Over the past few years I have had a major change in career path. I went from thinking that changing the world was all about passionate political leadership and paving some sort of revolutionary path to a utopian society. A politics and anthropology degree knocked that out of me pretty quickly. Not that I don’t think the world needs good leaders, it absolutely does, but rather I had a change in philosophy. I don’t think the world needs a new messiah. I think the world needs more people who are happy, who care for themselves and for each other, and who are individually empowered to create a better world for future generations.
I realised that actually, it’s okay to not change the world in one day, it’s okay to not be the president of some massive international organisation, it’s okay to not have everyone in the world know your name. Helping one person, doing one good deed, changing one person’s life is a gift to both the “giver” as well as the “receiver” and this is the kind of action I want to take in my life, this is the thinking that lead me to wanting to become a doctor.
I have at various times throughout my life entertained the idea of becoming a doctor or being involved in science. At age ten I think I wanted to be a DNA scientist to invent mermaids and fluoro coloured guinea pigs (groovy pigs)- how my thinking has changed! Anyway, numerous things put me off this path and instead I fell into politics, which has funnily enough been the thing to bring me back to healthcare. Initially I was all for an MSF (Doctors Without Borders) style career, flying into war zones and performing surgery in tents. This is all very important work, and I absolutely admire MSF and the work their organisation does, but unfortunately I don’t think it’s the right fit for me. Instead, I want to find a happy medium between modern medicine and alternative therapies such as naturopathy, yoga therapy and so on. This radical change has come about since I have researched more into the field or medicine, and I thought I’d share with you some insights I have managed to take from amazing resources online, such as some incredible TED talks, to highlight some of the issues I see with modern medicine, and some of the reasons why I support a more holistic, complementary healthcare agenda.
You can find him here.
Treating the whole person
I think fundamentally, the word “healthcare” can be broken up into two parts: “health” + “care”. Notice the care here? Care to me isn’t simply prescribing an antibiotic without investigation every time a patient complains of a chest infection. Nor does it involve prescribing without consultation (they are called consultations for a reason!). The biggest difference I have experienced as a patient has been to have a doctor actually listen to me. My new doctor blew me away the first time I met her simply because she listened and actually was interested in what I had to say, what I thought might be contributing to my problems, and how I wanted to go about addressing them. When I spoke to one of the nurses she said the same thing- my doctor actually cares, and actually listens. This has been the biggest difference anyone could make and I have as a result been more open to visiting the docs where I used to avoid doing so knowing that I would get the same un-personalised, unfriendly treatment.
What doctors don’t know about the drugs they prescribe
Ben Goldacre’s TED presentation is phenomenal, and is one of the most perspective changing presentations I have ever seen. He discusses a gaping hole in modern medical research, the inability of scientists to publish negative results. Throughout his presentation he gives examples of negative studies being refused publication by medical journals, and the lack of accountability in the research field as negative results are allowed to go unpublished and unrecorded. He uses the example of the 1980s anti-arythmic drug lorcainide which was found in a trial to not be effective in reducing death of heart attack patients. Due to the negative results, the drug was abandoned and the trial was never published. However, this publication bias meant that later researchers were unaware of the failure of this type of drug and therefore were lead down the same path. He highlights that for 12 antidepressant drugs over a 15 year period, 38 trials submitted to the FDA for approval produced positive results, while 36 produced negative results. In peer-reviewed academic literature, however, 37 (all but one) of the positive trials were published, while only three negative trials were. As you can see, the information that therefore was available for doctors, academics, other healthcare professionals and patients has been drastically skewed. I fully support Goldacre’s proposition that there be an enforced system that requires researchers to lodge their trial propositions before results are obtained to ensure that negative findings can be recorded. Medical professionals and patients alike need to know that they have all the information available to make informed decisions about the medicines they prescribe and take.
Healthcare .VS. Sickcare
Rebecca Onie’s TED talk really solidified something I have carried as my life philosophy for sometime now. Healthcare should be just that- about health. Healthcare shouldn’t be limited to putting a bandaid on certain issues based on a ten minute session with a patient. Neither should it be what Eric Dishman calls “parts care”. I firmly believe that healthcare should be about treating the whole person, and not just parts of them. It should be about providing life advice such as nutrition, fitness, how to care for children and so on. Onie highlights the difficulties for many people in poverty- they simply can not afford some of the necessities of healthcare. This encompasses adequate nutrition; electricity for heating; clean water and so on. Unfortunately doctors are not able to write prescriptions for power to be turned back on, or for fresh fruit and veggies. Health Leads is an organisation that is working on this precise issue and I would love to see and be involved in something of it’s kind in New Zealand.
Something I can’t stand in the medical practice is the amount of petty fighting that seems to go on amongst differing specialties and practitioners. I am so lucky that I have finally, after seven years, managed to find a doctor who is open to and even encouraging of alternative therapies. Doctors are great, and they do a phenomenal job everyday. However, health is such a broad and deep field that it is simply impossible for one person to know everything about everything related to their patients’ health. This is why we have specialists. However, it is important to recognise that specialists, be they gynaecologists, podiatrists or “alternative” practitioners such as acupuncturists, physios, yoga therapists all need to work as a team. Treating “parts” of patients simply doesn’t work. And as Dishman highlights, can often lead to major errors. In his instance he suffered heart palpitations and was being checked for heart conditions when actually he was suffering from the symptoms of overdose as three specialists all prescribed him variants of the same medication.
Pharmaceuticals can save lives. I do not dispute that and I would never encourage anyone to stop taking medicine that they have been prescribed by their doctors with care, thought and research. However, what does worry me is the ability pharmaceutical companies have to manipulate both medical staff and patients alike, such as in Goldacre’s issue of academic misrepresentation, but also on the consumer level. An issue my acupuncturist highlighted to me was that one brand produced a specialised line of product for sufferers of arthritis, which was being sold at a higher price point for it’s “specialty”. Upon investigation, the only difference with this product was that it’s cap was easier to remove for arthritis sufferers. These kinds of things are not uncommon, and it frankly makes me sick. Even worse are the hold that big pharma have on life-saving medicines such as antiretrovirals for the treatment of HIV/AIDs. Patents and intellectual property laws often prevent generic versions of the drug being made. While this may seem fair to those who have invested their time and funds in researching and producing these medicines, I think the line needs to be drawn somewhere. When millions of people are suffering, and can not afford branded products, I absolutely think that generic drugs should be made available. There should be no price for health.
These are just a few of the major issues that have caused me to re-think my previous medical aspirations, and to opt for what I consider to be a more holistic method of healing. I am looking forward to investigating it more and pursuing a career which takes the best of both modern and “alternative” medicine to treat patients as whole people deserving of love, care, respect, and good health.
PS. The TED talks I referred to can be found online here.