On the Surface some moments in life appear uneventful. When revisited, from the perspective of intervening years, they assume a meaning of great importance. Such a moment, etched as an image on my mind, occurred the afternoon of my first day in medical school.
On that particular day, the entering students, all one hundred of us, were taken as a group to the local Veterans Administration hospital. We marched proudly into the auditorium, sat down in hushed anticipation, and the dean of students said, "We are going to bring in your first patient." An elderly man in a bathrobe was led to the center of the stage. Addressing us, the dean said, "Tell me what disease this man has."
There was a second of silence, and then our questions started popping. We wanted to know if the man had a pain here, a pain there. The man answered all kinds of questions as best he could. He was direct and succinct; he must have had some experience with such demonstrations.
After fifteen minutes one of the students made the diagnosis: "He has an ulcer."
The dean nodded with pride. "Yes, he does.... That is wonderful! See how good you already are as physicians, and you have not even gone through medical school."
So here was the first lesson I learned as a doctor-to-be: ask for symptoms, make a diagnosis, and treat the symptoms. From those first moments in medical school I learned to focus on disease rather than health, pathology rather than the person, parts rather than the whole, an ulcer rather than an ulcerated life.
During the next four years, we learned to perfect our skills in this area: to take a medical history, perform examinations, differentiate among a constellation of symptoms, and, of course, treat the disease or ailment. When we graduated, we were the products of an expensive, thorough, and excellent education in the treatment of disease. We had an ever-expanding technical arsenal and a knowledge of hundreds of drugs to help us treat the sick.
We traveled across the country to internships and residencies. Finally, the day came; our training was complete, and we began to practice medicine. In private practice, at a university, or in a health plan, we were ready for our first patients.
The Patient Gets Trained, Too
As a consumer of medical care, you receive training, too. You have learned that, if you are troubled or ill and in need of diagnosis and treatment, you must first check your health insurance card and then call your health plan or physician's of lice an appointment. The physician you call will likely be a primary-care physician or a specialist limiting his or her practice to a specific anatomical area: foot, nears, bone, etc. Your ticket of admission is a symptom, preferably a physical symptom. Those symptoms that receive the most urgent attention involve blood, pain, or a lump. You leave for your appointment with a mixture of apprehension, expectation, and relief. The office, more than likely in a nondescript sterile building furnished with generic tables, chairs, and outdated magazines, is watched over by the office staff, who are well separated from you by an impenetrable glass wall.
When your turn arrives, you enter the doctor's consultation room, nervously find your chair and take note of the diplomas and licensure conspicuously placed on the wall. Each testifies to the training and professional status of the physician, assuring you that the physician is scientifically trained, tested, and certified.
The physician enters. He or she checks your chart, nods in your direction and asks, "What's wrong?" More than likely, you will relate the events leading to your visit with a focus on physical symptoms. Listening to your history, your physician, trained to synthesize these symptoms into categories called symptom complexes, which identify specific diseases, leads you into the examination room to complete a physical examination, which may include blood and urine tests, an electrocardiogram, and, potentially, a variety of other appropriate procedures or tests.
Your symptoms and examination findings may result in an interim diagnosis or a specific therapy. However, further tests or the opinion of another specialist may be required. If all the tests are normal, and your symptoms are nonspecific, you will be reassured, dismissed, and considered one of the "worried well" (a term used by health professionals to describe individuals who feel unhealthy but whose physical examination and laboratory tests are normal).
If therapy is initiated, you will be expected to comply with the recommendations and report back any side effects, as well as the outcome of treatment. If treatment is successful, your symptoms will regress, and you will return to life as usual, interacting with the physician only when another problem emerges to disturb your normal activities or body feelings. For the most part, this is the way healing is done today.
Temple Healing: A Lesson from the Past
How far have we come from our ancient healing practices? If you had lived in 500 B.C. and were ill or troubled, physically or emotionally, and in need of healing, you would have journeyed to Cos, Epidaurus, Pergamon, or one of the many other temples of the ancient Greek healing god, Aesclepias.* You would have participated in practices that continued without interruption from 500 B.C to 300 A.D. throughout Europe, the Near East, and the Mediterranean, where temple medicine was the foremost source of healing.
Your decision to journey to the temple would not be made lightly; healing was a sacred process-a communion with self and the gods. After consulting friends and physician, you would prepare to leave for the healing temple. The journey of several days would be interrupted with stories of miracle cures from those returning home. With rising hope and expectation you arrive at the temple gates. Here you would read testimonials etched in stone, such as:
Believe me, men, I have been dead all the years I have been alive. The beautiful, the good, the holy, the evil were all the same to me; such it seems was the darkness that formerly enveloped my understanding and concealed and hid from me all these things. But now that I have come here, I have become alive, as if I had laid down in the temple of Aesclepias and been saved. I walk, I talk, I think. The sun so great, so beautiful. I have now discovered men, for the first time now I see the clear sky, you, the air, the acropolis, the theater. [Papyrus Didotrana (approximately 360 B.C.)]
. . . lame. He came as a supplicant, to the sanctuary on a stretcher. In his sleep he saw a vision. It seemed to him that the God broke his crutch and ordered him to get a ladder and climb as high as possible. He dared to carry it out . . . and walked out unhurt. (fourth century B.C.)
Upon your arrival you would begin the process of purification through cleansing and fasting; a symbolic shedding of toxic attitudes and the unhealthy habits of daily life. At this point, you would become part of a dynamic and varied healing environment. Walking in the temple grounds, you would enjoy the beautiful gardens and the graceful and serene statues of the great Greek sculptors Phidias and Praxiteles. Roaming minstrels would lift your spirit, and you would participate in lively philosophical dialogues that would stimulate your intellect and challenge you to consider alternate perspectives to your current life situation.
You might attend dramatic performances such as the tragedies of Aeschylus, Euripides, or Sophocles, which portray the cycles and rhythms of human life and teach that we share life and human nature with our fellow humans, suffering together our pain and distress as part of life's movement toward knowledge, maturity, and healing; or you might have a massage, participate in an athletic competition, or consult the priests regarding diet or the use of herbs or pharmaceuticals of the time.
Each evening, dressed in your ceremonial white robes, you would gather with others in the sacred temple to leave offerings to Aesclepias as you bid him to visit you at night with a healing dream. In the morning, you or some other petitioner may awake healed. Others might relate the content of their dreams to priests who would assist in interpretation and provide instruction in dieting and the use of medicinals.
Day after day, removed from the stress and pulls of daily life, focusing on diet, fitness, relaxation, and self-examination, you would experience a slow return of energy and vitality. Finally, the day would arrive when you felt restored with a sense of wholeness, balance, and harmony, ready for your return home. Immersed in activities for mind, body, and spirit, you would have learned about yourself and developed new attitudes and behaviors-healthy, life-supporting ones.
As illogical as it may seem to our scientific minds, we can accept that many of the visitors to the temples returned home with renewed health. The continued existence of the temples for eight hundred years, the personal testimonials of healings, and the written words of the great philosophers and writers of ancient Greece support this conclusion. Some may have returned to health as a result of the natural history of their disease, others may have improved from the relaxed environment, pharmaceuticals, exercise, nutritional practices, community support, a shift in perspective, and the inevitable healing that comes from the release of the tensions of daily life.
Of greater significance is the fundamental approach of the healing temples, which viewed the individual as a whole person and emphasized the interactive unity of mind and body. Neither mind nor body was treated alone. Both were considered as aspects of the total human organism, the mind-body. This holistic view, an essential aspect of Greek humanism, allowed a natural evolution of holistic healing practices using science, the arts, philosophy, humor, and spirituality to replace stress with harmony, anger with peace, despair with hope, mental paralysis with possibility, and isolation with community.
Lacking a technical knowledge of physical diagnosis and therapy, the ancient practitioners of medicine were compelled to use their understanding of the human mind and spirit to heal the body. The individual-his or her attitudes, beliefs, and behavior-were inescapably central to the healing process.
Is Ancient History Revisiting Us?
You do not have to go very far from your own home to rediscover in modern society the essential elements of the Aescelpian healing temples. Every day, in a church, school, or other meeting area in your community, you can visit an Alcoholics Anonymous (AA) meeting with the million or so others who do so each day around the world. It is ironic that, twenty-five hundred years after Aesclepias, alcoholism, a disease that accounts for a substantial number of hospitalizations and deaths in twentieth-century America, is best treated through the twelve-step spiritual cure of AA. Alcoholics and their physicians, unable to successfully treat or heal this disease with all of the technology of modern medicine, rejoin their Aesclepian ancestors in turning to a more holistic approach.
The principles of AA, which are now extended to many similar groups coping with a variety of disorders, emphasize a disciplined and committed process of recovery through self-directed actions that range from self-investigation and life-style change to attitudinal healing and conscious living. The reader may respond by saying, "This is an emotional problem." Ask an alcoholic. It is a mind-body problem.
Another good example of the bridging of mind and body was reported in a 1977 issue of the Journal of The American Medical Association (JAMA).1 A Philippine-American suffering from a severe case of lupus, a disease involving many parts of the body, became despondent with the progression of her illness, which seemed unresponsive to medications. There could be no question, according to the report, of the severity of her disease, the involvement of multiple body organs, or the progressive advancement of her disease even while she was on the most powerful medications.
She returned to her native village seeking further help with the disease. Two weeks later, following the removal of a curse by a local witch doctor, she arrived back in her American physician's office apparently cured. To her physician's amazement she did not even suffer the usual withdrawal symptoms from her powerful medicines. Five years later she remained completely disease free.