Within a few short years following Flexner's curricula guide, alternative medical schools—schools of homeopathy and osteopathy to name two—were left with little more than fringe status, and most were forced to close their doors. (Homeopathy is a school of treatment involving the administration of minute doses of remedies to increase the symptoms a patient is experiencing in an effort to spur the body's powers to restore harmony. Osteopathy is the science of manipulating the musculoskeletal system to restore health.) Biomedicine was the standard. Doctors and the powerful lobby of the AMA successfully kept the "charlatans," as they called them, out of the arena for nearly sixty years. It wasn't until consumer confidence in conventional medicine started to wane three decades ago that an opening appeared for alternative paths of healing. Many of the changes began to emerge in the sixties. Reports on the serious side effects of commonly used drugs like antibiotics started chipping away at consumer confidence. Coupled with a resurgence of more virulent strains of tuberculosis and deadly bacterial species like strep-A (the flesh-eater), not to mention new diseases like AIDS and Alzheimer's and cancer that traditional treatments could not cure, medical shoppers began looking for more. They wanted to find something to help them feel better, not necessarily get rid of the disease, just make them feel better. They wanted a more satisfying way of life.
MEDICINE AMERICAN-STYLE
Western Miracles and the Deification of Doctors
Many of this country's medical breakthroughs have had some basis in ancient Eastern wisdom. Drawing on an eleventh-century Chinese practice of using a powder derived from aging smallpox scabs to prevent disease, English country doctor Edward Jenner further evolved this Asian discovery into a vaccine for smallpox. Jenner scratched eight-year-old James Phipps's arm with the cowpox virus. It was this simple experiment that, several generations later, led to the eradication of smallpox in America and most of the world.7 Although it was the Chinese who first used this technique, Jenner was named the Father of Vaccinology.
By the first half of this century, new medical discoveries had dramatically altered the face of Western medicine. Soaring past ancient horizons, medicine's innovations unveiled frontiers never before explored by even the most adventurous of healers. British bacteriologist Alexander Fleming was one such pathfinder. Returning from vacation in 1928, the pioneering scientist was cleaning up his laboratory and discarding used culture plates, when he observed something new: a fungus that had been flourishing on the culture plates in his absence was destroying the fringes of the deadly staphylococcus bacteria that had been smeared on the plates. His observations, although not fully appreciated and developed into penicillin until the 1940s, gave rise to a new era of treatment.8
At the same time government, academia, medical science, and the private sector, namely, drug companies with big dollars, formed previously unheard of alliances. Vast sums of government dollars were poured into medical research at medical schools and universities, and this powerful partnership9 began a miraculous wave of invention that launched Western medical care into an age of wondrous findings and technological advances. Smallpox and polio were virtually eradicated in the Western hemisphere; human eggs could be fertilized in test tubes instead of in the mother's womb; surgery and medical imaging, enhanced by computers and robotics, became commonplace; body organs could be transplanted from dead patients into living ones, from pigs to humans; and through innovations in communication, and remote surgery techniques, surgeons and patients could remain on opposite sides of the country during surgical procedures.
As we approach the end of this millennium, technology is advancing more rapidly than even such sci-fi legends as Robert Heinlein or Isaac Asimov could predict. We're entering the twenty-first century with people living well into their eighties and nineties; forty- and fifty-year-old women (an age that once marked the end of life) are giving birth; aging, withered bodies are being sustained by transplants, respirators, and feeding tubes, while women and men voluntarily hook themselves up to the Kevorkian death machine when they can no longer tolerate the pain of living with debilitating diseases.
It's no wonder that we've been misguided into thinking that our doctors, our external healers, are deities capable of performing the greatest of miracles. We don't just pray for such miracles; we expect them. When a doctor fails to meet our ever increasing demands for youth and immortality, we sue. We scream malpractice. Doctors work in fear of litigation, often feeling it necessary to order a battery of unnecessary and expensive tests.10
An Era of Alienation
For the first time in history, we're a generation for the most part sadly lacking the wisdom of those who went before us. We've abdicated responsibility for our health and turned our health problems to teams of specialists. And these doctors, not being generalists, are not in a position to see us as whole human beings. The result is alienation of the doctor and the patient.
We seem to have lost touch with common sense, that inner knowing that tells us the baby's cold needs to run its course, or you should elevate your foot and stay off it if you've twisted your ankle—the doctor would say the same thing. There was a time when cultures relied on this most valuable resource, common sense.
We have lost sight of the fact that healing messages are as individual as the beings searching for a cure. Because of medical progress, it has become easier to view the human body as a machine: take a number, line up, cut it out, cut it off; get the broken or diseased part fixed; forget about it. We have become faceless body parts in the medical maze. Doctors admit that it's easy to forget there is a person attached to the gallbladder, the lung, the breast.
One surgeon shared a story with me. He had recently done a routine gallbladder surgery on an older woman. Returning to his office for the postoperative exam, she stood clutching her fine leather bag as he breezed in to check her progress. He started talking, asking her questions. He didn't recognize her, but that was a pretty common thing since he had gotten so busy. He didn't recognize lots of patients. But the woman had this puzzled look on her face. "Who are you?" she asked indignantly, stopping him dead. Momentarily he thought, "Who am I? I'm the surgeon." He realized that he had never examined this woman while she was conscious, and that through arrogance he assumed all his patients knew him; after all, he was the doctor. This was a defining moment for him, and he actually left his group practice shortly after this seemingly benign encounter. The little woman, the gallbladder, clutching her bag, brought this well-known surgeon to his knees.
Dare or Death: It's A Game of Life Roulette
Life Roulette. The stakes soar faster than the wheel can turn. As we throw down a growing stack of cash for one more try in the game, pieces of doctors and patients dissipate among the ashes of malpractice, managed care, dwindling resources, and the needless, violent deaths. Children. Old people. No one is spared the pain of a medical system crying out for change. Perhaps it's the dwindling financial and human resources, or the mutant bacterial strains that antibiotics will no longer heal. Or is it cancer? AIDS? Violence? Guns? Gangs? Our inner city emergency rooms are turning thousands of patients away. Lined-up in halls, in waiting rooms, on park benches, their plea becomes a whisper lost in the murky residue of noise, cars, sirens and too many others. Quiet moments at any emergency room are rare, and they come suddenly, like the yellow-green stillness that falls over the trees, streets, and trailers just before the tornado's black funnel sweeps victims in its wake. While some patients are fortunate enough to have family or insurance to care for their needs, others are forced to seek solace in shelters rather than in the arms of a loved one. Others die, unnoticed, under bridges, near trash cans, in back alleys, in their cardboard beds.
Are We Managing Care, or Is It Managing Us?
Every one of us suffers for the needless excesses of our health care system. When most of our grandfathers, fathers, sons, or lovers were across the ocean fighting in World War II and women were working in factories, national health care dollars spent were about $4 billion. Half a century later, in 1992, the money spent on health care each year had soared to $800 billion, and conservative estimates indicate that number will soon exceed a trillion dollars.11