice of prevention and the acquisition of whole-person health.
When we consider health as a state of no- suffering or a respite from the ever present chaos of daily life, we fracture and diminish the nature of our humaneness. It’s a way of thinking and now a system that stems from a long history of standing medicine and treatment upon the science of reductionist logic. The roots reach back thousands of years, but a set point was established in the late 18th century through the work of philosophers and mathematicians like Pierre-Simon LaPlace and Nicolas de Condorcet who postulated that all phenomena were '·equally susceptible to being calculated”. in order “to tame the future.” Their calculus considered common mechanistic elements rather than individual and vitalistic points of difference. The product was a manifesto that relied upon social conformity-what is good for one is good for all. Medicine eagerly applied this reductionist thinking, analytically applying statistical reasoning for clinical diagnosis and treatment that was considered predictable and reproducible. This was further sanctified by the work of Pierre Cabanis in his 1798 paper, “On the Degree of Certainty in Medicine.” This may have set in place the paradigm upon which conventional American health care is currently practiced. The science and its clinical application became centered on disease care, reducing uncertainty to certainty and individuality to norm.
This foundation is now crumbling and giving way under the mounting evidence of failing to put self knowledge and prevention at the forefront of our health care. American health care is stiIl adherent to beliefs and practices that separate the whole from its parts. While the parts can reveal valuable insight about the whole, standardized health care is still fastened to linear and short-sighted presumptions like 'the whole is equal to the sum of it's parts', being normal or healthy means the absence of gross pathology, or that our genes are an absolute blueprint of our destiny. As a product of such reductionist thinking, which tries to order and sanitize chaos, we end up producing a paradigm of health care that is pathology-based and where treatment is symptom-centered— an unsavory pablum most of us have swallowed.
The consequences are costly, an economic black hole for most people and our nation. The physical, emotional and psychological misery can be unbearable, triggering a cascade down a slippery slope of unnecessary suffering. While our approach may appear to be highly scientific and sophisticated, a reality check on the outcomes begets very bad news. Essentially, we are failing. Look at the results. The United States ranks embarrassingly low in practically every global health statistic—be it infant mortality, longevity, recovery time or chronic disease. Yet, the medical affluence of our nation is unmatched. We spend more per capita and a greater percent of GNP on health care than any other nation, but the results, the status of our overall health, is shamefully poor. This is unnecessary and preventable.
Perhaps it's our unexamined beliefs and compliance with reductionist logic. Maybe it's shear denial and avoidance learned from early life experience—that everything is fine until we get sick. Or, maybe we are stuck in a cloud of disempowerment descended from the big business and for-profit monstrosity we’ve created around health care. While we have made revolutionary strides to deter major diseases through practices like personal hygiene and sanitation, we have paid little attention to the prevailing force of our human nature—the dynamic exchange between our biology and psyche. If health is our aim, we must also accept and integrate this inescapable truth into health care.
Take the young child who had been diagnosed with ADHD because of restlessness and difficulty concentrating in school. The first physician prescribed medication, a stimulant which shunted some of the restlessness, but escalated emotional agitation and sleep disturbance. A second prescription induced mental and emotional lethargy and depersonalization. Both prescriptions were discontinued and the patient was referred. Looking more closely, this child was living in a troubled home where his mental and emotional and personal nutritional needs were neglected. Family counseling, re-designing his learning environment and addressing his nutritional needs reversed the struggle and removed the need for the medication.
Consider two other individuals, each diagnosed with severe migraine headaches. After a short visit with their respective physicians, prescription drugs were administered. In both cases the medications successfully dulled the pain, but the migraines kept returning and the medication became less and less effective. Although each person exhibited a different presentation of a migraine, the diagnosis and treatment were essentially the same. A more comprehensive exam revealed one of the individuals struggling with hormone imbalance and a significant unresolved emotional conflict.; the other was experiencing marital stress and food intolerances. Addressing and treating the cause resolved the migraines and endowed each with knowledge about how to personally heal and prevent future migraines.
We seem to be oblivious to the severe consequences of denial and neglect upon our human function, our bio-psyche nature. We make hasty diagnoses with flimsy scientific justification and rain down pharmaceutical medications for treatment that potentiates further disorder and chronic chaos. The problems that manifest from quick-draw diagnoses and medications is the same problem emerging with the plethora of over-the-counter supplements. Both are customarily aimed at the diagnosis (the part) rather than the whole of the individual. Treating the diagnosis in lieu of the individual increases the chance for harm, even if the medicinals are ‘natural’. We have certainly realized that the treatment of disease or the diagnosis alone is not the same as prevention or health
It's the same irreverent logic and behavior we apply to the exploitation of Earth' s resources , in spite of the harm and poverty we' re creating for future generations. Given the courage to look, our world is a mirror—an axiomatic reflection of how we steward our lives, how we face into ourselves. Our planet is a living organism that parented our emergence as human beings. We are the product of an intimate and long ancestral relationship with nature that has constructed us from elements and spirit upon which we are co dependent. It would be redundant and insulting to suggest that we don' t know better. We do. Or, that we can't afford it. We can. Economically, politically , environmentally , health-wise— we must.
The forces of nature, our spirit and personal genome are designed for reciprocity, an exchange of give and take that has profound influence on our development in utero, as an infant and our destiny as an adult. There’s nothing we do alone. For us to get closer to a health care system that is endowed with a cosmology of prevention and trans-generational health, we must give up what impedes it. Our deepest science and wisdom reveals that human health is a product of how we live in a complex world. Our family life, relationships, education, work, food, air, watersheds, soils and forests—the entire cosmos of living systems are integrated to inform the health of ourselves and the planet.
Take genetics, for example. Each of us arrives as a human being with a password that connects us to the origins of earth-life, DNA. l remember being taught during pre-med training that my genes were a blue-print for the destiny of my health. That sounded like it was cast in stone, but upon further examination it turns out that our genetic nature is not entirely locked in place like once thought. The majority of our genes are in flux and being informed by our every-day choices — how we eat, cope, move and navigate through the day. We are literally in conversation with our genetic nature such that it can make a world of difference to our health and the world itself, for better or worse. Imagine a health care system, a world where the collective of health care providers practice and teach that inexorable truth.
The growing knowledge around genomics, cellular signaling, epigenetics, oxidative stress, psyche and substance tells that understanding the individual, not merely the symptoms, is the key to good health and prevention. But, who will invite the patient into the crucible of self awareness and guide that person through the myriad of ways to connect to one’s health? It has been said, "a physician never enters the sick room alone, but is always accompanied by a host of demons or angels." Who is brought into the room is determined by the degree to which the physician is compassionately engaged in his own self development and healing. It means taking into account that each of us are not the same, that our biography and biology is unique and determines a variance to our personal entelechy. It means recognizing that our nature, as Aristotle suggested, is greater than the sum of its parts. Dr. Albert Schweitzer wisely advised, "We are at our best when we give the doctor within each patient a chance to go to work.” Instead of medicine for the masses we would practice and provide care for the whole person.
Prevention and whole- person health has to become the first order of care. While this may be politically and even economically unacceptable, the heap of waste and harm of not doing so becomes all the more mountainous, casting a dark shadow over the revered ethos of First, Do No Harm.
It’s as if we’ve forgotten—consigned to oblivion the most precious jewel of our human nature, compassionate self knowledge. When obliged, then we begin to see things as they are. We begin to recognize our intrinsic, personal, and impersonal entelechy and our connection to the intricate tapestry of life in a complex world. At the root of our dignity is the discovery and illumination that what composes us also composes this world and vice versa. A gift to our children and this world is the cultivation of that treasury. The highest and deepest science, the best medicine— the reconciliation of our inner and outer world is rested there. Out of that comes a more simple, sustainable and meaningful life within a complex world, including health care.