Monday, May 17, 2004

Dr. Andrew Weil spoke at STFM yesterday.  It's hard to disagree with what he says regarding our distance from nature and the natural healing process.  His re-framing of, for instance, the role of antibiotics in infections is this: instead of antibiotics curing the infection, antibiotics simply reduce the overwhelming numbers of bacteria so that the body can heal itself.  We all know this principle - we use it in cancer therapy when we do "debulking" surgeries to get rid of some of the tumor mass prior to chemotherapy or radiation.  But what would happen as if we acted like we believe this principle?' Dr E.: Ms. J, your cholesterol is too high, which is a risk factor for heart disease...we need to do something about that. Ms. J: What should I do? Dr. E. (version A): Here's a prescription for Lipitor 20 mg.  Take it every day, and come back in six weeks, so that we can make sure it's not injuring your liver or muscles, and we'll drive up the dose as high as it takes, addiing another potentially toxic medication if that doesn't work. Dr. E. (version B): Well, you should eat the appropriate foods, get down to an acceptable weight, and get daily exercise, and your body will take care of most of the problem.  If it can't, we can help it along with a low dose of one of these liver poisons, that has been found to help in those refractory cases. Oh wait...we're supposed to be doing version B anyway, aren't we...so says the NHLBI.  But, often my impression is that sometimes we lose the healthy lifestyle perspective, and just give the drug in a relentless single-minded effort to attack that single number (LDL), almost mindless of the whole patient. Dr. Weil also makes the point that "integrative medicine" is not "complementary/alternative medicine", but includes nutrition, traditional medicine, holism and CAM.  This perspective may help us remain a little more open minded about his ideas. 6:17:40 AM