02 Aug The Difference Between Health Care and Climate Science
Last night I was driving home from dinner when I heard a discussion with Nathaniel Rich, author of a full NY Times Magazine devoted to looking at the science of Climate Change. The discussion was devastating to listen to because it painted a picture of a dire situation that was close to being solved 30 years ago. A couple of hours later, when I saw the article online, I could only get myself to read the first page. The piece explains that by 1979 a large network of climate scientists had looked at the complex interactions between weather systems and teased out how small temperature changes had predictable effects on weather patterns. From decades of research they had come to a consensus that man made impacts were responsible for an ever increasing climate change. The good news was they had also come to a consensus on things we needed to do to mitigate the changes, and therefore the impacts. The even better news was that by 1989, after a decade of debate and advocacy it seemed that we, as a world community, were committed to making those changes. Unfortunately powerful forces related to the energy industry did all that they could do to de-rail the validity of that consensus. As we know, they succeeded, and 30 years later we have a president who doesn’t believe in climate change.
The heartbreaking message of the article is that now it’s too late, and we are basically locked into a cycle of increasingly violent weather patterns and rising seas. As depressing as this is, the content of the article was not the full reason that I struggled to read the article. After some reflection on my resistance I came to see that it had more to do with my own sense of frustration with how systems work. For the past decade I have spent a great deal of time as an outsider looking in at the medical industry and I have been frustrated by how they hyper specialization and focus on data from randomized control trials has led to a kind of balkanization wherein the patient is seen as machine with parts rather than a person with feelings.
Climate science involves teams of people with different areas of expertise integrating that knowledge into a greater system of understanding. It’s as if a team of experts has spent decades examining a patient, Earth, and teased out how the complex systems that determine that patient’s health interact. After plugging prodigious amounts of collected data in powerful computer modeling systems they found a way to be able to predict how different factors might lead specific to fairly accurate outcomes in both the short term – i.e. whether or not it will rain; and the long term what might be the effect of a rise in temperature. While the short term modeling isn’t always exactly right, the long term predictions that were made in the 80’s have played out pretty much as predicted.
I understand that in some way people who work in public health- as opposed to the medical industry, work in a similar manner. However, as with climate issues, The needs of special interest groups, and financial considerations that have more to do with capital than with healthcare, shape how our day to day medical system works. It often doesn’t work in the way that data suggests it should. As someone who pays a lot of attention to both the data, as well as the pubic, journalistic, and institutional discourse on back pain issues I can tell you that for the most part the back pain industry ignores data that doesn’t line up with what they already believe to be true. I wrote a long post about how the evidence related to the dangers of MRI’s for back pain (the evidence says don’t use them) has been powerful for well over a decade but it has been ignored. The same goes for steroid shots and back surgeries. The National Institute of Health issued a report on pain stating that none of the treatments in use work, and we are spending exponentially more on them each year- and the treatment options haven’t really changed. The Lancet issued a report on back pain which decreed that we shouldn’t be doing MRI’s for back pain, that we should be avoiding steroid shots and surgeries, that people should be as active as possible, and they should seek counseling. All of these are things that Dr Sarno was saying 40 years ago. If you think this has led to a sharp left turn in terms of practice I have some waterfront property in Miami I want to sell you.
In general, from my outsiders viewpoint, the approach towards care in regards to back pain is profoundly unscientific, yet it continues on as usual despite the evidence. Dr Sarno called this malpractice generally practiced. In turn he was called a quack, a “back pain guru”, a charlatan, etc. However, his patients got better and he does have thousands of people who are devoted to him because he helped them overcome years of debilitating pain. We have a medical system in which specialization in different fields leads to advances in some realms, but many of these issues fail to address the overall health of the person. The medical system no longer sees patients as people but instead as material objects with parts the break down and need to be replaced, with abnormalities that need to be cut out, and chemical or electrical imbalances that need to be addressed with chemicals and currents.
I am not a scientist nor a doctor; I’m an artist. My skill set involves asking questions about systems that those who rely on these systems for their livelihood, as well as their sense of self and well being, are not as inclined to ask. – Barbara Heffernan wrote a great book, “Willful Blindness“, that reveals how difficult it can be for use to challenge the systems we are a part of. When we do we risk being kicked out of those systems so we unconsciously blind ourselves the contradictions inherent in them. In regards to health care, I think a great deal about how the ways in which we interact with, and orient ourselves towards that system, as well as how we perceive ourselves- has an enormous impact on our health. However, in general the health care industry has ignored these important factors because they are “immaterial”. They don’t fit in with the narrative about health care that we have developed over the past 60 years. During that time frame we moved towards a bio-mechanical model of medicine in which the goal has been to break down all of the ways the cells and the chemicals interact in regards to our health. Any discussion of how our emotions effect that process has been verboten. Doctors aren’t trained to consider the mind and psychologists and psychiatrists learn to keep their mouths shut about the body.
Over the past few years, while there has been a large up-tick in the use of words like mindfulness and mind body awareness, most people still aren’t even beginning to look at the profound impact our social structures, our economic structures, our educational structures, our class structures, and our power structures have on our sense of our selves -and on our health. When one suggests that these issues have powerful impacts, skeptics want proof in the form of randomized control trials. While important studies like the Adverse Childhood Effect study showed profound connections between childhood trauma and disease later in life, it was ignored for almost two decades. In the last couple of years people have begun to talk about it, but the system hasn’t figured out how to integrate that knowledge in ways that truly acknowledge how powerfully our emotions affect our health. The ACE study paved the way for more research. However, these kind of trials only take place when there is institutional interest and support for exploring them. When the whole system is designed around the denial of their import that’s less likely to happen. It’s a classic Catch-22. I was talking about this issue the other day and she sent me Rupert Sheldrake’s book, “Science Set Free”
Sheldrake is a biologist and the author of over 80 technical papers and 10 books. The back cover of his book explains how the materialist approach to the world discredits any phenomenon that can not be readily explained or measured.
“In Science Set Free, Dr. Rupert Sheldrake, one of the world’s most innovative scientists, shows the ways in which science is being constricted by assumptions that have, over the years, hardened into dogmas. Such dogmas are not only limiting, but dangerous for the future of humanity.
According to these principles, all of reality is material or physical; the world is a machine, made up of inanimate matter; nature is purposeless; consciousness is nothing but the physical activity of the brain; free will is an illusion; God exists only as an idea in human minds, imprisoned within our skulls.
But should science be a belief-system, or a method of enquiry? Sheldrake shows that the materialist ideology is moribund; under its sway, increasingly expensive research is reaping diminishing returns while societies around the world are paying the price.
In the skeptical spirit of true science, Sheldrake turns the 10 fundamental dogmas of materialism into exciting questions, and shows how all of them open up startling new possibilities for discovery.”
In regards to medicine, even when scientists make discoveries that they should relate to how the emotions affect the body they instead proscribe these issues to materialist causation. For example, with FMRI machines doctors can now see that chronic pain lights up a different part of the brain than the pain caused by touching a hot stove. Seeing this they call it a “neural pathway disorder” rather than see it as evidence of emotional distress- even though the part of the brain that lights up is more related to those areas that are understood to process emotions. They see it as a ‘misfire”. Previously they called it a chemical imbalance. This is evidenced in an article about Dr. Sarno that was written last year by science writer Julia Belluz in Vox. The article is very dismissive of Dr Sarno, calling him a guru and misrepresenting his ideas in even the headline. It was my writing about this that caused my friend to send me Sheldrake’s book. In the article she quotes a doctor who casts doubt on Dr. Sarno’s contention that emotions are the cause of back pain because his theory attributed the pain to the brain causing constriction of the blood vessels limiting oxygen which caused the pain. It is understandable that other doctors took issue with some of Dr Sarno’s suppositions, as well as the lack of “research” that he did to back up his claims. At the same time, they failed to even consider the validity of what he was saying in any kind of open or inquisitive way. As it didn’t comport with what they had been taught they failed to even think about it. It was much easier to simply call him a quack.
“Blaming this all on repressed emotions is a pretty narrow view of psychological contributors to pain,” Oregon’s Chou added. “It ignores a lot of what we understand now about changes that occur centrally in persons with chronic pain.” For example, we now have MRI studies showing that people with chronic pain have different areas of their brain light up when they are exposed to painful stimuli.
When I read about the FMRI machine showing the changes in the brain due to chronic pain it only confirms my understanding that the emotions are a causative factor but this doctor doesn’t even consider that. However Dr Alan Gordon and Dr Howard Schubiner have been doing a study based on examining people’s brains before and after emotionally based treatment and have astounding results. Yet these scientists are so focused on a materialistic view of the brain that they can’t even imagine how the problem might be involve other systems that they don’t fully understand. Here’s a link to a show on The Doctors in which Alan cured a teenager who suffered from chronic pain. It’s not in the episode but the show insisted on the brain scans before and after. On the first scan they were told it looked like he had a traumatic brain injury from the scan. A few weeks later, after treatment, his brain once again looked like that of a normal teenager. The emotionally based treatment provided a cure. This is anecdotal data, but it did lead to a larger study.
Clearly I’m not suggesting that all doctors miss the boat. Instead I’m talking about how systems create profound resistance to change. I’ve written a great deal about one doctor who does get it, Dr Wayne Jonas, who published “How Healing Works”. This book really struck a chord with me. Dr Jonas is a doctor and a scientist who has worked both as a general practitioner and a researcher who led studies that compiled data on large groups of similar studies. In some sense the work he did looks a lot like how the climate scientists took masses of data to get more holistic pictures of how the systems interact. After many years of this work, despite his resistance to what he found, Dr Jonas came to see that 80 percent of healing comes from within. In other words he found that only 20 percent comes from the healing element. What he discovered was that many social, emotional, and community based factors affect our ability to heal. Belief, community support, and our faith that we will heal play a much greater role than anything a doctor might provide. At the same time, the manner in which that doctor provides that care also has a major impact. In some sense this basic knowledge might seem obvious. I was so excited by reading his book that I immediately went to see what others had to see. While he has blurbs from major names in medicine, science, and government I quite literally have been unable to find anything of substance that was written about the book.
Ideas that challenge the core beliefs of systems often have a hard time getting over the gate. As Sheldrake points out the cracks are starting to appear in the materialist approach to science. Ideas related to emotion, belief, and spirit are staring to make some headwords. Thomas Kunh predicted this all in “The Structure of Scientific Revolutions”. He understood the systems- but maybe with a little less specificity than the climate scientists.