Whole systems medicine: A common sense approach to pain management
June 20, 2017
by Nancy Gahles, DC, CCH, RSHom(NA), OIMCommon sense is a basic ability to perceive, understand, and judge things that can reasonably be expected of nearly all people without need for debate. It is defined as sound practical judgment that is independent of specialized knowledge, training, or the like.Women tend to exercise common sense in the care of their family. People who come to me as an integrative and holistic doctor want to tell me their story. They want to share the narrative of what happened to them, and they want to tell me what has caused their pain. I want to know their story. I always focus on “what makes you tick and what makes you sick?” The language their illness speaks is the one that I must interpret. It’s only common sense. In my career, I emphasize the role of the integrative practitioner as an interpreter of the language of the body that the person is speaking. I exhort you to “inquire within” to listen for the clues as to what makes them sick.It is the job and the sacred duty of the practitioner to listen to the person who has come into your presence. This, too, is common sense. People in pain are vulnerable, emotionally and physically. They are often at the end of their proverbial rope. They come to integrative and holistic medicine most often because conventional allopathic medicine has failed to relieve them of their suffering. Deep listening with compassion relieves suffering. Listening as an objective observer, without prejudice, is a basic tenet of the principles of the medical art of homeopathy. In narrative medicine, the source of suffering will be revealed through the story. First, the presenting complaint, the pain. The person will describe where it hurts, how it hurts, when it hurts and finally, and why it hurts. In acute cases, this might be the end point. A fracture, a puncture wound, a burn, or a simple bacterial infection can be treated in an allopathic way. In 1966,Abraham Maslow, an American psychologist who was best known for creating Maslow's hierarchy of needs, said, “I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.”Allopathic medicine did cruise through the halcyon years of antibiotics until the allure of holism combined with a compelling sense of rejection of this dominant paradigm fueled the explosive movement towards integrative healthcare. The truth is that the pain complexes that people suffer with today are fraught with co-morbidities, drug dependencies, and a plethora of concomitant mental, emotional, and spiritual complications that defy allopathic or surgical solutions.In an effort to get a grasp on how to treat the complexities of the whole person who is suffering, we, as practitioners, are called to look beyond the hammer. We are called to investigate alternatives. It has long been a practice to look to other cultures, their traditions, and their indigenous healing practices for clues. Traditional medicine is also known as "whole systems medicine". Whole medical systems involve complete systems of theory and practice that have evolved independently from or parallel to allopathic medicine. Many are traditional systems of medicine that are practiced by individual cultures. The National Center for Complementary and Alternative Medicine (NCCAM), now known as the National Center for Complementary and Integrative Health (NCICH), created a series of five background papers on the major areas of complementary and alternative medicine as part of their strategic planning for 2005-2009. It is an eerie foreshadowing of the dire need we face for non-pharmacologic approaches to our devastating pain, addiction, and death crisis from opioids only in pain management. The call is out from government agencies, hospitals, and professional organizations to find solutions. The NCCAM paper gives us a view into whole medical systems that can be considered. It postulates, “While whole medical systems differ in their philosophical approaches to the prevention and treatment of disease, they share a number of common elements. These systems are based on the belief that one’s body has the power to heal itself. Healing often involves marshalling multiple techniques that involve the mind, body and spirit. Treatment is often individualized and dependent on the presenting symptoms.”The "marshalling of multiple techniques" in the treatment of one person is complicated. As a doctor of chiropractic, people come to me with pain—back pain, head pain, extremity pain. My common sense approach is implementing the multiple techniques available to me within my scope of practice. Manual manipulation, electrical muscle stimulation, ultrasound, TENS, cryo and thermal therapies, intersegmental traction, various physical therapies, therapeutic movement exercises are my “hammer”. Every back pain may look like a nail at first, but when the condition becomes chronic, one must “inquire within”. Go back to the person’s story. What makes them tick and what makes them sick?It was from this point that I learned about the value and the necessity of whole person healing. We call this whole systems because we, as humans, are a whole, interconnected, dynamic, network of systems, which communicate seamlessly within to keep us in equilibrium, homeostasis. That is called health. It is a state of well-being. My search led me to the whole medical system of homeopathy. The elegant solution to the pain complex that homeopathy offered was that it addresses the suffering of the whole person. One of the Laws of Homeopathy is "totality of symptoms". One must consider all the symptoms the person is experiencing in every system of the body, however disparate that may seem. For instance, a person may come to me complaining of low back pain. They may have concomitant symptoms of irritable bowel, acid reflux, and sleep disturbances. In the mind symptoms they may tell you that they are anxious, have mood swings, and periods of depression. Upon further inquiry, it will be revealed that they have never been well since their partner died. Grief and loss are experienced as pain. We have a body or vehicle, an intense network of senses that perceive events and conditions as painful. These perceptions are expressed in our person. Through the body language of our neuromusculoskeletal system, our organ language of bowel disorders, our mental language of ruminating thoughts, and our spiritual language of grief, loneliness and loss of meaning and purpose. Never has this been more clearly elucidated than when the terrorist attack on the World Trade Center on 9/11 wrought the highest number of per capita deaths in my community. The subsequent pain was seen in my office as back pain. Firefighters as a community don’t complain. They run into fires daily to save lives. This situation was so devastating , the loss of their peers so overwhelming that they suffered untold physical complaints. As they lay on my table in treatment, they would tell me the stories of their pain. It was the loss, the overwhelming grief, that found acceptable expression in back pain. The whole medical system of homeopathy is far too vast for explanation in the scope of this article. The salient point that I will make is an oversimplification of this honorable system , however, it is that homeopathy has a repertory of symptoms encompassing body, mind, emotion, and spirit. These are called rubrics. They are the words that the patient tells you in his story. When taken in totality, a homeopathic practitioner is able to prescribe a homeopathic medicine that matches the suffering of the whole person. Five years ago, my community was again devastated by Superstorm Sandy. The post-traumatic stress remains off the charts today. It is manifesting in all manner of chronic ailments, particularly cancer. Those who have lost partners and family members to cancer tell me unequivocally, “it was from the stress of Sandy”. Those remaining suffer from ongoing complex pain syndromes as well. We know the etiology. You can’t cut it out or burn it out. Pain killers have compromised and disabled many, and killed some. Homeopathy has greatly relieved many and cured some. While this, too, may seem an oversimplification, it is the truth of my story as an integrative and holistic doctor on the ground, working with the people. A true story of common sense. This whole system of medicine has shown itself to be consistently effective as a common sense approach to pain management and pain relief. Certainly, there are challenges that need to be addressed. Looming large is the clinician’s need for research that can point them to protocol that they can implement in their own practices. The studies that exist to support pharmacological approaches are funded by the largesse of the pharmaceutical industry and the academic teaching hospitals they fund. Homeopathy does not have access to that bucket of money nor does that method of research fit the mode of action of a quantum nanoparticle homeopathic remedy. Such has been and will be the case for all new theories, philosophies, and practices. This is not meant to deter us from proceeding into a brave new world. The charge is to answer the call for non-pharmacologic approaches to pain. The answer is to include homeopathy into the hallowed halls of conventional medicine and to make it available for access in mainstream healthcare. Woodson Merrell, MD, director of the Integrative Medicine at the Continuum Center for Health and Healing in New York City and a proponent of homeopathic medicine, speaks from his experience in an article titled Homeopathy in the journal, Medical Clinics of North America. He says the challenges adopting homeopathy into mainstream medical practice is partly because of lack of quality published research and quality education. More recently, there have been better studies, he notes, and the general public have been seeking homeopathic services more frequently. There are high quality educational programs emerging from homeopathic schools with pending State Department of Education accreditation. Individualization of treatment is the main requirement for homeopathic medicine. Merrell exhorts us to follow the common sense lead of the global healthcare community. “In many countries, homeopathy and other complementary modalities have been integrated successfully into a larger armamentarium for the modern physician. According to a study published in 1995 in the Journal of the American Board of family Practice, 69 percent of family practice physicians expressed interest in learning more about homeopathy.” Over 22 years have passed since that study was published. Merrell acknowledges that, “increasing public and professional interest calls for attempts to study homeopathy in a more systematic way and to provide quality academic overview for medical practitioners.” He goes on to offer a common sense conclusion, stating, “The growing number of complementary and alternative medicine centers affiliated with major teaching hospitals should provide a solid interface between evidence-based biologic medicine and many emerging complementary and alternative medicine modalities, including homeopathy.”A common sense approach to pain management, one that empowers the person to self-care, to motivation, to reclaim the inherent powers of their own bodies and minds, will lift us all up. That is health and well-being. Our natural birthright.