DIAGNOSIS: MEDICINE’S
HOLY GRAIL By Douglas Brown, CCH, FNP, RSHom(NA) [published in Homeopathy Today, Jan/Feb. 2005] "A label is a mask life wears. We put
labels on life all the time. 'Right,' 'wrong,' 'success', 'failure,'
'lucky,' 'unlucky,' may be as limiting a way of seeing things as 'diabetic',
'epileptic,' 'manic-depressive,' or even 'invalid'. Labeling sets
up an expectation of life that is often so compelling we can no longer
see things as they really are. This expectation often gives us a false
sense of familiarity toward something that is really new and unprecedented.
We are in relationship with our expectations and not with life itself" Rachel Naomi Remen, MD. "On Naming
and Awe", from Kitchen Table Wisdom. Riverhead Books,
1996, NY:p.66
What is an illness? Is it something that we have? A possession, like
an automobile or an iPod? If so, it certainly is deserving of a name,
a label. We need to call it something, identify it, control it. Giving
it a name helps to separate it from ourselves, and at the same time
reassures us that we are not alone; we are in the company of many
others who are similarly suffering. Diagnoses offer us comfort: they
give us a handle on an unpleasant, uncomfortable, perhaps painful
experience. A diagnosis points to a cause, some biomechanical break-down
that can be understood and hopefully treated. It reduces uncertainty
by association with statistics and prognoses. Finally, it gives us
the feeling that somebody is doing something about whatever it is
that ails us; freeing us, perhaps, from the nagging notion that symptoms
may be pointing us to look more deeply at the meaning, shape and substance
of our life.
Charmed by the allure and power of the diagnostic arts, I went to
Yale University to learn them. After working as a sociologist I was
frustrated with the inexactitude of the "soft" sciences.
I was impressed with the promise of medicine: the idea of applying
knowledge to relieve suffering seemed nowhere more evident than in
health care. Newly armed with my knowledge of anatomy, physical examination,
laboratory science, and differential diagnosis, I marched out of Yale
as a Nurse Practitioner, offering patients what I thought was a great
deal: I'd listen to their ailments, examine their bodies, order extensive
tests, and give in return diagnoses: along with the brightly-packaged
and extensively marketed pharmaceutical responses to all of life's
possible aches and pains.
After about 10 years an unpleasant awareness became increasingly difficult
to ignore. Many of my patients weren't getting better. Sure, the acute
cases of bronchitis and pneumonia were usually ameliorated from the
antibiotics. And acute flares of asthma, arthritis, ulcers, and abscesses
usually subsided with the care I provided. But the majority of my
patients suffered from chronic illnesses that I was being called on
to "manage", not to cure. And management often meant prescribing
more and more drugs, each one more expensive and side-effect laden
than the one before.
And there was something even more unsettling, a thought or intuition
that was troubling me beneath the surface of my outwardly productive
professional life: my patients' problems seemed somehow to be connected
with each other, not discrete entities as the problem list at the
front of the patient chart implied.
Let me explain: As you may know, a patient's chart has multiple sections:
The bulk consists of notes from each patient visit. "SOAP"
charting is the standard, where "Subjective" data, what
the patient says, is followed by the "Objective" data of
exam and lab test results. This leads to the "Assessment",
or Diagnoses, which leads quite logically to the Treatment "Plan",
usually more tests and/or referrals and prescriptions.
Typically at the front of a chart, behind the front cover, is a "Problem
List". This is intended to give the clinician a "snapshot"
view of the patient, and it is here where the diagnoses a patient
has received reside in unadorned, naked prominence, offering the reader
a quick and painless preview of the work about to present itself in
the consulting room.
Given the time limitations of modern medical practice, clinicians
are fond of focusing each particular visit on just one or two items
on the Problem List. "Let's focus on the pelvic pain today, Mary,
and get the annual (gyn) exam done,' I remember saying. "We'll
talk about the depression and the arthritis at your next visit."
The exam and physical findings might have led to a diagnosis of pelvic
inflammatory disease ("PID"), and prescriptions for multiple
antibiotics. Subsequent visits would address the nightly bone pains
and symptoms of depression, leading to more tests, prescriptions for
anti-inflammatory drugs, and an increase in the dose of Prozac. Nowhere
in the structure of this kind of patient care, nor in the biomedical
model upon which it is built, is there room for exploration of how
all these problems are inter-related, or for exploring the underlying
energetic situation that lead to her particular constellation of symptoms.
What is the alternative?
If Mary were to come to me now I would see all of her symptoms, from
pelvic pain, to bone pain, to depression, as aspects of an underlying
state. A state is a particular pattern of energy, sensation, feeling,
and emotion which manifests when there is an imbalance, a block in
the natural capacity of the organism to self-heal. Once the particularity
of a patient's state is recognized by the healer, it can be gently
overcome by the administration of the correct homeopathic remedy.
If I were to have approached Mary with this paradigm of understanding,
I would have come to a much deeper understanding of Mary's problems,
where all the symptoms could be perceived and understood as manifestations
of her state. I might have learned, for example, that Mary had been
the victim of sexual abuse as a child. That she felt humiliated and
shamed, and had developed the pattern of suppressing her anger to
the point that she couldn't even recognize it. I might have perceived
that beneath the common symptoms of depression there was a huge reservoir
of hurt and indignation, compensated for by fantasies of becoming
a famous leader for womens' rights. This would have led me to the
prescription of the remedy Staphysagria, stimulating a cure from within.
A cure of not only the pelvic and bone pain, but of the depression
as well. Known for it's remarkable capacity to stimulate healing from
surgical wounds, Staphysagria, the homeopathic remedy made from the
delphinium plant, also has the power to bring resolution to post-traumatic
stress disorders where the psyche has been wounded by assaults to
one's honor and dignity, and wherever these wounds are expressed in
the cell's expression of somatic pain. Treatment with the right remedy
might not only have hastened healing, but it would have given Mary
the energy to move from compensation in the realm of fantasy to actual
forward movement in her life, effecting positive change not only for
herself but for others.
With the mainstream medical approach, the diagnoses of Pelvic Inflammatory
Disease, Osteoarthritis, and Depression become the final products
of analysis and assessment. With a homeopathic approach, these labels
are at the most starting points for understanding the patient. At
worst, they are misleading labels which pretend to convey more understanding
than is really present. Diagnoses are convenient handles to interpret
reality, but these handles come with real hazards. As Remen says,
we come to see only the labels, and become blind to the reality to
which we are called to respond.
'What exactly are the hazards?' you ask. First of all many diagnoses
are inexact and wrong. Applying a diagnosis to a patient's condition
tends to abort further effort at understanding exactly what the patient
is experiencing and how his or her healing is inhibited. Secondly,
it all-too-often leads to prescriptions for suppressive drugs with
damaging effects to the organism.
With more serious illnesses there is a seldom-acknowledged risk: that
the very act of naming a particular kind of pathology may actually
help bring it about. An outrageous claim? I don't think so. We have
all heard of voodoo, where accused and banished members of a community
of like-minded belief actually die from the pronouncements, rituals,
and spells of the witch-doctor. With the even greater tools of suggestion,
power, and influence wielded by modern medicine, is it not quite possible
that a respected physician's opinion that one is afflicted with a
chronic — or terminal — illness, become a self-fulfilling
prophecy? Researchers found exactly this when they studied the so-called
"Nocebo Effect" in 1992: Women who believed that they were
prone to heart disease were nearly four times as likely to die as
women with similar risk factors who didn't hold such fatalistic views.
The higher risk of death, in other words, had nothing to with the
usual heart disease culprits — age, blood pressure, cholesterol,
weight. Instead, it tracked closely with belief. In short, their conclusion
was: "Think sick, be sick."
A related concern arises from new understandings gleaned from applying
quantum mechanical theory to our understanding of consciousness. What
if the very act of observing a pathological process somehow fixates
it, condenses into reality what was formerly a range of potentia?
We now know that subatomic particles don't locate themselves in space-time
until they are observed. What if a tumor isn't a tumor until it, too,
is observed?
This seemingly preposterous idea deserves some consideration. Studies
in the new area of retropsychokinesis suggest that consciousness does
not only influence events forward in time, but backwards as well (see,
for example, Schmidt, Helmut "Observation of a Psychokinetic
Effect Under Tightly Controlled Conditions" in Journal of Parapsychology
Vol. 57 Dec. 1993). In other words, what if the very act of diagnosing
a serious illness may reach back in time to cause it to have happened?
Perhaps this is a factor in the reported survival advantage of those
with strong powers of "denial".
Uncomfortable with this radical rejection of the reasonable? Just
remember that pathology, the actual derangement of the material fabric
of our bodies, is the end-result of a lengthy process that originates
in the realms of consciousness, energy, and form. That it is the culmination
of patterns that originate in what physicist Rupert Sheldrake terms
a "morphogenetic field". The work of diagnosis occurs in
only one dimension, that of material end-results. The potential for
real healing occurs in dimensions that the diagnostic art ignores.
This realization opened up a window of understanding on my frustrations
as a mainstream medical practitioner. So many of my patients came
in with symptoms for which I could not find any "organic"
explanation. This would lead to extensive batteries of tests to "rule
out" potentially serious diseases, many of which have no cure
within the mainstream medical paradigm. Patients were subjected to
many procedures, none of which actually helped them. Finally, as many
of these would ultimately prove inconclusive, I would be left with
the unsatisfying "diagnosis" of "psychogenic",
or "stress-induced", symptoms. Have any of you, dear readers,
been subjected to anything similar?
But isn't this absurd? Why do we have to consign our symptoms to either
the psyche or the soma, the mind or body? Of course there is stress
in all of our lives: this is a given fact of life on planet Earth.
How does the existence of stress explain the presence of a symptom,
or give us an understanding of why this particular symptom, at this
particular time?
The mind and the body are two levels at which the same underlying
disturbance expresses itself. The disturbance, the core wound, is
not restricted to one or the other, but rather manifests its presence
in different but related ways in each sphere. It is not enough to
tell patients "this is real disease, here's the mechanical problem"
versus "it's all in your head, don't worry". The task before
every healer is to trace the meaning of each symptom to a core disturbance,
and release the need for symptoms by charting the healing of that
core wound.
Illnesses are not possessions. They are expressions of our soul's
distress. Much as we would like to control our illnesses by possessing
them, the reality is that we are in many ways possessed by them. When
we are healthy we feel an inner freedom to bring love and creativity
into our lives and world. When we are ill our lives become an expression
of a pain that is somehow beyond us, a vehicle for an expression of
a disturbance that holds us in its grip.
As a people we are enamored of sophisticated technology. We want answers
to the questions "why" and "what" to be provided
by images from MRIs and numbers from blood counts and chemistries.
We have given away our power to our doctors, and neglected to read
the messages sent to us by our own souls. We happily consume the latest
in genetically-engineered drugs and forget about the casualties of
yesterday's popular and fashionable treatments. Our health care system
looks increasingly like a corporate production assembly line in which
diagnoses are managed and souls are not even perceived.
There is good news, however. There is an alternative. Doug Brown, CCH, FNP, RSHom is a graduate of Yale University School
of Nursing and the Hahnemann College of Homeopathy. He became a homeopath
when after 11 years of working with conventional medicine as a Family
Nurse Practitioner he remained dissatisfied with its failure to cure
chronic disease and with its fragmentation of care. He treats children
and adults in Portland, OR, and Walla Walla, WA, and can be reached
at (503) 253-6334, or by email at remedyman@comcast.net.
