medical model vs. ancient wisdom | hopefulandfree

The other day, a colleague asked me the following question (paraphrasing) :

?Hey, hopefulandfree, what do you think about the idea of?combining, say, dominant ?or traditional medicine with?ancient wisdoms, for lack of a better term?? ?

Huh? I didn?t know how to BEGIN a response that would sound even close to coherent.

However, I gave it a lot of thought.

For some reason, the following assorted?stuff (below) is EXACTLY the kind of thing that kept coming to mind while I kept turning over the COMPLEXITY involved with such a question.?Seriously. ?First, I tried to imagine an ?average patient? in the ?health care system.? Or at least a patient similar to someone I had actually encountered as a nursing student when I was doing my clinical rotation at a local, well-respected hospital.

Naturally, since my my imagination tends toward the?vivid side?this is the patient ?composite? I kept coming up with (based on NO ACTUAL HUMAN BEING, LIVING OR DECEASED. ARE WE CLEAR?)

A white, 31-year-old American woman who works as a Registered Dental Hygienist (RDH) in a mid-sized university town in Vermont; earns just over $45 an hour (with ?generous benefits?); commutes 12 miles to the dental practice where she works 3 days a week; has been married for 7 years to a Professor of Anthropology; does not have children; drives a one-year-old Hyundai Santa Fe with the works (heated leather seats, etc); takes two one-week vacations every year with her husband to relax at a rented beach house or mountain cabin; lives in a 4 bedroom house (1920s, restored) in a quiet part of the town near the university where her husband teaches; has 2 dogs (both yellow labs) and 3 cats (shelter rescues); cares for an aging (over grown) Iguana named ?Iggy? (unknown sex), which she?s kept as a pet in a massively over-sized aquarium since she was 14;?

she also grows a raised-bed vegetable garden each summer and keeps a large assortment of exotic flowering plants in brightly colored ceramic pots bordering three sides of her patio terrace where she and her husband?barbecue?and entertain guests outdoors on pleasant evenings (average of 2 times a month) between late May and early September; has her hair cut and colored (subtle highlights) at an upscale salon every 4 weeks; buys season lift tickets at a mountain resort where she snowboards 6-7 times each winter; visits with close girl friends once or twice a month (usually at her own home); goes to see theater movies (usually with her husband) 3-5 times a year; volunteers as a reader for sight-impaired elderly residents at an assisted living facility (near her husband?s campus) twice a month; watches movies on DVDs or instant Netflix once a week (or less often);?

?and she suffers from allergies to pet dander and most air-born (seasonal) flowering weeds but gets immunotherapy injections once a week to alleviate most symptoms; experiences chronic neck and shoulder pain (including severe muscle spasms at least 3 to 4 evenings a week) resulting from work tensions related to long hours of maintaining her body posture and muscle groups in rigid, awkward positions to ensure effective angles for close-up treatments on her patient?s teeth; sees about 9 patients on an average day; usually stays late (after work officially ends) for 45 to 60 minutes to review patient treatments and update patient notes and records (using latest dental office software), work which has to be delayed earlier in the day to make time for the continuing (almost nonstop) flow of patients; receives physical therapy twice a week on her days off and has therapeutic massages and?acupuncture treatments once a week;?

?she swims laps twice a week at a nearby club pool (for 30-40 minutes); purchases only organic products (from free range eggs to local grown greens), eats mostly unprocessed and ?whole? foods with no preservatives, abstains from wheat (suspected to aggravate Irritable Bowel Syndrome of unknown etiology), uses birth control pill, and takes multivitamins and assorted individual vitamins (making sure brands have no chemical additive, artificial ingredients, yeast or gluten); visits with siblings (2 brothers, one sister) two to three times a month (usually family style dinners at her own home or more rarely at homes of siblings and almost never at restaurants); walks her dogs for 3-4 miles each evening (after work) on a nature trail that follows the perimeter of a lake (man made) within walking distance of her back yard gate;?

?she sleeps about 7.5 hours a night on weekends and 6.3 hours on week nights; takes a 2-hour nap on Sunday afternoons when her husband visits his uncle (who has Alzheimer?s); was for several years quite phobic (near panic stricken) about large house spiders (not small ones) and circus clowns (appearing in places other than circuses) during?adolescence?but sought counselling during college years and now is hardly ever bothered by either ?issue? unless her levels of stress from work have been ?unusually extreme?; makes love with her husband, on average, 3.5 times a week; has participated in Wiccan-style spiritual retreats for women (only 3 times during the past decade but not since the time when she unknowingly ignored a group norm and was scolded by the self-appointed leader?an event which took place 4 years ago); has accompanied her husband to drumming circles and tribal-style sweat lodges on well over a dozen occasions during the past 6 years;?

?she does not attend church or believe in ?god? but listens to inspirational CDs by Pema Chodron and (much more rarely, in fact hardly ever anymore) Eckart Tolle while driving to work in the mornings; still listens to Smashing Pumpkins and Nirvana while completing household cleaning tasks on Saturday mornings; showers every morning and before bed but dislikes bubble baths and thus only uses their antique-like footed-bathtub (designed for soaking) when her husband lights candles and turns on romantic music, etc; has never played a game of golf in her life or had the desire?but secretly admires women golfers who hit it big in their twenties and retire by 35; was a champion-level volley ball player in high school;?

?she keeps a small stash of marijuana-infused gluten-free brownies in the back of her basement freezer for those days of the month; abstains from alcohol except for obligatory wedding toasts (the irritable bowel condition); visits her mother and father twice a year in nearby state (father and mother divorced amicably after their daughter completed college and they live ?minutes away from each other and probably still sleep together on holidays?)?and when visiting her parents she always uses the same airline, flight number and seat number for each trip because of minor superstitions (takes 0.5 Ativan tablet 30 minutes before boarding flight);?

?she purchases (and keeps current) maximum insurance coverage for self and husband (medical/life/mortgage/house/auto); contributes maximum allowed amount to 401K plan; keeps separate savings account in her own name for ?frivolous? purchases (imported hammock, back yard hot tub with massage jets as gift for husband, tandem bicycle for herself and 9 year old niece for occasions when niece visits 3-4 times during summer, miniature green house to grow organic tomatoes (remains unassembled in box in garage), surprise tickets to Greece for her grandmother and grandfather (?both in perfect health?) on her ?grampy?s? 85th birthday, and so forth);?

?also bought (but not with her ?frivolous? money) 2 candle-making kits last fall but has not ?found time? to attempt the candle-making process; uses her $800 sewing machine for rare mending projects and for sewing matching flannel pajamas every Christmas for her nephews (2) and nieces (3); has never witnessed or experienced violence in person (except for a parking-lot fist fight lasting less than one minute involving 2 men she didn?t know at her husband?s college?reunion);?

?she has never read or looked at a blog; buys her clothing at a mall where she shops 6 to 8 times a year (driving time to mall about 15 minutes); buys all food products and household supplies from a members-only Co-Op within walking distance of home); recycles every possible recyclable (verging on ?an obsession? according to self description); donates $30 per month to Green Peace and $200 a year to local no-kill animal shelter; orders an average 2 novels and 3 non fiction books from Amazon.com each month (for herself, but her spouse purchases about 4 times that number for his own reading enjoyment); reads about 1.5 books a month;?

?wears contact lenses during work hours and glasses at home; consults medical professionals of various specializations (not counting physical therapy and massage and acupuncture and allergy shots) approximately 13 times a year (eye doc, dentist,?gynecologist, allergy doc, family doc, gastro doc, orthopedic specialist and pain center doc); snuggles spoon style with her husband in their King Size Tempurpedic bed for approximately 12 minutes before falling asleep each night; does not drink coffee (again, irritable bowel) but has 1 cup of organic herbal tea with her morning poached egg and plain Greek yogurt and selection of fresh fruit (usually black berries even though the teeth-staining factor concerns her, but sometimes nectarines);?

?she drives with her husband to the woods each winter 2 weeks before Christmas to select and cut their Christmas Fir; sleeps with a stuffed Teddy Bear that she?s owned since age 7 whenever her husband is out of town attending conferences 4 to 6 times a year but keeps the bear on a shelf in her closet otherwise; listens to NPR for news; avoids all products that contain aloe (personal dislike); buys all cosmetics and personal skin care products from specialty shop in local mall; never wears nail polish;?

?she dislikes cooking and gratefully encourages husband?s enjoyment of all things cooking-and-baking related;makes it a habit to never leave dirty glasses or dishes in sink overnight and has been known to load and start the dishwasher at midnight if necessary; would prefer to weigh 15 lbs less than current weight but does not believe in weight loss diets and usually feels ?sexy?, attractive and ?stylish? (except for 2-3 days during TOM);?

?she worries often about global climate changes and seriously considers remaining childless because of ?fucked up? state of world economy/polluted atmosphere and oceans/overpopulation/poverty/rain forest?devastation/melting polar ice caps/dwindling number of species/lack of community ties in increasingly fast-past and high-tech world/corporate control of political systems/death of any democratic potential for return of public sphere;?

?she suffers from frequent (daily) feelings of profound sadness (grief, with momentary crying jags, once or twice a week) over all the aforementioned conditions (and also in response to numerous related global conditions left unmentioned here) yet avoids thinking ?whenever possible? about her powerlessness to change these ?post-modern tragedies? and knows only 3 other people (intimately enough) so that she can openly and fully share with them her deepest fears and concerns (yet is always reluctant to burden them?especially her husband, who is equally soft-hearted and sensitive to the pain of others?with reminders of these issues, and so mostly keeps her grief to herself)?

?But wait.

Is this an ?average patient??

Is there such a thing?

What if we change just ONE of the ?details? just mentioned?

What if I had described her as??An African-American?? ?

Or what if our imaginary patient was, say, Canadian?and lived somewhere in ?Ontario?, for instance?

What determines ?efficacy? of specific ?health care treatments? anyway?

What role(s) do social and material conditions play in the health outcomes of:

1) individual ?patients? and

2) particular ?treatments??regardless of kind of treatment (traditional medicine or alternative or combinations, or rarely practiced ?ancient? sources of ?wisdom?)??

Can these ?health? influences or factors be measured?or separated from each other qualitatively or quantitatively?or known or pondered in any ways that can be understood as relevant or useful?

How many of the social and material conditions described (in relation to ?Patient A?):

1) influence her health status,

2) influence effectiveness of individual treatment protocols,

3) influence effectiveness of pharmaceutical treatments,

4) factor as determinants (partial or primary) of this patient?s?

• longevity (life span)
• quality of ?health care?
• ?health outcomes? over time
• ?mental? health
• physical ?fitness?
• number and kinds of illnesses
• health status of any children patient may give birth to and/or raise
• final ?illness?, ?disorder?, trauma, or ?medical condition? which will eventually result in patient?s death

What other kinds of social factors (and material conditions/genetic/epigentic variables) can be understood as ?important? or ?relevant? or ?measurable? in relation to her ?individual health??

What kinds of ?influences? or ?impacts? ?or ?outcomes? (qualitative ?and quantitative) correlate with or result from ?the health? of OTHER CONDITIONS (usually minimized or completely disregarded in dominant discourses related to ?individual health?) with which (or in which) ?Patient A? participates and lives, for example:

• social structures (social/political/economic)?local to national to global
• institutions (such as education, political, religious, and so forth?at levels of neighborhood, community, city, state, nation, globe, etc)
• social norms (cultural, professional, family, etc)
• class/gender/ethnic, etc, issues (inequities, injustices, stigmas, privileges, etc)
• dominant discourses (educational, pop culture, medical, political, religious, economic, media-related, etc.)
• environmental conditions (quality of air, food, fresh water, soil, vegetation, oceans, atmosphere, and so forth, from indoor work place settings to pool where she swims to home interior to neighborhood?city?.and so forth to global level)

Frankly, I?m not sure where to venture once I begin looking in the direction of conditions and variables related to ?health? which are, specifically, almost always?overlooked or obscured by dominant discourses?especially in relation to ?medical research? or ?pharmaceutical research.?

Indeed, once I?ve tentatively begun to conceptualize ?health? from perspectives that remain ?outside? of dominant discourses?I don?t know where to start or stop. (I?m picturing thousands of concept maps. For openers.)

I?m not even sure where the concept of ?power? fits in to all of this?or how power relations factor in?say, anything from?

• an individual?s perceptions of power and/or powerlessness?or sense of control (including notions such as ?will power?, ?free will?, personal responsibility, ?free choice,? personal risk analysis, etc)?

to?

• forces of domination (???), which?maybe, at most?1% of the human population ever ?THINK ABOUT or CONSIDER seriously for any length of time?

Partly, perhaps, people don?t think about things like ?forces of domination? because the LANGUAGES we all use to converse, read, and write?even as scholars?and the DOMINANT DISCOURSES that socially construct our worldviews DO NOT PROVIDE US WITH THE NECESSARY CONCEPTUAL LENSES TO CONTEMPLATE, OR ENVISION, OR EVEN IMAGINE these vague, so-called threats?these unseen ?forces? that supposedly control our lives and create oppressive conditions we learn to?live with, as if they are normal. Inevitable. The human condition.

All of which, maybe, even seems (to you, for example?) ?like incoherent?and incomprehensible ivory-tower ideas (or, simply, fucked-up bullshit) dreamed up by horn-rimmed-wearing dorks (or, given the?benefit?of doubt, well-meaning but misguided geeks) who have nothing better to do than think up scary Marxist or Post-modern or Deconstructionist (yet?definitely DESTRUCTIVE) theories, and write dense unreadable papers for professional journals, and attend professional conferences where these aforementioned papers are PRESENTED to the only other people on earth who might comprehend the contents (what?s that about anyway?)? and then these?scholars?endlessly debate the ideas from their ?papers??ad nauseum?usually after imbibing several rounds of post-conference-session-cocktails in the nearest hotel lounge.

Or maybe not.

Maybe you have no opinion on this stuff ?cause you have an actual, authentic and NORMAL REAL LIFE to get on with. To live. To enjoy. Etc. And so forth?

Or maybe you don?t know what to think at this point?except you REALLY regret coming down this long, dark, twisty road with me in the first place.

So. Maybe we?re not so far apart, here, after all. I?m still trying to sort out this?

I can?t even come up with a name for whatever this?subject?may or may not represent?or be about?.

And I?m no closer to being able to provide any coherent answer to my?colleague?s question?any answer, actually, that doesn?t make it seem like I?ve lost my fucking mind.

Actually.

Since I?m being honest, here?

I can?t rule out that?unpleasant possibility either.

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Source: http://hopefulandfree.wordpress.com/2012/09/01/medical-model-vs-ancient-wisdom/

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