The Transformation of Health

JEAN MARIE MALECKI, MD, MPH, FACPMIntegrative Medicine Practitioner

May 17, 2013

Copyright 2013

You must be the change you wish to see in the world.

Mahatma Gandhi1869-1948

The Doctor-Patient Relationship

Compassion comes from the Latin words meaning “to suffer with”…which literally seems irrational. But compassion…involves entering the mind space of other persons so completely that one senses what the experience of illness is like for them.

Larry Dossey, MDJune 26, 2011

Differing Opinions In A Survey of 800 Recently Hospitalized Patients and 510 Physicians

“Compassionate care” is “very important” to successful medical treatmentGeneral agreement between Physicians and Patients

“The healthcare system generally provides compassionate care.”Physicians 58% Patients 53%

Differing Opinions…“…most health care professionals provide

compassionate care”

Physicians 78% Patients 54%

“ …were concerned about how changes in the health care system , including increased emphasis on controlling costs, would affect the ability of doctors, nurses and other professionals to communicate effectively and to provide emotional support to patients in the future.”

Physicians 55% Patients 67% R. Zimmerman

2011

Status Quo: Kill As Few Patients As Possible. Oscar London, MD

“Modern Western Medicine” : A Scientific Model

Disease-Based: The Magic Bullet Causes and Cures Nature, Nurture and Integration

Influences On Medical Decision-Making

“Internal” Excessive reliance on technology Increasing use of algorithms for

diagnosis and treatment decisions (“best practices”)

Desire to please the patient Liability (malpractice) concerns

Influences On Medical Decision-Making“External” Payers (insurance companies, managed care

organizations, Medicare, Medicaid, etc.) Integrated Health Plans Benefit Managers Pharmaceutical Companies Medical Equipment Manufacturers Direct Marketing to Patients (TV, Internet,

magazines, etc.)

How did I get to be “Top Doc”?

Rule 1. If you can’t save your patient’s life, find someone who can.

Rule 2. Give a patient your best shot.

Rule 3. Feed a cold. Starve a lawyer.

Rule 4. Don’t try to feel a breast lump over the telephone.

Rule 5. Don’t turn your back on back pain and don’t airily dismiss a complaint of gas.

Hippocrates-The Hippocratic Corpus

• First Do No Harm• Life is short, The Art is Long• Opportunity is Fleeting• Experience is Delusive• Judgment is Difficult• Code of Ethics

Principles

• Diseases are events• Equilibrium must be maintained: “innate heat” • Human body tends to heal itself• Pre-determinism: notion of a Demiurge

(material creator)• “Pneuma” and “Psychic Pneuma”• The “Rete Mirabile”

The Underlying Philosophy…

• Disease involves a patient’s entire body and mind.

• Therapy must be directed to the whole context of the patient’s “situation”.

Medical Eras adapted from Larry Dossey, MD

ERA I ERA II ERA III

Space-Time Characteristic

Local Local Non-local

Synonym Mechanical, Material or Physical Medicine

Mind-Body Medicine Non-local, ERA III or Eternity Medicine

Description Causal, deterministic, describable classical concepts of space-time and matter-energy. Mind is not a factor; mind is a result of brain mechanisms.

Mind is a major factor in healing within the single person; mind has causal powers. Medicine is thus not fully explained by classical concepts in physics. ERA II includes but goes beyond ERA I.

Mind is a factor in healing both within and between persons. Mind is not completely localized to points in space (brains or bodies) or time (present moment or single lifetimes). Mind is unbounded in space and time and is thus ultimately unitary or one. Healing at a distance is possible. Not describable by classical concepts of space-time or matter-energy.

Examples Any form of therapy focusing solely on effects of things in the body. Almost all forms of modern medicine, drugs, surgery, CPR, etc.

Any therapy emphasizing the effects of consciousness solely within the individual body :psycho-neuro-immunology, counseling, hypnosis, biofeedback, relaxation therapies, and most imagery-based “alternative” therapies.

Any therapy in which effects of consciousness bridge between different persons: all forms of distant healing, intercessory prayer, and interpersonal imagery.

Quantum HealingQuantum healing is healing the mindbody from a

quantum level. That means from a level which is not manifest at a sensory level. Our bodies ultimately are fields of information, intelligence and energy. Quantum healing involves a shift in the fields of energy information, so as to bring about a correction in an idea that has gone wrong. So quantum healing involves healing one mode of consciousness, mind, to bring about changes in another mode of consciousness,body.

D. Chopra, MD

Near-Death Experiences and The Brain

• what is seen

• what is heard

• what is experienced

Religion/Spirituality and Health

• Out of 200 patients, 70% wanted questions asked about their religious or spiritual beliefs.

• Decreased high risk behaviors• Increased relaxation response• Changes in immune function• Positive health impact• Mental Health and the forgiveness process

The Mystical Mind

Integration of biological, psychological, social and spiritual

When does the brain begin and the world end?

Reality and BeyondRecognizing limitations makes us more open to newways of seeing and exploring reality

Neuroscience

• Altruism and compassion• Empathy• Forgiveness

Single Photon Emission Computed Tomography (SPECT): Resting versus Focused Meditation in Tibetan Buddhist Monks Newberg et. al., 2001

Relationship:

The Universal Spiritual Urge and The IntricateWorkings of the Human Brain

• The Scientific Approach

• The Spiritual Approach

• An Integrated Approach

What Is The Key To My Success?Rule 1. Make a house-call and become a legend in

your own time.

Rule 2. Don’t under-estimate the healing power of blarney.

Rule 3. Ask your patient what’s shaking down at work and what’s cooking at home.

Rule 4. Let the patient make her own diagnosis.

Rule 5. Remember the brain.

If I Ran The Zoo