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Sunday, November 15, 2009

The Other Healthcare Crisis

There’s more than one healthcare crisis in this country. Of course, there’s the issue of coverage for everyone, but another crisis is exemplified by just how callous, narrow-minded, and often ineffectual our current medical system is.

17 years ago I was paralyzed from the neck down with a crushed spinal cord and brain damage. Thankfully, my total quadriplegia was short-lived and through both hard work and good luck I was able to recover most of my previous abilities.

But the sad truth was that most of my recovery was achieved not because of, but rather in spite of our vaunted medical system. Very little of it was due to traditional Western medical treatment. In fact, even when I was completely paralyzed and in almost inconceivable pain, I still had to summon the strength and fortitude to argue many times with the hospital staff to force access to alternative and non-traditional therapies.

I even had to fight to see my own chart, because once they found that I was having my wife read it me, they physically removed it. My entire hospitalization seemed designed to disempower me, to leave me helpless and dependent.

The assaults on my sanity and dignity that I suffered while a quadriplegic were extreme: One day a doctor breezed into my room with a gaggle of mostly female medical students in tow. He ripped off my sheet without even a ‘hello’, leaving me completely naked and shivering, and proclaimed ‘this man is obviously seriously neurologically compromised and will never function normally or walk again’. He then breezed out, without even bothering to cover me up. I shudder to think that this is the bedside manner taught to medical students, and I am amazed that doctors are either not cognizant of the profound psychological effects that their pronouncements have on patients, or simply don’t care. The power of suggestion, especially from an authority figure like a doctor, is a real, palpable phenomenon, yet they continue to blithely say terribly frightening and destructive things, ignorant of the fact that their words can have physical, even mortal consequences.

Another day I was dragged off, without warning or explanation, and left shivering on a gurney alone in a back hallway for hours, until I was finally dragged off somewhere else for a new round of tests.

I was traumatized, not just by my accident, but by this inhumane treatment. Some of the staff, particularly the doctors, treated me as an idiot or some kind of manikin, to be poked and prodded without regard for my pain, my emotions, or my dignity. And in all the time I was there, not one mental health professional visited me to see if they could help me retain my sanity and process what was happening to me.

Even more ironic was the reaction I got when I exceeded the doctor’s expectations wildly.

At best, I was supposed to never be able to handle stairs again, and to be in rehab for 6 months. Instead, I left after 3 weeks under my own power to a four story walk-up apartment. When I returned for a check up 6 weeks later, the neurologists clustered around me, amazed that my right arm, which had been clenched like a stroke-victim’s, was now working quite well. They proclaimed me a ‘miracle’. When I interjected that I was most certainly not a miracle, but rather the product of much hard work and Chinese Medicine, Chi Gung, and numerous other alternative therapies, they demurred – “oh, we don’t believe in that ‘chi’ claptrap”, they said.

There was no open-mindedness among these supposedly empirical, scientific men, and no real curiosity about how I’d accomplished my practically unprecedented recovery. They knew better than the patient, case closed. They then prescribed a powerful drug for my spasticity that almost killed me. I quit the drug and redoubled my chi gung , which didn’t mask the rigidity and spasticity as the drug did, but rather allowed me to access my clenched muscles and learn how to release them.

It’s ironic that in the years since, when my symptoms have returned, it is always the alternative therapies, the ones not covered by my insurance, which have helped me. Countless other people challenged by chronic disease or injury have also found their most efficacious treatment in alternative, unsanctioned modalities.

Double-blind studies have proven the efficacy of some of these, like homeopathy and chi-gung – even though Western medicine can’t figure out how they work.

But homeopathic medicine is cheap, and chi-gung, once you know it, is free. There’s no profit in it for the corporate medical infrastructure. And so instead we have a system that promotes big-ticket items like MRIs, radioactive tracers, and expensive and dangerous drugs.

It’s been known for years that two people can have equally disturbing x-rays and MRIs, yet one can be wheelchair-bound and in terrible pain while the other plays tennis daily with no symptoms – but Western medicine seems oddly incurious about these suggestive nuances..

Luckily for me, I tend to rail against authority, so the dire pronouncements I’ve received have been more like challenges. A doctor tells me I’ll never walk again, I say oh yeah? And then I proceed to hike, bike, scuba dive, and generally thumb my nose at his supposed authority.

But not everyone is as rebellious or perhaps resilient as I have been. We need a health care system that is interested in results, not the bottom line, and we need to educate our doctors to retain their humanity, to foster a real connection with their patients, and to be cognizant of their patient’s internal lives and psychological needs.

Recently, a doctor told me that I had the worst spine she’d seen in thirty years. What possible therapeutic value was there in this comment? It only served to frighten and depress me. Why on earth didn’t she know that? Why aren’t doctors trained to be people first, healers second, and technicians third, instead of the other way around? When was the last time a radiologist or neurosurgeon or even your GP or internist touched you, either physically or emotionally, in a warm, giving, empathetic way? When did they engage in a meaningful dialogue wherein they listened respectfully as you described your symptoms without constant interjection? When was the last time you felt cared for, in the truest sense of the word? If the answer is recently, count yourself among the very lucky. Most of us are stuck with overworked, unimaginative technicians who throw drugs and MRIs at everything by reflex.

We need a healthcare system that treats people – doctors and patients - as thinking, feeling individuals, not pieces of meat; one that prizes prevention and personal do-it-yourself responsibility over risky procedures and overlapping prescriptions of drugs, all of which interact in ill-understood ways to produce vicious side effects. Our healthcare industry in general has strayed away from the true meaning of healing. It’s become a haven for apparatchiks, technocrats, arrogant high-priests, and cynical businessmen.

Here, as in so many other areas of our society, empathy, and humanity need to be restored to the fore for real healing to take place.