16 Sep The Biology of Hope

Dr Turk on drugs from rumur on Vimeo.

When we interviewed Dr.Dennis Turk, the director of pain research at the University of Washington, for our film “All the Rage” he pointed out two very important facts about drugs to us. The first is that for every dollar that a drug company spends on advertising it sees somewhere in the range of “14 to 26” dollars in increased revenue. That’s a pretty strong return on investment. The other is that studies have shown that patients are less satisfied with their doctor if they leave their appointment without a prescription. If you combine those two facts you can understand a great deal about our nation’s relationship to medical care.

Andrea Leonard-Segal on health care from rumur on Vimeo.

Drug companies want people to use their drugs, and their marketing is very effective. This creates a further incentive for doctors to prescribe drugs, because patients want them. I wonder what would happen if we no longer allowed direct to consumer marketing of prescription drugs? While there are many useful drugs, it is also clear that the “side effects” (or more accurately the “other than hoped for” effects) of the drugs can be very dangerous. We also talked to Dr. Andrea Leonard-Segal, a rheumatologist who wrote a chapter in Dr. Sarno’s book “The Divided Mind”. She explained that the “conveyer belt” medicine where doctors “count widgets”, and are only with patients for a few minutes at a time is clearly not good for the patients. After visiting with Dr. Sarno she came to understand how important the mind body connection is, and she now treats patients with this understanding.

The other day I was in a used bookshop and happened upon Norman Cousin’s book “Head First: The Biology of Hope and the Healing Power of the Human Spirit”. His name was familiar to me, and I had a vague sense of skepticism attached to it. I quickly thumbed through the book, and found that despite a slightly stilted style, there were a lot of ideas that connected with me, and the themes of our film. I then recalled having heard about his writing as being unscientific mumbo jumbo, which explained my first reaction. I bought the book and skimmed it quickly yesterday.

Cousins was the editor of the Saturday Review for many years and was known as a kind of folksy leftist who did a lot to promote cultural exchanges with the Soviet Union. After one such trip to the USSR he was stricken with pain and a creeping paralysis. After he was hospitalized, he quipped that he quickly realized that a “hospital was no place for a sick person.” His doctor was an old friend of his, who felt strongly that patients should be involved in their own healing. Cousins was not given an exact diagnosis but when doctors from the Rusk Institute for Rehabilitative Medicine (the the center at NYU where Dr. Sarno worked) were brought in he was told that it might be ankylosing spondylitis, a degenerative disease of the connective tissue. Once he was told that the doctors had no way to cure his debilitating disease he started to work on his own cure.

When discussing his symptoms with his doctor he had been told that they could be attributed to heavy metal poisoning. He recalled that diesel trucks had blasted by his room Russia all through the night on his recent trip to Russian. Each morning he woke feeling unwell. Then on his final day there he had gotten blasted in the face by a cloud of diesel smoke. He fell ill upon returning home. His first thought was that if the sickness had come from the smoke, then his wife, who had traveled with him, should have also gotten it. He then reflected on the fact that he had worked himself beyond his capacity for the previous six months, and that this chronic stress and exhaustion might have had something to do with it. He remembered reading a book, by Hans Selye, that illuminated the process by which stress, and negative emotions, could be involved in the onset of illness. He quickly read the book and it strongly resonated with his theory. He realized that if negative emotions could be causative, then positive ones could be curative. He began watching funny movies and immediately felt relief for short periods of time. “I made the joyous discovery that ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep,” he wrote. He stopped taking painkillers and kept laughing. He also experimented with high does of vitamin C which he believed helped to ease the swelling and inflammation he was suffering with. He slowly recovered and then many years later wrote “The Anatomy of an Illness” to let others know about his experience- and discusses the book in the above clip.

10 years later he was asked to come and collaborate with the UCLA medical center, where he was given the position of Adjunct Professor of Medical Humanities. “Biology of Hope” is about that experience. It’s filled with the same kind of realizations about the connection, between mind and body, that we are trying to illuminate through our film. Of course he, and his work, were subjected to the same kind of skepticism that Dr. Sarno, and others who grapple with this idea, face. To be clear, Norman Cousins is not arguing that negative emotions are the only cause of illness, or that positive emotions like laughing, can not cure all illness on their own. However, he is saying that the medical community too often ignores the import of patients emotional state when thinking about both causation and cure. There is a lot of science coming out that supports this idea. As an example, just today I got an email about an article that studies the effect of patients “catastrophizing” their pain. In other words, if they are anxious and worry that their pain will never go away, the study has found, it’s more likely that the pain will stay. ” Overall, Dr. Edwards said, higher catastrophizing is a risk factor for long-term pain and for disproportionately negative consequences of pain, including worsening physical disability, medication misuse, and higher healthcare costs.”

It is interesting to see that the ideas he gained traction with in the 80’s are connected to the ideas that Dr. Sarno was working with. It is clear that those ideas are gaining renewed appreciation, traction, and scientific validation every day.