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Towards holistic healthcare
Dr. B. RAMAMURTHI was a world-renowned neurosurgeon. He was also an exceptional person. And strangely, it was a chance meeting with him — at a function he presided over for senior citizens — that led to our continuing friendship over the next few years, till he passed on. "Just walk into my clinic and if I'm free we can talk," he'd say. True to his word, he was indulgent to the point of exchanging his views on various issues — whenever he could spare some time between surgeries and consultations — in spite of my generally unscheduled visits to the Neurosurgery Clinic at the Voluntary Health Centre, Adyar. What follows is a record of some of our conversations we had — on the mind-body connection, on holistic medicine and related issues...
EARLY theorists like Dr. Herbert Benson, author of The Relaxation Response have said '75 per cent of the illnesses that bring patients into Doctor's offices are in the mind-body category'. More recently Dr. Deepak Chopra, M.D., best selling author and leading exponent of mind-body medicine has said, `90 per cent of the procedures, and drugs currently used will soon become obsolete. Illness will soon be treated by the way people, think, or eat, or live their lives'. Your comments?
The entire basis of these statements is what our ancient medicine men like Charaka and Susruta believed, and propounded. Our 5000-year-old system of Ayurveda, which supported the belief that the mind influenced the body, was derided by the West as utter bunkum... Cellular physiology, they said, was not dependent on external factors. But traditional systems maintain that it is dinacharya or daily behaviour that affects your body. That your emotions affect your body is an age-old truth, which the West is only now beginning to understand and accept. Fortunately for future generations, we are again trying to learn (or relearn) all this from the West — a rather profound irony!
Psychoneuroimmunology (PNI), the study of the mind and its processes on the immune systems, is an interesting field. The first major text on PNI by Robert Ader came out in 1981, the next in 1991. Do psychosocial and psychospiritual roles affect a cure?
The PNI research is simply giving a scientific explanation for a known observation. When you have faith in a particular doctor or therapy, you tend to respond better — to the person or the method. There is a natural increase in chemicals called endorphins, which constitute the body's natural immune systems. Once these systems get activated, the patient is well on the road to recovery. What the mind believes in, gives strength to the body.
Nerve cells actually communicate through electricity and chemistry. And only one-millionth of the actual number of neurohormones present has been identified by ongoing scientific research. Studies have demonstrated that certain people are able to produce endorphins by mere mental control. Our own Ramana Maharshi had a major surgery on his arm without anaesthesia. So, for a trained mind it is possible to produce neuropeptides as and when needed.
The body-mind is being hailed as a dynamic emerging system. But many say, `Your mind may help your attitude, it will never make a difference to your physical state.'
The mind definitely influences the body. It has been scientifically proved that greater stress causes greater pain. The way a person reacts to a factor of stress or pain can decide how quickly that particular factor is alleviated.
My favourite analogy is that a man's body is like a sleek Mercedes car. If you constantly operate on first gear, you'll consume more oil, more petrol, produce more noise, and destroy the car! But when you travel by and large on the fourth gear, the car is always in good condition. So, utilise your body and brain to function optimally, to eat better and live healthier. Meditation and Pranayama can help you achieve the state of fourth gear!
Why has there been a movement in recent times away from aggressive therapies, towards less militaristic, immunological approaches?
Where there is a need for what you call "aggressive" therapy, it has to be utilised. Where a tumour has to be removed you cannot but do surgery. Personally I would call it a movement away from modern medical technology. One reason is that the public expects too much from the medical profession, due to various reasons, press hype being the least of them (I've found that once the problem has been tackled with medical intervention, patients only remember the side effects and not the pain they've been saved from). The other is that many doctors themselves have failed in their duties. Commercialisation has pushed many to cross even certain humane limits that should be applied to patients and the treatments they're given.
It is important to accept that there are definitely areas in healthcare where modern medicine does not help. With advancing technology, we do have access to fantastic medical happenings, but it is wise to remember that the risks are also greater, maybe to the quality of life or even life itself. The stronger an antibiotic the greater the side effects are found to be. So it is imperative that all medical decisions are carefully considered with the patient's health and well being as the primary concern.
Polarisation between Eastern and Western thought is essential for the developmental process, and the present generation is looking to alternatives that integrate rather than disregard, encompass rather than exclude. Does this augur well for the future?
A doctor must realise that he is an advocate for the patient and not for any system of medicine. As a doctor, I'm here to make a patient well, not to propagate any system, and this is how any doctor must approach any patient. Each system of medicine can complement the other. While Allopathy gives quick relief, it is also ineffective in many chronic ailments. Complementary therapies could prove beneficial here, but relief will be gradual and slow. The efficacy of the system should be taken into account. Sadly, our own Indian allopathic practitioners have been brainwashed to despise our ancient traditional systems, to believe that Allopathy is the only scientific system. It is time we expend some serious thought on a comprehensive model of healthcare.
Most alternatives are considered capable of little more than making a patient `feel better' during the course of `real 'medical treatment. What do you think?
That's not true. Over the last 800 years, the world has been dominated by the so-called "modern" or Western modes of thinking. Western medical thought has been dominated by aggressive or "male" aspects of thinking processes, a thought flow that concentrated on Man alone, negating the Universe and all other living things. It is time we learnt to adapt to more friendly methods, ones that incorporate the feminine aspects, which are gentler and more holistic. Integrate the yin and yang, so to say. Well-proved, time-tested methods can be availed of as and when required, from a good practitioner.
Fact is, many claim cures which don't exist. Consequently there are situations where even legitimate facts are negated by the scientific coterie. If more people come forward to provide and document relevant research, even the scientific community will have to accept such results.
On healing methods like prayer, and Therapeutic Touch (otherwise called Pranic Healing), exciting early research in the West shows that extraordinary fields may open up for both physical and psychospiritual healing. Your comments?
If such methods of healing work, it is good for the patient. But unless conclusive evidence proves this we cannot authenticate any of these findings. The point is, where there is faith there is a positive effect on the patient in need. Experiments on animals have proved beyond doubt that even a placebo can cure by improving the immunochemistry of the body.
On the role of spirituality on health, does the spirit have meaning beyond the psychological and social significance we assign to it?
From the layman's point of view, a spiritual life gives you calmness and peace of mind. It also helps one adjust better in relationships with others and bring down environmental stress, a means to be at peace with yourself.
Sadly many confuse being religious with being spiritual. I think religion is nothing but spirituality spoilt by man's selfishness, naturally there are many manifestations of this selfishness. If you are truly spiritual, you are at peace with yourself, you have no conflict, you work better and every action and situation flows and benefits from this spirituality. So, this aspect could definitely affect a patient's well being positively.
On iatrogenic (caused by the physician) complications, how important is it to be an effective advocate for your own healthcare? People with skills in extracting better outcomes from institutions get more benefits than people who quietly put themselves at the mercy of the system.
Modern medicine has become a very powerful weapon in tackling the borders of life and death, but with stronger drugs and more skilled, delicate procedures, a greater element of risk is involved. There is an urgent need for exercising more control, say through a self-auditing body within the medical profession itself, like in Western countries where there is close monitoring by senior members of the profession.
But in India, I find many are voiceless patients, even the educated. Ignorant of their rights, they prefer not to protest, even where necessary. There is absolutely no point in continually blaming the system, the question here is `Have you tried to fight the system, or taken any step in that direction?'
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Excerpts from a series of conversations SHOBHA MENON had with Dr. B. Ramamurthi a few months before he passed away...
While complementary therapies can be useful, sometimes allopathy is inevitable.