Senate Hearing - Integrative Care: A Pathway to a Healthier Nation

Dear Subscribers,

This email is intended to be an informal commentary on the Senate hearing on integrative health care. Some of you wrote that the link did not work, others had no trouble. Obviously, I am clueless, but here is the link that worked for me:

http://help.senate.gov/Hearings/2009_02_26/2009_02_26.html

The hearing that was aired is 163 minutes long and several of you watched the whole video. Therefore, you must have found it interesting, as did I. The emails I have received thus far indicate that more or less half of you were truly encouraged by the fact that this type of testimony occurred in our Congress. There was a mood of excitement among the participants as well as internet audience. The other half was disturbed by this or that; the subject is so important that a public forum would not be a waste of time at all. I am simply too overextended to take on something of this magnitude.

Cynics First

If you are habitually skeptical, what you heard was either a competition to see who could be the most obsequious or it was politics as usual. If you are an optimist, you heard something to the effect of "President Obama wants to solve the health care crisis." The subject matter covered a really wide spectrum from school lunches and grassroots cadre to answer the call to service by educating others on preventative medicine to very big issues such as suspending official attempts to marginalize alternative medicine. I thought a lot of interesting ideas were logged onto the record, but my interim assessment is that while something positive could come of this, it will be a bureaucratic quagmire for a number of reasons, but I have other reservations, including the fact that MDs are spearheading attempts to integrate the odds and ends of alternative ideas they have assimilated into a frame of reference that was not designed to contain these odds and ends.

Once upon a time, I was very diplomatic and I tried valiantly to use the word "integrative" but I got rid of it when I realized that "integrative" implies there are no irreconcilable differences between modern medicine and traditional medicine. I believe the differences are, in fact, impossible to reconcile. Even if there were no profit motive, no lobbyists, no politicians on the take, and no insane regulations, the curriculum of each discipline is different. Therefore, if you stand back and let some of the excitement dissipate, what you really heard in the testimony was MD defectors whose chief claim to fame is that they take nutrition seriously. If you are Andrew Weil, you also take breathing seriously and he seems to be on the verge of making a convert of at least one senator. Unfortunately, these intellectual hobbies that make such good material for talk shows do not really make one holistic. Perhaps this is what integrative means to certain people: keep vaccinating and operating but remember to eat your cruciferous vegetables and think positively. . . while you breathe.

This is actually about as integrative as I have found most academic and treatment facilities to be. Medicine may be prohibitively expensive but it is profitable so only if the system of profiteering collapses is there any real promise for holistic medicine. In the meantime, "integrative" tends to refer to adjunctive measures that do not affect the cash flow of mainstream medicine. Yoga and massage and light aromatherapy and visualization do not jeopardize Big Pharma's wallet. Herbs do and, as we heard Dr. Ornish say years ago, diet does also.

Grassroots Initiatives

How far an American equivalent of the grassroots doctor could go depends on how we view our society and economy. If we absolutely cannot afford to offer modern medicine to everyone and if we believe as a society that everyone is at least entitled to the opportunity to be healthy, then a major investment in preventative medicine would be on the table. If indifferent to the plight of the disenfranchised, unemployed, and homeless, then we have an immense problem because either others pay for the care of their less fortunate brothers and sisters or we have two different systems of health care, one for the rich and another for the poor.

To some extent, we could say there is nothing new about such initiatives. We might argue that teaching drug users not to share needles is preventative medicine. Educating parents and schools to omit corn syrup in the food served to children infringes on vested interests so the chance of the importance of this message being heard is significantly less than the public service announcements and posters aimed at drug users. The odds that the ultimate message would be any more honest that the ridiculous food group presentations used to indoctrinate us are therefore commensurately lower.

Nevertheless, preventative medicine is obviously the place to start, but it must perforce include enormous issues such as dental amalgams, chlorination and fluoridation of water, and even what can be flushed down the toilet and ultimately into our Prozac-laced water supply. The issue is thus whether or not we can really be serious and, if so, just how serious can be become. This is why I think a bureaucratic quagmire is inevitable and any real effort to fix what is broken in the system will meet fierce resistance.

Training

I have never asked a doctor how long it takes to become a competent medical doctor. Obviously, the academic training only produces people who are able to master the curriculum the way it is presented. Experience comes later and expertise and excellence come later yet. For herbal medicine, there are a few schools with varying content, but I think it takes a typical herbalist about 14 years to feel reasonably competent about fundamentals and it will take yet another 7 years to be good enough to formulate without relying on textbooks. In short, what I am saying is that herbal medicine is a completely separate discipline just as chiropractic medicine, acupuncture, massage, and psychology are separate from modern medicine. To do as Dr. Weil suggested, i.e., give conventional medicine more responsibility for herbal medicine would pose a risk to what herbalists themselves value about their plant medicines.

Big Pharma is predisposed to look for active constituents and predictable components. They therefore favor isolating the active chemical and standardizing formulas to a prescribed content of their favored constituent. If the same methods were applied to the wine industry, we would not have any vintages much less varieties such as Merlot or Burgundy or Bordeaux. In fact, we might not even be willing to differentiate red wines and white because we would decide that only type is suitable. The plant world thrives on diversity, not the type of standardization that lends itself to the assembly line efficiency. More importantly, plants adapt to soil and climate and pollutants so allowing for nearly endless variation is probably critical to our survival. In short, I would hate to see herbal medicine overseen by the medical profession. To be really emphatic: let the herbalists do what they do best and that is to grow an amazing profusion of herbs and harvest them at the peak of their perfection and make them into extraordinary formulas. It is as impossible to imagine the medical profession making good herbs as it is to think a burger flipper from a truck stop can make a good soufflé.

In Sum

While we speak, our fundamental right to eat what we choose and to grow our food the way we want is in jeopardy. This has occurred because of megalomaniac industrial food producers who have not just cornered the market on food sale but nearly destroyed biodiversity . . . and along with this the family farm and the traditional farming practices that have sustained civilization for thousands of years. Agrobusiness has a long reach and seeks a monopoly that would impact how land is used as well as what is grown on the land. One of the many miracles of plants, whether used for food or medicine, is their generosity. They produce many seeds, seeds that assure their own survival as well as ours. To produce terminator seeds is the ultimate violation of laws of Nature and we all stand in peril because of this senseless and criminal behavior. Why would we willingly surrender more authority over our food or medicine to an industry that has abused its power to this extent?

In sum, then, I have to say that appealing as the doctors testifying at the Senate hearing were, I personally see alternative medicine and nutrition as subjects outside the curriculum of mainstream medicine so I would prefer to see patients seeking nutritional advice from those with expertise and specialization rather than those who picked up some interesting ideas here and there. Likewise, much as I would hope to live long enough to see the end of persecution of alternative medicine, I do not want the alternatives to be swallowed up by mainstream medicine and then buried.

Blessings,

Ingrid