"The penalty good men pay for indifference to public affairs is to be ruled by evil men." attributed to Plato

"Bad men need nothing more to compass their ends, than that good men should look on and do nothing." attributed to Edmund Burke

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Thursday, 4 August 2011

Myalgic Encephalomyelitis or Chronic Fatigue Syndrome and holistic healthcare

There has been some debate going on in the last week or so about the real cause of that little understood medical condition that used to be called Myalgic Encephalomyelitis, ME, or the post-viral fatigue syndrome, and is now more commonly referred to, in Britain anyway, as Chronic Fatigue Syndrome. In Opinion, in The Times today, David Aaronovitch gives his own take on this. He shares my own scepticism that science must and eventually will find physical explanations for all manner of disease. “There is no medical utopia, and the search for a biological answer to all our problems is a false trail. We humans are more complicated than that,” he writes. And there is no shame in having a “psychosomatic” disorder – it is as real as any other disorder – it is just that the causes are more nebulous and ill-defined.
Now some of the debate here, continued into the letter pages, is around the funding that is available for research into this very real and debilitating condition. I suffered from this condition myself at University many years ago although no name was then given to my complaint. But I do know it was very real for me at the time, and totally incapacitating. Yes research is certainly needed and I agree that there must be a balance between exploring the different potential physical and mental causes.
But those from both sides of the debate would do well to read a small gem of a book, A Year Lost and Found, written by the late Michael Mayne, busy parish priest who subsequently became Dean of Westminster Abbey within the Anglican Communion. He was well qualified to write about ME or CFS and the patient’s perception of healthcare. In his book A Year Lost and Found he describes his experiences and struggle with a debilitating episode of the condition. Of all the various treatments and advice he received he significantly gives special credit to a certain Dr D, whose particular efficacy in helping him cope with his condition is attributed to

“his grasp of the inter-relatedness of body and spirit…he talked and he tested or massaged parts of my body. Sometimes he just talked. He had the great gift of encouragement. He understood that the question ‘How are you?’ is at root a metaphysical question, which is not sufficiently answered with clinical lists and data …but goes to the deepest part of ourselves as the complex and uniquely precious beings we are.”

Mayne tragically died from cancer in 2006, but not before heroically putting the finishing touches to his final book The Enduring Melody. This started as a meditation of his life, but when the cancer struck it became his daily meditations interwoven into an autobiography of his final year. The book is a brave and very thoughtful journal through those last ten months. It culminates in a reflective essay on illness and healing, and the need for a holistic approach. ‘To treat a disease,’ he said:

“is to inhibit it and hopefully help the body to destroy it or control it: to treat a patient is to observe, foster, nurture and listen to a life...In an ideal [health service] it would be good if every doctor and nurse in training would reflect on the mystery of the human being with both the learning of the scientist and the observation and sympathy of the novelist or the poet.”

He was writing of the United Kingdom’s National Health Service but his thoughts are equally relevant in the United States, which is actually ahead of the UK in recognizing the importance of spirituality in healthcare.
Mayne understood only too well that chasm that is so often evident between what the patient actually receives from a short medical consultation and what he is really looking for.
Of course credit should be given for the advances that are being made in medical science, the technological achievements, the surgical and clinical skills, the development of ever more efficacious drugs and the efforts of the very many health care professionals working competently and tirelessly using best knowledge, experience and facilities for the benefit of the patient.
Perhaps more doctors than we realize do understand and practice the philosophy of holistic health care, with due regard to the full impact of body, mind and spirit in considering the ‘wellness’ of the person. Even so it is unlikely that this can often be realistically achieved within the normal time constraints of a busy practice. Nevertheless there is an opportunity here that should not be ignored; indeed we may not be able to ignore it for much longer. I read today that in Britain there will be 80,000 centenarians by 2033, compared with 11,600 in 2009, and the numbers will continue to increase rapidly. As we all live so much longer the financial drain on our health services will become unsustainable if we continue to insist on drugs to cure all our ills. I believe strongly that we need to work towards a far more holistic healthcare, and one also in which we take far more personal responsibility for our well being. How about more yoga, meditation, tai chi, healthier diets, and yes even psychotherapy or mindfulness cognitive behavioural therapy for a start, to help slow us down, relieve hypertension and reduce our cholesterol, sort out our minds, help us cope better with what life throws at us, rather than continuing our national culture of pill-popping for every ill without question and expecting scientific explanation for everything we experience?

(this is developed in some more detail in my book Healing This Wounded Earth, in two comprehensive chapters on The History of Soul Medicine and The Hope of Soul Medicine)

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