Thursday, March 16, 2006

Healing, Authority, and Experiment

Being in the healthcare business, I've had plenty of opportunity to reflect on what it means to be a healer. I have to say that I maintain a certain amount of discomfort around the idea that I am a "healer" at all. The reason for my discomfort is my anti-authoritarian nature. I am so anti-authoritarian that I don't like being an authority! And to be a physician is intrinsically to be an authority. This is the conundrum that I am faced with every day.

It is a great responsibility, to accept a patient's trust, to treat them and to advise them about their health. It is a responsibility I take very seriously. My dislike of being an authority doesn't have to do with an unwillingness to take responsibility. Rather, it has to do with my unwillingness to claim to know anything special. Granted, I went to school and studied hard for years; granted, I have been in practice for eight years and have accumulated a certain amount of clinical experience; granted, I have happy patients who would testify that I helped them with their injuries, their coughs, their premenstrual symptoms, and so on. But when a patient looks at me and says, after I have been poking and prodding and feeling the pulse, "Is it my liver?": what I am thinking to myself is that I don't even know what that means. All I know is that when I assess what is going on and apply needles and herbs, something shifts. Was there something wrong with their "liver" if the liver pulse was wiry? Who the hell knows?

I think that, on the whole, it is True Believers who become successful doctors. Their embracing of a model - whatever model, western medicine, Asian energetics, it doesn't really matter - gives them the authority to say, "Yes, it's your liver, and I have just balanced it." These are the same people who confidently tell their patients that a weekly chiropractic treatment, or regular acupuncture for three months, will make them better. I envy them their confidence, even as I wonder whether their belief in their model, plus the economic motive, has clouded their ethics.

I am not a True Believer. I think that a lot of what passes for medicine is bullshit. I am skeptical, rational, creative, and experimental by nature. I had a teacher once who said, "Medicine is a series of experiments that you engage in with your patients. The more experienced you are, the more refined your experiments get." Most patients prefer authority to experimentation. They don't want to be guinea pigs. They want a doctor who tells them what's wrong with them, then proceeds to fix them. My patients are different. They know that I'm not experimenting ON them; they sense that I'm experimenting WITH them. Like me, they see that there is a playful and curious aspect to healing. They experience healing as an exploration, as an embodiment and metaphor for life.

I think it was Kierkegaard who said, "Life is a mystery to be appreciated, not a problem to be solved." I'd rather help patients explore the mystery, than claim to solve their problems. It is immensely rewarding when they start to feel better as a side effect of this exploration.

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