Over the past months I have really battled with my right knee. I don’t have the vocabulary to express what the pain feels like, apart from that things do not feel like they fit properly, like a poorly packed suitcase or badly built puzzle, but no one knows why my knee is sore. Everything looks right on x-rays and MRI’s and blood tests, but it does not feel right in my leg. It also feels like everyone has a different theory as to why my knee, well, “doesn’t fit”.
I am a big believer in both Western and alternative medicines. I don’t know why one must choose. It seems the debate is as dichotomous as liking either Bovril or Marmite (have you noticed how no one ever likes both?) or being a Christian or an Atheist. Some things must be finite choices that eliminate other options, but why must health paths be one OR the other? When and how did health care become a dualistic issue?
There are incredible benefits to both western and alternative practices. My GP is brilliant, and I trust him with my life. My doctor of Chinese medicine is wise beyond all understanding. The surgeons that I’ve used have saved my life and improved its quality. Ozone therapy helped me when nothing else could, but so has serious schedule 6 meds and simple solutions like good nutrition. Seeing my shrink to work on my fears and bottled-up emotions, sunlight, good friends, fresh air and exercise all help me stay alive and healthy. Just like it takes a village to raise a child, it takes the full spectrum of health care practices to keep us going and I hate that we feel like we must choose. Why does it need to be an either-or situation? Why are both camps so anti the other and do they treat each other condescendingly? Why is there no room for the other? I have wondered about this for some time and here is a theory.
Apparently, there was a great big shift in the early twentieth century when traditional natural remedies and ancient healing practices made way for the rise of modern Western medicine. The more you read about this (and believe me, there is a lot to read and I think quite a few rabbit holes into which you can spiral if you like a good conspiracy theory), you realise that it all boils down to a dude by the name Abraham Flexner. Old Abe published a report on medical institutions in 1910, as he was asked to do so by a few wealthy industrialists (Carnegie and Rockefeller being the most famous of them). In this report he made recommendations that changed the way medicine is managed, and spectacularly mismanaged, in the western world.
A few things he recommended made a lot of sense and were obviously much needed. Here are a few items in his report that had a wonderful impact on the world and for which he should be celebrated:
- He standardised medical education.
- He suggested that medical schools / universities be closely associated with reputable hospitals to provide hands-on training (we know this works, just look at the benefit of our teaching hospitals!)
- He determined that students should not be trained by part-time educators or volunteers but insisted that there be permanent educators in the field.
- He insisted on well-equipped laboratories to support scientific research and experimentation.
- He changed the admission criteria so that only people who are totally committed and equipped could study medicine.
- He lengthened the duration of medical education to cover a more comprehensive curriculum.
- He insisted on strong leadership and governance (Do I need to elaborate? Let’s just say “Tembisa-tenders” and we all know why this is important don’t we?)
- He recommended that doctors continue their education throughout their careers, which of course makes total sense, especially with the lightning speed at which things are being discovered and are changing.
But now, and this is where with my advantage of the 20/20 vision of hindsight comes in, this is where old Abraham messed up;
- He had no time for anything to do with nature, nutrition or traditional medicine and curriculums that supported these were simply scrapped. Due to the withdrawal of funds, the student-doctors were now deprived of a wealth of knowledge built up over centuries. In the past, these healers were revered and respected, but now, they were ridiculed and marginalised.
- The rise of big pharma is directly linked to the report as investors now saw an opportunity to invest in research for developing new drugs in a profit driven industry where the focus became symptom management rather than addressing root causes. With the Carnegie foundation behind him and the Rockefellers associated too, you can imagine the accusations of illuminati connections and using this report to for the rich to get richer and the poor poorer.
- He closed a huge number of schools. This might not have been a bad thing, but a lot of baby was thrown out with the bathwater, and this also reduced the amount of doctors out there.
- A fan of diversity, Mr Flexner was not, and because of his extreme desire for uniformity and standardisation, he stifled innovation and variety in medical approaches and alternatives. It was his way, or the highway.
- He was a known chauvinist and racist (seeing that he was a poor Jew and a short man, Freud would have a field day) and closed down many black and female schools. (He probably thought the black schools were all voodoo and sangoma vibes and that the female schools were filled to the brim with witches and their black cats flying around on brooms).
- He was much more interested in research than anything else, and by default funds went towards this instead of practical training of more health care professionals, impacting the availability of doctors and huge demand for them, and this, I blame for giving them the God-complex from which many of them now suffer. (None that I know of course).
Dr Gabor Maté also laments this dualism in health care. His frustration is that doctors (and he himself is a remarkable one) treat patients in isolation, manage symptoms only and do not ever venture into the full spectrum of their humanness and environment. He explains it like this: “Dualism – cleaving into two that which is one – colours all our beliefs on health and illness. We attempt to understand the body in isolation from the mind. We want to describe human beings – healthy or otherwise – as though they function in isolation from the environment in which they develop, live, work, play, love and die. These are the built in, hidden biases of the medical orthodoxy that most physicians absorb during their training and carry into their practices.”
In today’s hospitals we have also managed to forget the value of good care. This afternoon I said goodbye to an American woman who was with us for about three weeks. She had a spectacular fall on safari and went from being a capable, hugely successful independent woman to well, everything but. She cried and cried when she arrived and battled with the whole concept of being cared for. Today, when we said goodbye to her, she also cried and cried. She repeatedly said how she will miss us, how she has never felt so loved and cared for, and how she was petrified of going back to her fancy, first world life in the States. “No one cares for people like you do,” she said. I remember before her arrival that she phoned me repeatedly. Her only reference to a “stepdown” was the horrible facility in which her mother died in NYC. Twenty years ago she paid this facility per month in US dollars what we charge in Rands in 2023! Her mother died a horrible clinical death. She was so scared of coming to a stepdown in Africa and she seriously expected a POW camp with worse food. And then she came to us. It was a soft, gentle landing. She wrote every single staff member a card, gave them a huge tip and even told me she loved me. During her time with us we looked after her entire person, not just her broken body. She had massages, outings, good nutrition, vitamins, physios, doctors for her mental health, sunshine, blow-dry’s, social worker visits, check ups with surgeons, prescribed meds, over the counter meds, homeopathic meds and even some acupuncture… and lots and lots of love and laughter.
We don’t really do anything special at the Recovery lodge. We only treat our guests like we would want our own loved ones to be treated. It’s the most basic rule of human interaction we try to teach our children from the time they are little that we live out here in our business, but it’s remarkable and truly tragic how rare and unique it makes us. We try to remember that there are many paths, many opinions and many solutions and that if you can somehow collaborate and work together without the greed and ego, there is a place in the sun for us all, and most importantly, a place for the patient to get to optimal care.