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Sunday, 29 December 2013

History of Western Medicine contd: Soul Medicine

There have been glimmers of hope in the development of what I like to call “soul medicine” but sometimes they seem to be lost from view.
In its 1990 definition of palliative care, the World Health Organization said that the
‘control of … psychological, social and spiritual problems is paramount’ in the total care package of those with incurable disease.
At the same time, Michael Kearney, clearly not sharing the optimism of Dossey or the W.H.O., was predicting that the holistic focus in palliative care (let alone in the wider medical field) was in danger of being lost under the weight of the biomedical model of medicine (1) and the narrow mindedness of those who paid attention only to physical symptoms, whom he called ‘symptomologists’. His concerns were justified. Only a few years later in a paper in Progress in Palliative Care a leader in the field, Sam Ahmedzai, wrote in his editorial: The view now, within palliative medicine, is that it is okay to be symptomologists, and proud of it …Ultimately, suffering from losses, lack of love, existential doubts as well as from poverty and cruelty are not medical issues, and the response to them is not necessarily the responsibility of any healthcare discipline (2).

Surely those who have argued for the exclusion of psychological concerns from the field of medicine, let alone spiritual elements, must be mistaken? 

Many have campaigned over the years for a greater understanding of suffering and holistic healing in a medical context. This first assumed some recognition in the UK within the field of cancer and other terminal illness care, where an understanding was developed within the hospice movement, founded in 1967 on the ideas of Dame Cicely Saunders. The spiritual theme of medical care is also picked up by Michael Lerner who has a special interest in mind/body health in the care of cancer patients. In his book, Choices in Healing, (3) he explores the very diverse range of mainstream and complementary treatments available to the cancer patient. These include for example the practice of Yoga and the power of prayer, in addition to shamanism, all clearly understanding the importance of the inner life of the mind and spirit to the overall well being of a patient in the context of a terminal illness. Some of this is inevitably out of date in a fast changing world but Lerner’s book is still available as a valuable overview of the wealth of ideas and treatments available. The book is well illustrated from literary sources that delightfully complement the consideration of the technical aspects of treatments.

Michael Kearney, palliative care consultant and former medical director of palliative care at Our Lady's Hospice in Dublin, Ireland, has also long campaigned for medical practitioners to pay more attention to the interactions of body, mind and spirit in healthcare (4). He writes of the ‘deep’ as well as the ‘surface’ elements of suffering, and the patient’s “soul pain” that must be acknowledged in addition to the physical pain. He suggested that the principles of Asklepian healing should be taught alongside the traditional and well-established Hippocratic style training almost universally taught in medical schools today, so that they can again work together as happened in Hippocrates’ day.
Healing, he says, needs to be given the environment in which the natural human psyche can be given the space to take over and do its own healing work. 

The overriding problem in healthcare today seems to be that too often our doctors are ‘Techno-doctors’ (5) and ‘Super Specialists’ in a system that reduces patients to paper statistics and doctors to slaves of machinery, forgetting the importance of the personal, the subjective and the social aspects of care. ‘By their very nature doctors deal with bits and pieces – microbes, hormone deficiencies or tumors – while patients experience illness as the disorders, disruption and possible disintegration of their ordinary lives…Every healing art sees illness in its own terms. Patients need to remember that the illness is theirs and theirs alone.’(6) And perhaps some physicians need to remember this also?

Apart from the palliative care available for patients at the end of life, it still seems that the different forms of spiritual and religious healthcare (S/RH), complementary and alternative medicine (CAMs) and conventional allopathic clinical practice are not working together as well as they could and should. Many of the CAMs are gaining credibility within mainstream traditional healthcare but the influence of S/RH lags woefully behind.

To be contd...


(1) in Foreword by Balfour Mount p viii to Kearney, Michael, A Place of Healing: Working with Suffering in Living and Dying, Oxford University Press, USA (November 30, 2000), p. 31. Now see Place of Healing: Working With Nature And Soul At The End (Spring Journal paperback, August 27, 2009)

(2) Sam H.Ahmedzai (1997) ‘Five years: five threads’ (editorial, Progress in Palliative Care, 5(6), 235-7

(3) Lerner, Michael, Choices in Healing; Integrating the Best of Conventional and Complementary Approaches to Cancer, Cambridge, Massachusetts: MIT Press paperback edition 1998, p.123.

(4) This is explored in much more detail in Michael Kearney, A Place of Healing, 2000, foreword by Balfour Mount p. iv. Now see Place of Healing: Working With Nature And Soul At The End (Spring Journal paperback, August 27, 2009)

(5) Helman, Cecil, Suburban Shaman: Tales from Medicine’s Frontline, London: Hammersmith Press, 2006, pp. 5.

(6) Ted Kaptchuk and Michael Croucher, 1986, pp. 26, 37, cited in Mayne, Michael, A Year Lost and Found, London: Darton Longman and Todd, 1987, p. 38.

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