Tuesday, August 31, 2010

The Place Where We Think From; Perspective in Healthcare


View from my new house in Dhadagaun. A Place to Think.

Compared with many in steady work I have a lot of spare time. My working day is from 8.30am - 4.00pm, but I work only three days per week. The other days are entirely in my hands to fill as the mood takes me. I can do something ‘meaningful’ as Saint-ExupĂ©ry's Little Prince learns adults are supposed to do, or I can do nothing. When we consider that though, it is in fact impossible to do nothing. Even if we sit and appear to do nothing, our minds are gently sifting and sorting events from previous days, or even years. With nothing pressing to worry about, our minds sort more effectively. We throw away concerns that are no longer really concerns, and process mental conflicts to a conclusion, instead of letting them buzz round and round in our heads ad infinitum, until they have ‘snowballed’ to abnormal and frightening proportions.
It doesn’t really matter what we do in our spare time, so long as it is done at our own pace. Doing things at our own pace allows mental processing time, albeit subconsciously. Going for a ride on our bike over rough ground requires much concentration, often to the exclusion of everything else, a bit like juggling. I challenge anyone to juggle three balls and think about their shopping list at the same time; it’s not possible. Such activities in themselves become a form of meditation or hypnosis. They are more productive than sleeping, because we have something all encompassing to occupy our conscious brain at the same time. In the early stages of sleep we tend to run through past events, and if those events were cause for anxiety, in the absence of other demanding stimuli like juggling to occupy our minds, we stay alert and never reach a state of ‘calm’. Sleep is therefore poor. It is hypothesized that sleep is more about mental processing than physical recovery, thus we can get away with only four hours of sleep daily, but only if it is quality sleep.
 
Whilst life is never without its stressors, some are more manageable than others. Long term spare time, as opposed to a two week holiday in the Med.; which doesn’t even give time to switch off from work properly before returning for more of the same, allows a real chance to take stock and consider the route to the next desire or goal. We might not know what the next goal is, but with desire we can take steps in the right direction, hoping the true goal will become clear on the way.
 
So, while doing ‘nothing’ recently, I found myself thinking about, thinking. I have been thinking about thinking for some time actually, but the process of sorting all those thoughts into order enough to write about has taken some time. The instigator for wanting to write this is primarily my bewilderment at why the medical profession in many areas still shuns Osteopathy. Distancing themselves from faith healers I can understand, but failing to make an effort to understand something that is 100% scientifically explainable is perplexing to say the least, especially in light of my current employment. 
 
Our thoughts are the result of a combination of the chemical interactions in our brains, and our minds. Scientists and philosophers alike have long tried to establish whether the mind and brain are one and the same, or distinct entities. As far as I’m concerned, the jury is still out. Personally at the moment I favour the separate entities idea. Clinicians favour the ‘same thing’ idea. The Dalai Lama goes for separate. Clinicians tend to be constrained by the thought that everything must be scientifically provable. But if everyone followed all the Dalai Lama’s ideas, which include celibacy, the species would become extinct. So maybe we need to find some middle ground here. The mind has elements that are more than just the sum of interactions between physical bodies (atoms/molecules etc). There is influence from ‘other worldly’ events too, and other unexplained observations. 
 
For example, the Earths tides are created because of the gravitational pull of our moon. Considering that the human body is approximately 65% water, how is it affected by the moon’s forces? We know it is, but quantifying it is not so simple. At the other end of the scale, each of our trillions of cells contains what scientists call ‘junk’ DNA; it comprises 50% of our entire DNA pool. Nature doesn’t create ‘junk’, so what purpose does this ‘redundant’ 50% have? 
 
I am not suggesting we suddenly pay heed to Russell Grant’s Astrology Column, that’s merely one person’s interpretation of potential extra terrestrial influences. This is more a case of considering what we know, or to be more precise, what we think we know, and considering the place from which we think the things we think.
 
We know what we know until we learn something new which supersedes that knowledge. Our new found knowledge re-positions our perspective on life. To quote a line from my favourite movie, Men In Black, “1500 years ago everybody KNEW the Earth was the centre of the universe, 500 years ago everybody KNEW the Earth was flat and 15 minutes ago you KNEW that people are alone on this planet. Imagine what you’ll KNOW tomorrow.” That has to be one of the most poignant lines in any movie.
 
The theories of Hipparchus and Ptolemy stated the Earth was at the centre of our Solar system; with the planets, including the sun, revolving around the Earth. This theory stood firm for more than 1500 years until the early 1500s AD, when Copernicus trashed it, saying the Sun was at the centre, and everything else in our system revolved around that. For those 1500 years, everybody KNEW the Earth was the centre of the universe. To contradict this ‘fact’ was considered heretic as Galileo was to find this out the hard way, by standing against that extraordinarily resolute boys club known as the Catholic Church (CC Boys Club).
 
The number of years we live before learning such seminal facts is determined by our openness and opportunities to learn. In the time of Kepler and Copernicus, access to reliable science was more limited than it is today. Thus 1500yrs passed before people came around to a new way of thinking and seeing their world. New knowledge changes the way we view our world and those in it. For someone born in 100BC, whether the Earth revolved around the Sun or vice versa was of little consequence, but for today’s space travelers it’s rather fundamental.
 
Of course not all revelations concern such distant happenings. Early physicians believed our blood was an invariable medium throughout the species. Thus when Blundell performed the first blood transfusion in 1818, supported by the belief that his patient’s internal bleeding would be rectified by supplementing with an external source, his patient died. The reason was not known until Landsteiner’s discovery in 1901 of three distinct blood groups; A, B & C (now known as O); and that each group has a built-in spontaneous defense mechanism that is triggered when mixed with blood from certain other groups. The fourth group, AB, was discovered a year later in 1902. Now of course this fact is considered fundamental basic science. Everybody knows we cannot just inject blood from one person into another, without first knowing which blood group they possess, unless we want to play Russian Roulette with their lives.
 
Nearly 100 yrs passed before physicians stopped killing a high percentage of their patients with this transfusion technique. Now, there is much debate over the ethics of lethal injections in the name of euthanasia. Society’s acceptance of such practice ignores the fact that physicians of old did it in the name of science, supported by the uninformed belief they were helping, despite still mystified as to why many patients died. This is a very real, physical example of changing views based on understanding of the day.
 
Let’s look at a less tangible example of belief. Imagine a child being told by their mother, “If you suck your thumb it will get smaller and when you get older, you won't have one”. There is no validity in this comment; on the contrary, if you continually suck your thumb in your growing years, it is more likely it will get longer! But the child spends the rest of their growing years fearful of putting their hands near their mouth in case they should inadvertently suck a finger or thumb off! In adulthood they might have difficulty eating with their hands as a result of this imprinting or in fact doing anything that involves their hands near their faces. All based on a totally irrational story; blind belief without question. This is called classical conditioning and affects every one of us in many unseen ways. Sucking thumbs is actually an entirely normal practice. Research has shown thumbs are often sucked as a surrogate nipple. An action observed in children who have been shown little physical contact from their mothers in the weaning stages of development.
 
To admit a life was spent under the misapprehension of certain beliefs is difficult. The creationist versus evolutionary theories show just how obstinate some mindsets can be in favour of personal views despite overwhelming evidence to the contrary. Egos, loss of face or embarrassment are in many ways greater barriers than just being ‘blind’ or unaware of alternative thinking.
 
At other times however, discovery of a significant new fact may spur us on by confirming long held beliefs, encouraging us to continue on our path. 
 
With new understanding our mindsets might view things differently. Thus it must be a great asset to progress to keep an open mind at all times and judge events not solely on scientific findings, but on end results, i.e. what we see and feel. Gladwell explained in ‘Blink’, that our intuitive powers are extraordinarily accurate, simply because they are not just feelings. Intuitions are the result of our brain assimilating an enormous amount of information in a very short period; too much in fact for us to rationalize and express verbally.
 
I read recently another of Gladwell’s short stories called ‘John Rock’s Error’, about the controversy created by the development of the birth control pill, and how subsequent research has shown that our understanding of a normal menstrual cycle is in fact wrong. Rock’s view, was based not only on observations of women in unnatural situations (modern city living), it was also heavily influenced once again by the ‘CC Boys Club’.
 
Scientific opinion on ovarian cancer has changed in light of recent research. It was found the lower incidence of ovarian cancer in the Japanese compared with the Americans is in fact mostly a product of lifestyle and diet. Paradoxically it is irritatingly gratifying how many of today’s medical conundrums conclude unnatural or unhealthy lifestyle and diet to be the cause. In other words, depriving our bodies of essential fuel that allow them to function properly on the one hand, and poisoning them with our toxic environments on the other. 
 
Scientific theories are valid until they are disproved or superseded. But not everything has yet been explained scientifically. All we know is NOT all there is to know. The absence of scientific proof does not mean that which is unexplained is invalid, without credibility or does not work. Science has yet to explain many things; gradually with time and research it explains more and more, but this is only done within the framework that is our current knowledge of the arrangement of things in our universe. Tomorrow, in light of new knowledge, that perspective may change so drastically as to throw all we KNOW now into disarray.
 
Man has been on this planet in his current form for close to 200,000 years, judging by current archeological findings. Whilst he has always used plants as a source of therapeutic remedies, they cannot be classed as pharmaceuticals. Pharmaceuticals have only really been in widespread use across the species for about 120 years. Morphine was first used as an anaesthetic in 1804, followed by cocaine in 1860 and phenol as antiseptic in 1865. This means approximately 199,880 years passed during which we survived well enough, without recourse to drugs, growing to today’s staggering world population of 6,862 million. That’s impressive by any animal’s standards. Clearly the physiology which drives us was working remarkably well. We may not understand it all, but indisputably it works.
 
I am sure even without a lot of expensive research, but just a little education, most people can appreciate a lifetime of burgers and chips is not going to be as healthy as one comprising locally grown, whole foods unadulterated with chemicals. Taking this a little further, if people really knew just what is happening to their food source these days, what the chicken they bought from the supermarket was actually fed on, and what exactly was sprayed onto the salads they think are so healthy, they would be shocked. They would also begin to realise just how far their current food source has strayed from the things our ancestors ate several generations back. (Recommended reading: Michael Pollan’s ‘The Omnivore’s Dilemma)
 
Not only has the nutritional value of our foods declined significantly as a result of depleted mineral reserves in land used year after year, with no attempt to replace lost nutrients through the use of real natural organic fertilizers, i.e. manure, but the level of chemical toxicity we are subjected to has increased alarmingly. At a time when we need more good nutrition to help detoxify these unwanted chemicals, we are actually getting less than before. Many of the chemicals we come into contact with today our bodies have not evolved to process at all; cavemen didn’t have to use up valuable energy detoxifying mercury amalgams or polycarbonates! Needless to say, such things hang around in our systems interfering with normal physiology, leading to a wealth of acute and degenerative disorders. This concept doesn’t take a highly educated brain to appreciate. If for every gallon of petrol you put in your car, you also put a handful of powdered plastic, sooner or later the engine will stop.  Its interesting that car manufacturers put ever increasingly sophisticated filters on the fuel line, but we still drink fluorinated and chlorinated water straight from the tap!
 
It is estimated the average human body contains about 10 trillion cells, give or take a few. It is also estimated we befriend 100 trillion bacteria, mostly in our bowels. We really do live on a knife edge balance between staying human, and allowing this profusion of bacterial and fungal spores to take over. Just look how quickly a body starts to decay once dead. The bacteria and mycosis run amok almost immediately once human life has stopped. We live in a true symbiotic relationship; the bacteria manufacture key nutrients essential for human life and help keep the fungus at bay. But our bacteria have not evolved to deal with anti-biotics in our beef and chlorine in our water supply. Pharmaceuticals and increasingly clever technology look for ways to keep us from falling off the knife edge, and yet, the answer is actually very simple. 
 
Instead of spending billions of dollars on scientific research and lining the pockets of drug companies, who fundamentally want to keep us sick or they would go out of business (that sounds cynical maybe, but not when you know about some of the practices carried out in the third world concerning drug supplies), effort should be put back into proper natural farming methods as our early ancestors developed. Thus the overwhelming chronic degenerative conditions seen in the world these days would be significantly reduced. (Dean Ornish’s Spectrum, contains more scientific data on reversing chronic conditions with diet alone, than most can be bothered to wade through. The research is overwhelmingly conclusive).
 
Back to thinking, about thinking, the belief that nature knows best is still, amazingly, contested by some clinicians, and yet those beliefs arise in the face of a lack of real understanding or ignorance. Just like Blundell unwittingly killed off patients ignorant to Landsteiner’s critical discovery 100 years later.
 
Excluding surgical procedures, I wonder how long it will take clinicians to realize it’s better to encourage that which we know works, instead of providing things that interfere with the normal. I am frequently asked in clinic if the nutritional supplements I have recommended will ‘interfere’ with their medication. This thinking shows just how out of touch with nature we have become. It is not possible for something that is essential for health to ‘interfere’. Without it you would be dead, drugs or no drugs! Drugs are designed to interfere with normal physiology and in doing so prevent the end products thought to be causing the problem. To put it bluntly, that’s a pretty arse-about-face way of thinking. To interfere is to fight; to swim against the current. It’s ok while you can keep it up, but entropy always wins. The moment you stop swimming, or tire, the unrelenting current washes you downstream without the slightest concern.
 
Sadly, because so many people don’t allow themselves time to think these days, they always want an instant cure for their health issues, thus the use of drugs will prevail.
 
Ironically the place from which we think historically has relied on the acquisition of new knowledge, and yet when it comes to accepting a natural approach to health, we actually need to unlearn and look backwards to old knowledge that is fast being lost.

Kathmandu, August 2010

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