Commentary
2004; Lippincott Williams & Wilkins; Volume: 79; Issue: 1 Linguagem: Inglês
10.1097/00001888-200401000-00023
ISSN1938-808X
Autores ResumoGrounded in George Engel’s biopsychosocial model, the first two years of Rochester’s “double-helix” curriculum helped me understand human beings as a complex mix of biology and psychology within the framework of society. Once I left the carefully constructed outpatient curriculum and moved to the hospital wards, however, I began to fear that medicine was the great dehumanizer. I felt I couldn’t see or hear my patients through the fog of lab values, med lists, and procedures. Overwhelmed with the “bio” aspect of medicine, I was eager to put the “psychosocial” back into my clinical practice. Bastyr University’s four-week elective in complementary and alternative medicine (CAM) seemed like just what I needed—a wholistic, mind-body approach to medicine highlighting integrative therapies like naturopathy, healing touch, and acupuncture. “CAM Camp,” as we called Bastyr’s first-ever CAM program designed specifically for allopathic medical students, attracted 15 students with a strong desire to care for patients as whole people—body, mind, and spirit. About a third of the group had seriously considered attending a natural health sciences institution like Bastyr rather than an allopathic medical school. The rest of us, however, greeted complementary and alternative medicine with a mixture of wonder and skepticism. On the one hand, it was wonderful to interact with practitioners of wholistic medicine who care deeply for their patients as whole human beings. On the other hand, the claims of some CAM practitioners reached well beyond the realms of the scientific evidence that we had been so carefully trained to honor. The poem “A Summer Dilemma” compares complementary medicine with the spider webs I encountered in the woods on my walk to Bastyr each morning—invisible yet tangible, evoking both wonder and annoyance. Complementary therapies rely on entities like Qi (Energy) and Wesen (Life Force) that are as invisible to the scientific “eye” as spider webs are to the physical eye. Although practically invisible, neither the webs nor these energy-forces are intangible. Although I was a skeptic, my hair stood on end when a Reiki practitioner focused her healing energy on me. And some mornings, after 30 minutes of guided Qi Gong meditation, I felt a curious glowing in my abdomen and chest. I also couldn’t help but wonder at the miracle stories the patients eagerly shared in clinic, ranging from painless menstrual cycles to cured migraines. While these stories are truly wonderful, my classmates and I couldn’t help feeling annoyed when lecturers offered logically implausible statements about CAM therapies. One herbalist, for example, claimed it was highly unusual for an herbal therapy to have any side effects, because the plants “know” what each patient needs and act only at sites of imbalance in the body. Another lecturer spoke passionately about the scientific evidence for acupuncture, but was unable to present p values or recall whether the clinical trials cited included control groups. Sometimes in class I wished I could hold a protective shield against these incessant claims to legitimacy, just as I did with the fern frond in the forest. What does a scientifically trained mind do with what is invisible, yet tangible? The metaphor of the web holds together the wonder and annoyance that characterize my experience of both complementary and allopathic medicine. While complementary medicine does an admirable job upholding the wondrous human being as a whole, it often lacks a firm scientific ground, as defined by Western science. Allopathic medicine has minimized the unknown with meticulous scientific research, but the associated tubes, procedures, and medications have also minimized the wonder of the human being as a biopsychosocial whole. “A Summer Dilemma” suggests that one must choose between wonder and science, but since writing the poem, I have come to question whether this dilemma is, in fact, a false one. Because CAM has re-opened my eyes to the wonder of humanity, perhaps I can, in turn, re-open a space within allopathic medicine for the human being as a whole—mind, body, and spirit. Shelley Schoepflin Sanders
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