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TIMES ARE CHANGING!
Why are millions of Americans, especially those who are better educated, spending billions of dollars every year on a wide variety of alternative, complementary, or holistic therapies such as herbs, acupuncture, and meditation? Why are they either abandoning treatments recommended by their regular doctors or supplementing prescribed therapies with some other regimen that much of the medical establishment rejects or ridicules? And why are they doing so in view of the stunning achievements of the medical establishment? Just think. Using the scientific method, doctors have made it possible to bypass your coronary arteries; to change your heart valves; and to repair or replace your heart, liver, and kidneys and most of your joints. Cosmetic surgeons can leave you looking half your age. Your genes can be manipulated, and several inherited diseases can be prevented or cured. There are powerful new antibiotics to eradicate infections that used to kill. There are drugs to control pain, restore your sex drive, open the airways to your lungs, shrink your enlarged prostate, melt your gallstones, and promptly end migraine attacks. There are machines to shatter your kidney stones and regulate your heart rhythm. There are ways to remove your gallstones, appendix, ovaries, and other prized possessions without even cutting you open. Virtually invisible hearing aids can restore your lost hearing; you are able to read again the very next morning after your cataracts have been removed. So why the rush to explore radically different avenues of treatment?
The growing popularity of alternative medicine, despite all the accomplishments of medical science in this century, is the direct result of the many questions relating to health, well-being, and survival that remain unanswered. In the words of one great physician, Sir William Osler, Medicine is a science of uncertainty and an art of probability. Yes, we are living longer and better, thanks to antibiotics, safer anesthetics, improved surgical techniques, and innovative technical devices. But, this longer life span has, at the same time, left us vulnerable to many degenerative diseases that cripple and kill. We continue to suffer and die from cancer, rheumatoid arthritis, Parkinsons disease, multiple sclerosis, Alzheimers disease, AIDS, and emphysema. There is no way to stop arteries from clogging, cataracts from forming, prostates from enlarging, migraines from starting, or kidneys and livers from failing. These ailments can sometimes be slowed, but rarely prevented or cured. Worse, many of our best available treatments are ineffective and end up only prolonging the agony of death.
So the sick and vulnerable are hungry for other options, of which the most accessible, understandable, and appealing to the layperson is alternative medicine. Healthy people are also exploring, or at least considering, some form of alternative medicine because of the perception that following some of its basic tenets can help prevent disease before it starts--not always the primary goal of conventional medicine.
Another reason alternative medicine is gaining credibility is because the established medical profession is losing credibility--in part because doctors always seem to be changing their minds. Theories and practices that were presented as sacrosanct, indisputable, and inviolable often turn out to be harmful in the long run. Here are just a few examples of how conventional medicine has reversed its position on some important theories and practices:
--Thirty years ago, following a heart attack, the rule was six weeks of complete bed rest- -no phone calls, few visitors, and only a bedpan for diversion. In those days, any doctor who permitted such a patient to sit up at the edge of the bed after only one or two days, or sent him or her home in a week, as I do today, would have been severely criticized and would probably have lost his or her hospital privileges.
--In the mid 1970s, when Nathan Pritikin theorized that a low-fat, low-cholesterol diet, along with exercise, could reduce the incidence of heart disease, he was ridiculed by most doctors. Thats because he was only a Mr. and not an M.D. Twenty-five years later, those who were his most vocal detractors then are now practicing what he preached.
--Giving a nitroglycerin tablet under the tongue to relieve chest pain during an acute heart attack was also a major no-no. Today, doctors administer nitroglycerin to heart attack victims immediately--and intravenously!
--Not so long ago, if you had gallstones you were whisked into a hospital and had your gallbladder taken out without delay, even if you were symptom-free. Today, your doctor will probably advise against such surgery unless and until you develop symptoms.
--Think of all the lives that might have been lost had we scoffed at, and not tested, the ridiculous idea that an aspirin a day helps prevent strokes and heart attacks.
Small wonder, then, that there is growing conviction that despite its past and ongoing miracles, the medical establishment is not infallible and should take a hard look at some fresh and different concepts, philosophies, and approaches to the prevention and treatment of disease.
Why have most doctors refused to do so? I can assure you that its not because of any conspiracy to withhold cures and breakthroughs from the American people. All those books and magazine articles exposing the many secrets your doctor wont tell you because they threaten his income are paranoid hogwash. One reason for this reluctance is a fear that legitimizing alternative approaches may encourage patients to abandon treatments with a proven track record. Thats why some doctors feel more comfortable with the term complementary medicine, which implies a merger of conventional and unconventional techniques--rather than the wholesale disavowal of established therapies. Also, M.D.s are trained to look at facts, not act on rumors. The Hippocratic oath requires them to first, do no harm, to be cautious and careful in choosing any treatment, and to be convinced that it has a reasonable chance of success. The fact remains that much of alternative medicine has not been subjected to the rigorous scientific scrutiny high medical standards demand.
But the gap between conventional and unconventional practitioners is narrowing, as more and more doctors (and patients) realize that the other medicine can no longer be ignored, that any rational and promising approach must be evaluated impartially and scientifically. One of the main reasons for this attitude, in addition to societal pressure, is that newer diagnostic techniques, and the appreciation of the tie between the brain (where emotion is generated) and the immune system (whose strength and integrity determine vulnerability and resistance to disease), have resulted in a better understanding of how some forms of alternative medicine may be effective.
Alternative medicine has one foot out of the closet; its brown-paper wrapper has been torn away. Patients with cancer, especially those who have been written off, are trying hypnosis or acupuncture to control their pain, meditating, engaging in spiritual therapy, or experimenting with special diets. Chances are that if you have chronic backaches, your doctor may advise you to see a chiropractor or acupuncturist, or to try a relaxation technique, or a bodyworks treatment. If you have chronic insomnia, dont be surprised if your doctor first suggests chamomile tea or valerian at bedtime, before writing a prescription for a sleeping pill. And should you muster the courage to ask about chelation, royal jelly, or coffee enemas, while you will probably be told theyre worthless, your doctor will at least discuss them with you.
Even the National Institutes of Health, the very embodiment of the medical establishment, is expressing interest in some unorthodox therapies. At last count, its recently formed Office of Alternative Medicine and various other agencies of the federal government were spending more than $23 million a year to evaluate such diverse approaches as acupuncture for drug abuse, anti-HIV activity in plant compounds, and the efficacy of chiropractic. Several health insurance companies, such as American Western Life Insurance, Mutual of Omaha, a few Blue Cross plans, and others--members of an industry not especially known for its compassion or generosity--are now reimbursing policy holders who participate in wellness plans that include the Pritikin and Ornish programs for prevention of heart disease, as well as acupuncture, chiropractic, naturopathy, and techniques for relaxation and reduction of stress. And in 1997, the Oxford Health Plan began reimbursing for a wide variety of alternative therapies.
There has even been a softening toward unconventional medicine in academe. A Center for the Study of Alternative Medicine has been established by my friends Richard and Hinda Rosenthal at the medical school of Columbia University, offering elective courses for students, and seminars for interested health care professionals. More than a score of other medical schools have followed suit. Given its almost absolute authority with respect to what is good and bad in medical care, this new interest and flexibility on the part of organized medicine (by no means unanimous--there is still a core of diehards) is all the more remarkable. Establishment doctors are still demanding proof, as they should, but at least theyre looking outside their own bailiwick.
A word of warning: Unfortunately, many quacks and hustlers who call themselves alternative practitioners deal in fraud and deceit, not alternative medicine. Because of the hype that inevitably accompanies any different approach, you can never be sure whats real and legitimate, what will work and what wont, and whether its safe to abandon the tried and true therapy recommended by your own doctor. Theres really no place to obtain that information. If you investigate a particular complementary technique, youll usually find that its passionately and uncritically endorsed by its proponents, and violently and equally uncritically condemned by its detractors. There is no middle ground, very few open minds, and lots of name-calling.
I wrote this book to show that there is a middle ground. I hope it will provide answers to your questions, and that after reading it, you will be able to distinguish those treatments that may be useful from those that are futile, fraudulent, or fraught with danger. As a practicing doctor and member of the academic and medical establishment, who has tried promising alternative treatments, I have reviewed and evaluated the field unencumbered by preconceptions. In my search for the truth, I have interviewed many patients, including those who have ventured into the realm of alternative therapy; I have had frank discussions with many of its practitioners; and I have studied the world literature looking for documentation of the effectiveness of the more widely used unconventional treatments. I didnt find much in the traditional scientific journals because, quite frankly, the establishment has never encouraged the use of alternative therapies or reported their results. What studies there were rarely documented the claims made for complementary techniques. On the other hand, those done by unconventional practitioners and published in their own organs, while full of enthusiasm, are usually short on data. Keep in mind, though, that just because something hasnt been scientifically tested doesnt necessarily mean it cant be effective. Many of these interventions have been tested in the laboratory of human experience--and have passed with flying colors.
From the Hardcover edition.