Do No Harm

In retrospect, scheduling acupuncture on Monday and a dentist visit on Tuesday was lining up two ways to get poked with little bits of sharp metal. The one that involved the most needles was relaxing and less expensive. The other cost as much as a small kitchen appliance (I’m shopping for a new range) and involved negotiations to discourage negative commentary. They worked on different parts of me, but their styles and attitudes didn’t have to differ, yet they did.

Western medicine in under assault. Costs are rising. Insurance for providers and patients continues to become more complex and expensive. Tests are layered on tests to make sure that nothing is overlooked. As I wrote about recently (Comfortable Care, May 4, 2011) cramming all of those tests into a very short visit results in an assembly line running through a clinical factory. The health care workers may be nice folks, but they are under pressure to produce, and unfortunately it produces an uncomfortable environment. Recently I had anxiety attacks (or something like them – they weren’t officially diagnosed) whenever I visited the doctor’s office. My experience with western medicine had become a negatively reinforcing loop. That’s not healthy.

The dentist’s office shouldn’t be as onerous as the doctor’s office, even though they are both Doctors. The battery of tests aren’t as extensive. Maybe the insurance isn’t as high. Maybe the field of probable treatments is more constrained. In any case, I’ve used the same dentist for almost a decade because they do a good job. I’ve even traveled off-island to maintain that relationship, effectively adding a $30 surcharge to each appointment for ferry fees and gas. They do good work and have many other patients who travel hours. They tell me I’m not the only one.

Yet yesterday they unknowingly played out a Jekyll and Hyde episode as if to parody western medicine. The reception was pleasant, and where they told me about the other island travelers. The greeting by the hygienist was the typical small talk about family and housework.

But then, as the equipment was rolled in, she brought up the topic of my blood pressure. When I couldn’t tell her that it was lower because I hadn’t checked recently, she playfully chastised me by playfully reaching as if to playfully choke me into doing the right thing. It was done from a sense of humor, but looked very odd from my position in the chair. Fast forward to the end of the professional and cordial x-rays, cleaning and inspection. The dentist finished and started chatting as usual. He went into great detail about heart surgery in his family. After a short while I stopped him and asked him to change the subject because I didn’t want to wind up in an anxiety attack. Ah, but he just wanted to make a point, so he skipped ahead to the worst details of the number of bypasses, the various parts extracted or replaced, and the extensive recovery support. He was proud of the might and power of western medicine.

Finally I got him to stop. And I told him that what he saw as a long list of positives I saw as a long list of bills. Within his list of procedures I suspect that some where there to lower the risk to the hospital and providers as much as to help the patient. What he saw as a path back to health. I saw as a path towards possible bankruptcy.

I have health insurance, but it has limits and a high deductible. I have health insurance because we don’t have national health care, so I have to do what I can on my own. My restricted insurance costs as much as my food bill, and food is definitely more important for my health. My health insurance is really health care insurance, insurance against the costs of the health care system. The health care debate is decided by legislators and lobbyists, and I suspect that none of them have to worry about finding coverage. To them the issue must seem abstract. Otherwise calling something Romney-care or Obama-care would be a good thing because it includes the word care. Evidently care is not valued.

Ironically, I am paying my health insurance, doctor’s bills and many other bills by selling off my investment in a biotech company, Dendreon (DNDN), which only has one product (Provenge) and it’s expensive. Granted it treats prostate cancer better and safer than conventional treatments, but it also costs $93,000. That’s enough to bankrupt some folks, or at least severely cut into their savings. Dendreon has plans to help. Insurance and Medicare will cover it for some. And yet, Provenge is cheaper that chemo and radiation, as I understand it.

Western health care is expensive. But you knew that. Western health care is also based on the Hippocratic Oath, which includes the paraphrased “Do No Harm”.

If a procedure cures the patient but ruins their life, I contend that they have been harmed. I do not doubt my physicians’ motivations. For the most part they have my medical health in mind, but in this society and with this health care crisis, medical health is impacting financial health which is impacting medical health. Tests run without regard to cost can be unhealthy.

Allow me to lighten my spirit by remembering back to Monday and my acupuncture appointment. Breath in. Breath out. I already feel better. For the last few months on an irregular schedule, I’ve visited Oriental Healing Arts. I mentioned them in that previous post, so I won’t go into greater detail here. Monday’s visit though acted as a counterpoint. Explicitly their attitude is that my body is healing itself and they are there to help. The way to help that, especially for people dealing with stress like myself, is to have a pleasant environment where the patients and treatments are handled in a relaxed fashion. She focused on what I was doing right, and reinforced that. And then, as necessary she suggested a change or two in diet, exercise, and attitude. Her suggestions were casual and friendly. She suggested that I cut out refined sugar. I pointed out that I rarely eat it, but M&Ms were on sale. She laughed.

She laughed. I repeat that because instead of admonishment she saw the humor. Instead of making me feel like I was doing lots of wrong things, she pointed out the right things I was doing, while treating me like an adult who knew that M&Ms were health food.

It doesn’t have to be western versus oriental; yet, that seems to be the distinguishing characteristic difference. Western medicine focuses on what’s wrong with the body, what mistakes the patient is making, and how the doctor is going to fix it. Most alternative or non-Western practitioners seem to concentrate on what’s right, and how to help the body and the person bring it back into balance.

Some things are mechanical: broken bones that need to be reset, cavities that need to be filled, cuts that must be bandaged. But maybe that philosophy has its limits. Maybe it isn’t always the external and the immediate that must be considered. Maybe the body’s own capabilities, the soul’s needs, and financial realities must be considered too, because to concentrate on only one might do harm to the others.

Oh yeah, and another feature of the non-Western treatments I’ve received appeals to the frugal part of me. They tend to be less expensive, more accommodating, and require less paperwork. Save me time and money while helping me get better? That takes me farther from harm.

(And thanks to all of the other non-western health care providers who are working me. I’m feeling better, thank you. Though I have a headache from staring at the screen by writing this rather long post. Time for a good walk outside.)

About Tom Trimbath

consultant / entrepreneur / writer / photographer / speaker / aerospace engineer / semi-semi-retired More info at: and at my amazon author page:
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