How often do we hear that word bandied about by practitioners of “complementary and alternative medicine” (CAM) or, as it’s increasingly called, “integrative medicine” (IM)? Lots. The reason is that CAM/IM practitioners seem to think they own the word. They’ve so utterly co-opted it that it has become meaningless, in the process perverting it. No longer does it mean “taking care of the whole person.” Not really, at least not anymore. Thanks to quacks having taken possession of it as their own, “holistic” now has a connotation of woo, in which it is said to be impossible to be a truly “holistic” physician if you don’t embrace pseudoscience wholesale. Traditional Chinese medicine (TCM), acupuncture, the magical thinking that is reiki and other forms of “energy healing,” homeopathy, reflexology, and any other form of non-science-based medicine, some or all of these a doctor must practice in order to be “holistic.” Or so the quacks would like you to believe. It’s a false dichotomy of course: Either doctors must embrace quackery, or they are not “holistic” or “humanistic” and they don’t care for their patients enough.
They’ve succeeded, too. They’ve framed the issue just the way that favores them. Even though a good primary care doctor, be he internist, pediatrician, or family practitioner, is a holistic doctor, no woo required.
That doesn’t stop CAM practitioners from continuing to push this image of the cold, uncaring doctor lacking people skills, contrasting it to the allegedly infinitely more touchy-feely CAM/IM practitioner, who cares about every aspect of his patients’ lives and is thus able to combine the “best of both worlds” to help them. Unfortunately, as Mark Crislip once put it, “If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.” That’s why it never ceases to amaze me when I see apologists for CAM/IM try to push just this dichotomy. Normally a post promoting such nonsense wouldn’t necessarily catch my attention, but last night I happened across a post that compared “holistic medicine” to homeopathy, and I was intrigued. This post was, not surprisingly, on a blog called Mother Nature Network and entitled, appropriately enough, What’s the difference between holistic and homeopathic medicine?
The difference between cow pie from two different breeds of cow, as far as I’m concerned. But let’s here Judd Handler tell it:
A holistic medical doctor combines modern, Western scientific treatment with alternative medicine or complementary treatments, such as chiropractic, acupuncture or massage. Both a homeopathic physician and a holistic medical doctor will look at the whole picture. How they differ is that the homeopathic doctor would prepare a remedy in liquid or tablet form, while the holistic doctor would provide a patient with the option of a pharmaceutical drug in addition to alternative treatments, which could include a homeopathic remedy.
Homeopathic treatment — often bashed by modern scientific institutions and doctors — in general falls under the holistic umbrella. Homeopathic medicine examines the whole person. It integrates a person’s constitution, diet, emotional and mental state and stressors, among other factors — hence the term holistic.
But are either of these holistic? How can a treatment be “holistic” when it has no basis in science, which is definitely the case for homeopathy. Such a “holistic” practitioner might be great at ferreting out every last little detail about a patient’s life, but there’s a huge hole in his “holism,” and that’s actually understanding the patient’s disease and how to treat it. In claiming the mantle of “holism,” CAM/IM practitioners forget that they lack a critical part of that concept: Knowing what what you’re doing and having treatments that work. If you want to see what I mean.
None of this stops Mr. Handler from trying to make a distinction between homeopathy and “holistic medicine” in which homeopathy is holistic most of the time, but not always, and homeopathy can even be—gasp!—not holistic at times:
If you have a cold, it’s easy to buy a homeopathic supplement from a health food store or supplement shop, and that might help you, but taking these pellets or solutions without examining why you got sick in the first place lacks a holistic perspective. The same could be said about over-the-counter drugs.
Most homeopathic practitioners are practicing holistic medicine; consumers who buy their own homeopathic remedies aren’t necessarily doing so.
In other words, you need the “holistic” practitioner to tell you what’s wrong with you and how to treat it, the difference between a holistic doctor and a homeopath, apparently, boiling down to whether or not they use diagnostic testing:
Holistic medical doctors often encourage diagnostic testing (adrenal function and hormone levels, for example) in an attempt to find the underlying cause that led to the imbalance; homeopathic physicians treat the whole person, but generally do not suggest the use of modern diagnostic tests.
Of course, as I discussed when I posted about how often “adrenal fatigue” is a wastebasket diagnosis that has no meaning in science or support in clinical observations or science, the “modern diagnostic testing” described above is nonsense. It inevitably finds something wrong with a patient. Whether that “something wrong” has anything to do with reality or not is another matter. Be that as it may, from the description above, one could actually argue that the homeopath has less potential for mischief than the holistic doctor. Actually, one could easily argue that anyway, given that homeopathy involves diluting whatever fantastical remedy homeopaths come up with to nonexistence, leaving nothing but water.
all of this brings us back to the key problem with “integrative medicine,” which is, of course, what Mark Crislip said it is. It’s not a good thing to mix fantasy with reality, at least not with respect to medicine. It leads to some scary things. For instance, I can’t help but be reminded of Reiki Doc, whom I first encountered over the weekend and blogged about yesterday. I didn’t realize what a Pandora’s Box I had opened when I became aware of Reiki Doc’s post about using reiki in the operating room on patients without their consent. You, my readers, apparently went on to read far more than I did of Reiki Doc’s blog, finding numerous tidbits I missed, to the point where I quickly realized that, if I wanted to, I could easily spend a week or two doing nothing but deconstructing Reiki Doc posts.
Instead of doing that, however, I’ll do just one more, because it illustrates another aspect of CAM/IM that is disturbing in the extreme. It’s an issue I’ve discussed before, and it’s what I call “The Secret” aspect to alternative medicine, or, as I’ve put it before, “wishing makes it so.” The idea is that the patient “attracts” good to himself or herself by wanting it bad enough. The problem, of course, is the flip side of this idea, namely that it implies that patients attract bad things to themselves, too, which makes it their fault if they are sick or stay sick. Reiki Doc clearly subscribes to this idea herself:
I have spent more time than I care to admit in The heart room. It just gets spooky: there are some patients, who out of fear or whatever, do NOT want to be there. Like the patients with the epidurals that won’t go in, these ones have the ability to block interventions ALL OVER their body. The I.v. Won’t go in. The arterial line is a challenge. You try and try and try to get a central line. When it is time to put the breathing tube it’s hard to see the glottis, the opening between the vocal cords where the tube goes in. The saw breaks, the sutures snap, and the vein graft is poor quality. The surgeon struggles. The negativity is pervasive.
In other words, when things go poorly in the operating room, it’s the patient’s fault because of his “negative energy,” that not only attracts bad things but actively resists healing! It’s not just in the cardiac suite, either:
Your fear and non-acceptance of conventional birthing techniques, for whatever reason, puts it on your mind. A lot. What you don’t know, and what the nurses can see but can’t explain, is a simple Law of the Universe: we create what we think of and expect to happen, and the Universe deletes the word ‘not’. You constant worrying about the method of birth sends a stream of requests to The Universe: I want c-section, I want c-section, I want c-section. And nine times out of ten that is exactly what you get.
So, yes, ladies, if you end up with a c-section, it’s not because of biology or other problems; rather it’s your own fault because, according to the Law of Attraction, you’ve “manifested” the c-section on yourself. It’s depressing reading, because this goes far beyond the idea that wanting something will make it more likely that that you will achieve it because you will work harder for it into the realm of thinking that your mind has power over the universe. Perhaps the worst aspect of this sort of thinking is the “blame-the-patient” mentality behind it. There’s enough of a tendency in medicine to do that as it is; we don’t need a mystical rationale to justify it, nor is it “holistic” to do so.
What physicians really need to do is to reclaim the mantle of “holistic” medicine from teh quacks who have contaminated it with the assumption that you need quackery to be a holistic doctor and that it is possible to bend the universe to one’s will by desire alone. It won’t be easy. Over the last 20 years, the linking of holistic medicine to pseudoscience has become so tight that it will be hard to overcome.