The Future of Health Care / Dr. Paulos Mar Gregorios PDF File
Allopathy or Western Medicine seems bound to recede, in the not too distant future, from its present dominance and monopoly of healing. The signs are unmistakable, though very few doctors and surgeons seem to be able to read the signs the way I do. I personally attribute that unwillingness or inability to their training and mind set.
We have briefly stated some of the reasons in our consultation papers on MEDICAL ANTHROPOLOGY AND ALTERNATIVE SYSTEMS OF HEALING. But they bear restatement.
First, the cost of western medical care has generally become exorbitant, and often beyond the means of a majority of the world’s people. The more technologized the methods of diagnosis and therapy, the higher the cost. Art Buchwald’s humorous column appearing in the Hindu of Sunday, October 16, 1994, is not just humour, but a cutting social satire, which deserves to be heeded. The point is this: the patient or patient’s relatives have, especially in the USA, little say in how much the diagnosis and therapy would cost; the doctor is held by the fear of being used against for not using all possible techniques of diagnosis and therapy; he therefore protects himself and prescribes expensive testing and treatment, and most people find that the* health insurance is exhausted before the treatment leads to cure. People are going bankrupt, or have to sell property to pay their medical bills. The situation is not radically different in many West European countries, though the insurance racket is perhaps less complicated. In India too, hospital expenses are a heavy burden on most domestic budgets. This has to change.
Second, we have enough documentation about the menacing growth of doctor-induced or hospital-induced pathology in all countries. The statistics on hiatrogenic ailments and hospitalisation is frightening. One takes great risks today in going to an Allopathic doctor for treatment. He may meddle with your body by chemical or surgical intervention which results in unexpected new pathological disturbances. There is great risk in western medical treatment as many people in all countries, including the present writer, can easily testify. The doctor or hospital may be careless, negligent or ignorant; sometimes even callous; it is the patient who suffers consequently.
Third, as Dr. Girija says in her article on “The Crisis of Health Care” in the same issue of the Hindu cited above, “The news from the Western Medical front is ominous. We who are so used to looking westward for all kinds of miracle cures are in for a shock. It has been recently reported that antibiotics have become increasingly ineffective. Many of the bacteria known to western doctors are said to have developed resistance to several widely used antibiotics. In the U.S. in 1992 alone 13,300 hospital patients died of infections that resisted every drug used. The crisis is serious enough for an American doctor to admit in a recent best-seller that western medicine’s purported triumph over infectious disease has become an illusion.”
The matter is more serious than what most people think. If the West is so scared of the Indian Plague outbreak, should we not be equally concerned about the West which should be declared an infected territory with many strains of disease-causing bacteria against which there seems to be no remedy? Tuberculosis, Meningitis, Malaria and Gonorrhea can be caused by some of these resistant strains.
The whole antibiotic culture, despite its achievement in saving many lives and healing many diseases previously thought to be uncurable, is certainly not an unmixed blessing, obviously. When we bragged some decades ago about our overcoming to certain infectious diseases, we hardly envisaged a scenario where our over-use of antibiotics leads to the generation of resistant strains of some of the deadly bacteria – a scenario in which human beings could be “overcome” by bacteria resistant to all antibiotics infection by these resistant strains should be viewed with as much alarm as the spread of AIDS. In both cases inescapable and proximate death seems to be the outcome.
It is time that the medical system abandoned the easy path of prescribing antibiotics for everything, including for viral infections! If we refuse to abandon this path catastrophe awaits us, globally.
Fourth, there is the over-chemicalisation of the earth and of human bodies, as also of animal bodies. In the west, cattle are also often fed with chemicals and treated with antibiotics, which then get lodged in milk and meat. Without knowing it we may be consuming more than a fair share of antibiotics, through our normal food intake. I am told that milk is certified to be saleable in the USA even if it contains traces of up to 80 different antibiotics. Through chemical fertilisers and chemically processed farm feed, we pump in tremendous quantities of chemicals both into the earth and into the human body. Food preservatives stuff more chemicals into the human body, and even into the earth through the disposal system. Chemicals are changing not only the human body, but also the human mind. The current upsurge of mindless violence in our societies may be at least in part due to the over-chemicalisation of body and brain. The life environment is itself ruined by over-chemicalisation of land, air and water. Only a civilisational change, including radical transformation of the industrial-technological culture and of the agricultural, nutritional and medical systems, can rescue us from this sad predicament.
Fifth we see a depersonalisation of healing, happening in the western system, due to overreliance on technology. Some people even envisage a situation where we would no longer need, in most illness to consult medical doctors at all; a home computer can connect to a central information network, and by feeding in the symptoms can get both diagnosis and prescriptions from the central computer. That may be quite desireable in certain ailments; but certainly healing is largely a matter of life imparting life, not machines and chemicals dispensing health in do-it yourself packages. The human element of the healing community is central and vital to human health. We cannot afford to mechnanise and technologise it, without disastrous consequences to the very structure of human personality. We have to arrest the over-technologisation of diagnosis and therapy, not merely because the technology is expensive; more because it is frighteningly dehumanising.
Sixth, we need to re-examine the near monopoly of the western medical system in the health care ministry. The Chinese are now waking up to this problem and the government is actively promoting Acupuncture, Acupressure, Herbal medicine, and other traditional Chinese healing systems. In Japan there is a whole movement for activating traditional Chinese and Japanese ways of healing, and to make them more scientific and efficient. The traditional Chinese word for good health ‘chi’ and its Japanese equivalent ‘ki’ are being revived and applied to new techniques like acupuncture using laser beams instead of needles (High Genki) and so on. Our own Deepak Chopra in California has managed to hit the New York Times bestseller list with his Ageless Body, Timeless Mind – A Practical Alternative to Growing Old (New York, 1993), which not only proposes Yoga and Ayurveda as alternative healing systems, but also proposes a radically new perspective on the human reality and the process of aging and healing. Chopra, a journalist who later was trained as a physician, has quite convincingly argued that the very world-view and view of humanity that prevails in Western Civilisation is at fault for many of the defects of the Allopathic system. The US National Institutes of Health have now (in 1993) by Congressional action, set up a 25 member Advisory Panel and an Office of Alternative Medicine. It seems Deepak Chopra is on the Panel.
Our own central government is not totally inactive in the matter of alternative systems of medicine and healing. The Indian Council of Medical Research is currently examining 30 herbal based substances for possible treatment of AIDS. We have now the prestigious Dhanvantari Award instituted in 1973. In 1975 and 1984 the award went to two Ayurvedic physicians, Dr. Shiv Sharma and Dr. Haridutt Shastri; in 1979 and 1987 it went to two Homoeopaths, Dr. Diwan Harish Chand and Dr. B. N. Chakravarti, and finally to Naturopath J. M. Jussawalla in 1989. There are Yogic/Naturopathic institutes in Delhi, Mongher, Bombay, Poona and Bangalore as well as elsewhere. Even abroad, the University of Turino in Italy, for example, has started Ayurveda courses with Indian collaboration.
Our Vice-President Shri K. R. Narayanan in a speech in Delhi advocated greater priority to traditional medicine (Indian Express 7 August 17, 1994). Dr. Jasbir Singh Bajaj, Member, Planning Commission, recently urged the 450,000 Allopathic doctors registered with the Medical Council of India to join with the 550,000 other healers on the rolls of the Central Council for Indian Medicine. That would make it a round one million of healers. The response so far from the MCI has been less than enthusiastic, because most western trained medical doctors hold to rather condescending and stereotyped generalisations about other healers.
The Indian Health Ministry has now a special cell for alternative systems of healing, as well as a separate department of Ayurveda with an initial investment of Rs. 26.5 crore. But all this is but a small beginning of the radical process of change required: mainly bringing up the standards in training and practice, and thereby raising the present low standing of alternative medicine; and then starting clinics in urban and rural centres where many systems of therapy are simultaneously available with high quality and low cost, to be chosen in each individual case between patient/patients’ people and a diagnostic team functioning at the Clinic, changing the therapy when necessary.
Despite better training facilities for Ayurveda and Homoeopathy, the standards in these alternative systems remain pathetically uneven. Even Ayurveda, badly practised, can do harm, as the present writer has discovered to his hurt. Besides, practitioners of Ayurveda are too easily tempted to use their license to dabble amateurishly in western medicine. Government will have to be more rigorous in monitoring the practice of medicine in all systems. Our Medical education in Ayurveda, Homoeopathy, Acupuncture and Siddha Vaidya will soon have to be brought up to a higher standard in special joint (with western medicine) training centres for these systems; it is absolutely necessary to give some training in these alternative systems to students of Allopathic medicine as well. The latter may be one way of raising the standards everywhere.
Dr. Girija may be exaggerating the problem in her concluding paragraph in the Hindu article cited above:
The writing is on the wall. The current crisis in Western medicine ought to remind us that our blind and continued reliance on this alien system of medicine can only lead to inevitable catastrophe. The only way out of this morass is to beat a hasty retreat and take to our traditional and time-tested systems of health care and medicine which have stood us in good stead for thousands of years. We can ignore this simple truth only at our own peril.
“Beating a hasty retreat” from Allopathy and “taking to our traditional systems” is not my solution to the problem which is very real. We will have to be more sophisticated than that.
Medical anthropology and theories of health and healing
Seventh, there is the large and difficult question of the theoretical foundations of modern western medicine. Those foundations are difficult to identify, because so much is assumed and so little clearly expressed about it.
The western medical system as we know it, is the product of two centuries of development, the same two centuries when modern science and the present secular civilisation grew up. In fact western medical theory is inseparable from those two factors – first modern science, with its conviction that a proper integration of experience and reflection, using human critical rationality and technological skill, without the aid of Religion or Tradition, gives us full access not only to truth, but also to the manipulation of realities, including the body-mind of human beings, according to our desires and purposes; secondly a secular civilisation in which God has nothing to do with not only medicine and healing, but also with the educational system, with the media including communication, literature and information, and with the newly created institutions and theory of political economy, of statecraft and democratic representation of the people in decision-making as well as of power distribution and regulation.
There is a shared world-view, not based on science, but held by scientists and others, often without criticial examination. Deepak Chopra calls it the assumptions which form the bedrock of our shared world-view, and goes on to list these assumptions thus:
1. There is an objective world independent of the observer, and our bodies are an aspect of this objective world.
2. The body is composed of clumps of matter separated from one another in time and space.
3. Mind and body are separate and independent from each other.
4. Materialism is primary, consciousness is secondary. In other words humans are physical machines that have learned to think.
5. Human awareness can be completely explained as the product of biochemistry.
6. As individuals, we are disconnected, self-contained entities.
7. Our perception of the world is automatic and gives us an accurate picture of how things really are.
8. Our true nature is totally defined by the body, ego and personality. We are wisps of memories and desires enclosed in packages of flesh and bones.
9. Time exists as an absolute and we are captives of that Absolute. No one escapes the ravages of time.
10. Suffering is necessary – it is part of reality. We are inevitable victims of sickness aging and death.
(Ageless, Body, Timeless Mind, op. cit. p. 4)
Deepak Chopra goes on to offer us ten alternative assumptions for “a new paradigm.” These new assumptions of the new paradigm, Chopra admits 7 “are also just creations of the human mind, but they allow us much more freedom and power.” These are “the makings of a new reality, yet all are grounded in the discoveries of quantum physics made almost a hundred years ago.” The seeds of this new paradigm were thus planted by Einstein, Bohr, Heisenberg and other pioneers of quantum physics. In other words, the new paradigm which Chopra proposes to us is still a science-based world view; only difference is that it is not the obsolete world view of Newtonian Physics, but the current and modern one of Quantum Physics. I will present to you his ten new assumptions for what they are worth, and then offer my own brief commentary, based both on the new science and the ancient traditions of humanity. Here are the ten new assumptions in Chopra’s own words:
1. The physical world, including our bodies is a response of the observer. We create our bodies as we create the experience of our world.
2. In their essential state, our bodies are composed of energy and information, not solid matter. This energy and information is an outcropping of infinite fields of energy and information spanning the universe.
3. The mind and body are inseparable one. The unity that is ‘me’ separates into two streams of experience. I experience the subjective stream as thoughts, feelings and desires. I experience the objective stream as my body. At a deeper level, however, the two streams meet at a single creative source. It is from this source that we are meant to live.
4. The biochemistry of the body is a product of awareness. Beliefs, thoughts and emotions create the chemical reactions that uphold life in every cell. An aging cell is the end product of awareness that has forgotten how to remain new.
5. Perception appears to be automatic, but in fact it is a learned phenomenon. The world you live in, including the experience of your body, is completely dictated by how you learned to perceive it. If you change your perception, you change the experience of your body and your world.
6. Impulses of intelligence create your body in new forms every second. What you are is the sum total of these impulses, and by changing their patterns, you will change.
7. Although each person seems separate and independent, all of us are connected patterns of intelligence that govern the whole cosmos. Our bodies are part of universal body, our minds an aspect of a universal mind.
8. Time does not exist as absolute, but only as eternity. Time is quantified eternity, timelessness chopped up into bits and pieces (second, hours, days, years) by us. What we call linear time is a reflection of how we perceive change. If we could perceive the changeless, time would cease to exist as we know it. We can learn to start metabolizing non-change, eternity, the absolute. By doing that, we will be ready to create the physiology of immortality.
9. Each of us inhabits a reality living beyond all change. Deep inside us, unknown to the five senses, is an innermost core of being, a field of non-change that creates personality, ego and body. This being is our essential state – it is who we really are.
10. We are not victims of aging, sickness, and death. These are part of the scenery, not the seer, who is immune to any form of change. This seer is the spirit, the expression of eternal being.
(Op. cit. pp. 5-7)
Deepak Chopra claims that all of these statements are grounded in the discoveries of quantum physics made almost a hundred years ago. I have difficulty in accepting that claim, for I detect many elements brought in from the ancient tradition of Upanishadic or Vedantic thought. I am not yet ready to accept the agelessness of the body. Neither am I able to phantasize a world within history where no one gets old. At the moment I cannot hear Quantum Physics telling me that the experience of a nonchanging reality lying beyond all change would give me the ability to control change. The name for such claims is not science but speculation. Deepak’s problem always seems to be the tendency to be carried away by a little scientific knowledge, into unbridled enthusiasm especially when playing to the American gallery. Hitting the New York Times Bestseller List is no guarantee of the truth of the contents of a book. It means largely that it is written to meet the requirements of an American Bestseller. But there is much in it with which one can enthusiastically agree: mind-body unity, the unity and interconnectedness of all reality, including knower, known and knowledge, that life is essentially a dance, the play of vibrations, the radical and basic unreliability of the five senses and sense-perception, that time-space is not absolute, that causality can be nonlocal or transcending time and space. Science does not prove these things to me. I recognise that presently available scientific data do not generally contradict these convictions.
The Immune System – Key to Healing and Health
The human immune system is the key to the new understanding of health and healing. But we seem to have inherited distorted perceptions of the function of this system. Our traditional paradigm for understanding the human immune system is that of a well equipped and massive army, armed with white corpuscles and antigens, standing ready to wage battle against any alien invasion in the human body. We conceive the function of the immune system to be basically defensive militantly so.
Our knowledge of the human immune system has grown dramatically in the last couple of decades: first because of the rise and development of a new composite discipline called Psycho-Neuro-Immunology or PNI; second because in the attempt to overcome the rejection by the body of alien organ transplants, medical science had to struggle hard to find ways of suppressing the immune system in order to enable the body to take the transplant. Today we are more ready to see the truth of Deepak Chopra’s Vedantic Scientific statement that the subjective and the objective streams of our experience both stem from the common origin of both, the true inner core of our being, which is timeless and unchanging. However that be, it seems now evident that the core of our identity as a unique human being is the immune system, which as the guardian of our unique identity, rejects the “other”, the alien transplant. I am indebted to Dr. Verma, former Director of NIMHANS in Bangalore, for that precious insight about the Immune System as the guardian of our unique identity.
But the immune system is more than merely the guard and defender of our unique identity. It is also the Master Healer within us. It is the most technically advanced healing centre in the Universe, equipped with all the tools needed for both diagnosis and therapy, if only we will listen to it and let it do its work. That is the principle on which whole systems like Homeopathy and Naturopathy are based letting the body-mind do its own healing, while we stand by and help in the process by boosting the immune system, by cleansing and deitoxification of the body, by providing a wholesome environment for the organism to breathe and live in, and by stimulating and exercising various parts of the body. Everyone knows that the Homeopathic system is totally based on the natural immune system doing the healing. The same is true to a large extent, of other alternative systems like Acupuncture/acupressure and Pranic Healing as well as Macrobiotics.
Healings as Rectifying Relationships
The major defect of western medicine is its taking the human body in isolation both for diagnosis and therapy. The living human person is a subsystem within a large complex system of relationships. Some of the most obvious elements on which the human subsystem is ever dependent are earth, fire, air and water, trees and animals, rain-clouds, the sun and moon, food and drink, the family ambiance, work satisfaction and social acceptance. But western medicine hardly ever takes these into consideration for diagnosis or therapy.
Our inner core which we call the Self, is both a giver and a taker. Alas, too often it tries to take more than it gives. It is greedy and acquisitive, either exploitative or parasitic, either dominating or enslaved, and but seldom caring for others or nurturing the needy; it expects others to fit into one’s own world, and when they do not, react violently and in anger or frustration.When relations are ruined, health goes to ruin as well. The greatest source of pathology in the human is the disoriented inner core, bent on making itself the centre of everything, seeking to dominate and exploit all, hating those who do not respond, and ruining relationships.
Healing follows restored and right relationships. The central defect of Deepak Chopra’s work is the failure to take relationships as central, and its focussing too heavily on the individual and his/her overcoming aging and sickness, beating entropy and death. One’s own inner core is important but it does not exist in isolation from other people’s inner cores. True relationship is community, where the centre is not in the one or the other, but in the whole. Not only western medicine, but even Ayurveda and Homeopathy often fail to take this into account. The role of the Christian Confessional in healing was always restoring relationships with others as also with the Transcendent. Its modern secular substitute, Psychoanalysis/Psychotherapy does not always give due importance to restoring right relationships – with others or with the Transcendent.
Attitudes are fundamental for health and healing – attitudes towards oneself, towards Reality as such, towards one’s own stress and suffering, but also attitudes to others to their woes and joys, to their ills and sorrows to their welfare and fulfilment.
I am an Eastern Orthodox bishop. My people call me Hasyo deelan, which means “Our Healer.” True spiritual ministry is the healing of people – body and soul. In our tradition, salvation means healing, giving life where death rules. To save means to make alive. That includes deliverance from not only Hell, but also from the power of death and of evil as well. But not just from a future Hell where the flame is never quenched and the worm dies not. Salvation means also delivering people, and that not just Christians, from present Hell, the hell of stress and anxiety, of guilt and fear of condemnation, of pain and torment in all forms, from disease and sickness, from evil and fear of death.
It is as part of that universal healing ministry that I am committed to the renewal of western medicine on a more genuinely wholistic and human basis, as well as to the revival and revitalisation of traditional systems of healing, so that all systems of healing can be at the service of all humanity, especially of the poor and the marginalised.
In this preliminary consultation, we should look at the whole scenario of diverse healing systems without bias or dogma. We shall be as unsparing in our critique of alternative systems, as of the dominant system. Our basic purpose is the revitalisation and reorientation of all healing systems, and their simultaneous and integrated availability to people, first in a few “Polytherapic Healing Centres” on an experimental basis, and later, everywhere in the world.