When the remedy begins with an open mind

Yet again I found myself explaining to a patient that I wasn’t sure what was causing her symptoms, but that after the X-rays and blood tests, I had found nothing wrong with her. I reassured her that her abdominal pain was nothing serious and offered her medications to try to alleviate the symptoms. She had already tried them all with mixed success.

Such situations made me feel like a failure as a physician. Even though I had conscientiously ruled out anything life-threatening or more clearly definable, I was again left with the answer that seems to be the case all too often in primary care: “I don’t know, but it’s nothing serious.”

So I gave “Ms. Henderson” a prescription that would stop cramps and another that would block acid. I didn’t hear from her right away, so I figured that had done the trick.

At her next appointment, three months later, she was worried about feelings of dizziness. I asked about the abdominal pain, and she seemed to strain to recall it. Then she remembered that the medicines I had given her had made her sick, so she had tried acupuncture. The acupuncturist said something about deficient spleen qi, or something, she said, and whatever it was went away after a few treatments. But, she said, about this dizziness ...

So again we went through the dance of tests trying to find something I could diagnose with a big “aha!” and be able to prescribe the definitive cure. Again I found nothing wrong and prescribed a medicine to treat the vertigo without knowing the cause. Again I didn’t hear from her for a few months, so I figured I had helped her.

Wrong again. She was back three or four months later with a feeling of general fatigue. When I asked what had happened to her dizziness, she told me that the medicine I had prescribed had made her tired. So instead she tried an herbal remedy recommended by a friend -- something with ginger, she said. The dizziness had vanished in three days. But, she said, about this fatigue ...

I almost wondered why she kept coming back to me.

I’m sure I’ve had at least one time in my past 10 years of practice when I had a definitive “aha!,” when I knew the exact diagnosis as well as a proven cure. But that has been rare. I’ve had some half “ahas!” when I could make a definitive diagnosis, but usually these were coupled with “well -- we don’t have a cure, but we can try this or that to treat the symptoms.... “

Other times, I’ve given treatments that got rid of the symptoms beautifully without ever knowing the cause.

A firm diagnosis, coupled with a proven cure, has been rare.

I could easily have felt disillusioned by my profession, considering that Western medicine seemed to have little to offer Ms. Henderson -- and the many patients like her. But she didn’t necessarily expect me to have all the answers.

What she needed from me was a compassionate ear, some reassurance that her condition wasn’t life-threatening and, she hoped, something to alleviate her symptoms. Once I was able to reassure her that there was nothing seriously wrong, she felt free to explore whatever approaches might work to ease her discomfort.

The embrace of complementary medicine has been driven by patients much more than physicians. Our patients feel more comfortable than we do with the idea that we may not understand every reason for distress in the human body and psyche. Once the Western physician reassures, more and more of our patients are showing us that there are other approaches to healing, if not curing.

And once I let go of the notion that I was a failure if I couldn’t definitively diagnosis every patient that walked into my office, I became open to other approaches to healing -- approaches that have been used and proven valid for centuries.

I have learned about the use of herbs and botanicals to alleviate symptoms for which I would have previously used more toxic pharmaceuticals. I have used time traditionally spent reading only Western medical journals to also study nutrition and acupuncture. Most important, I have joined a team of complementary medicine professionals with expertise in traditional Chinese medicine, nutrition, herbs, chiropractic, massage therapy and mind-body healing. Together, we discuss what each can offer for the health and well-being of a particular patient.

Thanks to patients like Ms. Henderson, I have learned that in addition to using Western medicines to treat symptoms, I can use many other methods to heal and to prevent disease.

I still don’t have to have all the answers, but I owe it to my patients to follow their lead.

Myles Spar is an internist on the teaching faculty at UCLA, a staff physician at the Venice Family Clinic and the medical director of the Akasha Center for Integrative Medicine in Santa Monica.