What’s wrong with the world? A musing on allopathic (western) medicine

Monday December 11, 2023

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“What is wrong with the world out there?” may be another way to ask the question, “what is wrong with the medical system?”

Let’s start with the word “medicine.”

From the root “medicus” – a Latin word that shares its roots with another Latin word, “medus” – A kind of mead.

Hard stop.

Let me take a side detour through my thoughts on mead.

Mead is honey wine, an ancient alcoholic beverage that dates to 7000 BC or earlier. It plays a central role in the development of philosophy, myth, sacred rites, and medicine, and its etymology may be traced to the Sanskrit word madhu. Madhura is one of the six tastes used to balance the tridosha and the five elements in Ayurveda. Madhu is honey and means “sweet.” In Ayurveda, madhu is known as a potent rasayana – a life giving and restorative substance used to conserve, transform, and revitalize energy in the body. It is said that substances which contain the madhu quality penetrate faster to the cellular level.

Ask anybody with blood sugar control issues, the sweet taste of sugar can send one’s energy and metabolism wildly out of balance. This is why Ayurveda also instructs (and warns) to use only small quantities of the sweet substance. Undigested quantities of madhu are as “fatal as any poison” (Charaka Samhita).

Madhu, or honey, in its various forms, are said to have the following capacities, used medicinally:

• Medohara – it dissolves or destroys fat
• Agnideepan – it intensifies the heat of metabolism, fires up digestion, and is digestive
• Varnya – it imparts glow
• Sarya – penetrating like an arrow
• Vatahara – it destroys (or pacifies) vata
• Pittahara – it destroys (or pacifies) pitta
• Kaphahara – it destroys (or pacifies) kapha
• Vatakara – it can cause an increase in  the qualities of vata, such as mobility
• Rakta shamaka – it balances the blood or pacifies the qualities of the blood
• Lekhana – it is scraping, it removes impurities
• Saukumaryakara – it may increase sensitivity
• Hridya – it supports heart health
• Vajikara – it supports reproductive health
• Sandhanakara – it is helpful in combination and alliess with other substances
• Vrana shodhana and ropaka – it is wound cleaning, purifying, and healing
• Sangrahi – it collects and gathers together
• Cakshushya – it is used as a wash for the eyes, wholesome for the eyes or eyesight
• Prasadana – it appeases, and can be used for purification
• Sukshma marganusari – it seeks out the minute channels in the body and penetrates to the subtlest matter
• Vrana vishodhaka – it purifies or removes poison from wounds

Madhura rasa is said to be capable of sarvadhatu vardhana meaning it aids in the development of all bodily tissues.

Let’s pause here. As with so much of Ayurvedic medicine, the foundational medicinal properties of substances are not an “either-or” proposition… they are a “both, and.”

The sweetness of honey, and the sweet flavor of all food and herbal substances can be either a poison or a panacea, depending on the context and content of its use.

So, back to mead – and medicine.

Here we are, in the anthropocene epoch, educated to believe that the ways of western philosophy and science are the superior ways of the world. And these ways, of allopathic medicine and hard science, are absolute and not to be questioned. In the story about the young woman above, a woman’s self-determination and choice for her future is held in her physician’s – or politicians’ – hands. Ancient ways of managing sexual health were erased out of our collective consciousness, along with witchcraft and much of herbalism, from the dark ages on. What arose out of the ashes was the profession of medicine, largely by men for men, increasingly systematized, licensed, and consolidated since the 17^th century when William Harvey “discovered” that the heart circulates blood throughout the body (despite books written in the lineage of the Indian Rishis, passed down through the millennia, which describe hrdaya, rasa and rakta – the heart, red and white blood cells, lymph, and circulating blood serum).

Modern physicians across all specialties have trained many long and hard years, indoctrinated into their world view of anatomy and pharmacology, with specialized practices such as internal medicine and its subspecialties such as cardiology, gastroenterology, neurology, pulmonology or respiratory medicine and rheumatology; age-based specialties, such as pediatrics and geriatrics; gender based specialties such as obstetrics and gynecology; and anatomy based specialties such as urology, nephrology, and otorhinolaryngology; each specialty either overlapping another (think Venn diagram) or entirely disembodied from the whole human.

Four years of a pre-med bachelor’s degree, most in biology or the physical sciences, followed by four years of medical school, rotating during a final two years through clinical work in a variety of specialties, before becoming an intern in a residency program for another year or more. Further specialization requires further study, or fellowship, lasting between 3 and up to 6 or 7 more years.

In 2022, the rate of burnout among doctors was exceptionally high, with rates of alcohol abuse among more than 20% of physicians. In 182 studies involving nearly 110K physicians, nearly 70% reported emotional exhaustion, with 68% reporting depersonalization.

Here in the west, we have developed a system of medicine in which providers, under enormous pressure, simultaneously abuse the sweetness of sacred soma, “spirits” per se, on which the foundations of healing were established, while dissociating from their own humanity… becoming human automatron robots.

What is wrong with our world, indeed?

Ayurveda, the Science of Life, has a few important comments on the purpose of life and the pursuit of health. Fundamentally, Ayurveda’s blueprint for health is as follows:

Health consists of a balanced state of the three doshas (combinations of elemental energies), the seven dhatus (bodily tissues), the three malas (wastes), and agni (metabolic fire), together with the clarity and balance of the senses, mind, and spirit expressed as bliss.

It might be called the first system of salutogenic medicine – supportive of human health and well-being rather than being solely focused on factors that cause disease. Models associated with salutogenesis generally include wholistic approaches related to the physical, social, emotional, spiritual, intellectual, vocational, and environmental dimensions.

Interestingly, the modern father of salutogenic medicine, Aaron Antonovsky, also wrote about the “Sense of Coherence,” which provides health resilience, defined as:

“a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic, feeling of confidence that (1) the stimuli deriving from one’s internal and external environments in the course of living are structured, predictable and explicable; (2) the resources are available to one to meet the demands posed by these stimuli; and (3) these demands are challenges, worthy of investment and engagement.”

In his formulation, the sense of coherence has three components:

• Comprehensibility: a belief that things happen in an orderly and predictable fashion and a sense that you can understand events in your life and reasonably predict what will happen in the future.
• Manageability: a belief that you have the skills or ability, the support, the help, or the resources necessary to take care of things, and that things are manageable and within your control.
• Meaningfulness: a belief that things in life are interesting and a source of satisfaction, that things are really worthwhile and that there is good reason or purpose to care about what happens.

Unfortunately, in today’s modern medicine system, lack of coherence permeates the medical system, from the first point of contact, scheduling, by uncaring, rushed administrators, through the patient visit (30 minutes is a considered a generously long appointment), hospital stays (with the ever changing rotation of shift workers, nurses, medical students, residents, and attending physicians, and their myriad opinions and changing orders), to billing and the navigation of the insurance paradox (Life and Health Insurance being the 5^th largest industry in the world) in which health care consumers, aka patients, actually believe that insurance is supposed to cover health care!

Such lack of coherence can and does eventually lead to iatrogenic harm, harm caused while under the care of a medical provider, which is the nation’s leading cause of accidental death, exceeding all other causes of accidental death combined. The leading journal STAT reports:

“The current thinking is that solutions to medical errors are more likely to be found at the organizational level rather than expecting individual clinicians to be aware of all relevant facts at all relevant times and take all the right actions. Hospitals have many moving parts: caregivers of many kinds, layers of support staff, a variety of patients, an array of devices and tools, an even broader array of medications, records, procedures, protocols, treatment spaces, and more. If the right pieces do not come together in the right place, at the right time, and in the right way, mistakes can happen. The systems approach holds that the “system” controlling these interconnecting parts needs to be redesigned to make it harder for things to go wrong… Because iatrogenic harm requires additional medical care, errors bring more revenue into the organization, though of course no hospital administrator sees errors as a way of generating more revenue. Meanwhile, system redesign requires money, time, and new expertise. If management made those investments, and succeeded in preventing harm, the organization would be rewarded by seeing its income fall.

… The one thing we can be sure of is that if the health care industry and the law continue on their customary paths, the long-lasting epidemic of iatrogenic injuries and deaths will continue to be a permanent feature of American health care.”

Meanwhile, perhaps it is worth remembering that doctors and nurses are increasingly unhealthy and unhappy. In 2021, the American Nurses Foundation released its Comprehensive Survey About Nurses. In it, they reported that among nurses aged 34 years and younger, 81% report feeling exhausted, 71% report feeling overwhelmed and 65% report being anxious or unable to relax. And for those who intended to leave their current position, top reasons included work negatively affecting their health and well-being (47%) and insufficient staffing (45%).

It is no wonder we’re sick and the world is sick. What’s wrong with our world? In the hyper-competitive world of modern medicine, until we slow down long enough to consider the answer, we’ll keep coming up with the same results.

“The definition of insanity is doing the same thing over and over and expecting different results.”

Consider instead, the four aims of life according to Ayurveda: kama (desire), artha (abundance), dharma (duty) and moksha (liberation). These four aims will be the subject of another musing for another day.

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References

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