Monday, July 7, 2008

Karma or Quack?

Oh, I've given myself bad karma and a bad spondylitis flare. Now why couldn't my neighbors experience karma that would keep them from setting our doormat and front door on fire with a firecracker on July 4? (It went out right away, but I don't need that kind of drama in my life.)

Anyway, here's a news report on the Cancer study that shows cancer patients die at the same rate whether or not they demonstrate a positive emotional state:

In a book review of Anne Harrington's The Cure Within: A History of Mind-Body Medicine, Jerome Groopman (How Doctors Think) details how the body may indeed become ill from stress. The problem, apparently, is that people believe the opposite is also true, that because A-->B, ~A-->~B. That's faulty logic. Harrington says that doctors are unwilling to recognize that such measures as support groups don't reduce mortality and save lives. It isn't that support groups and organizations and spiritual practices aren't helpful. Navigating and experiencing the health care system and dealing with a new diagnosis can be extraordinarily difficult. Having others' support can make all the difference. People's inner well being is as important as their physical health.

In addition to the belief that A-->B, so ~A-->~B, there are very obviously questionable conclusions made in many research studies. Most often this takes the form of asking patients who have a particular illness to rate themselves on various measures of psychological state and disability. What's actually found and what could be fairly concluded from these studies is that people who are more ill rate their psychological health as worse than people who are less ill. That should not be any kind of surprise to anyone. But this is not the typical researcher's conclusion. Most of these studies conflate psychological state and disability at a single point in time, so that it's concluded that people who are less ill are less ill because of their positive thinking; it's the familiar causation and correlation error. In making conclusions not supported by the evidence, doctors sound dangerously like the Andrew Weils and Louise Hays that many of them would refute.

The placebo effect and conditions aggravated by stress, such as migraine or irritable bowel syndrome, indicate that there is a mind-body connection of some sort. But some moderation is needed, with an appreciation for the complexity rather than simplicity of the connection. We cannot wall ourselves in to remove all our stresses. There are many treatments, but few real cures offered by contemporary medicine. As people in the breast cancer community say, you never know if you're cured unless you die of something else. It is apparent that many conditions and illnesses cannot simply be willed away.

Again, this isn't to say I don't try. I, for one, tried to figure out fifth chakra issues as I prepared for surgery; I wasn't able to conclude anything in particular. I am smart enough to know it's better before surgery to pray for my doctors' guidance and abilities than for my own health. I don't believe in praying for better health; I am blessed and that would be a selfish request. To those who say they pray for me, I would like to say, pray for my ability to handle it and to help others. Why should any God spend any effort on my healing, but not give food to the hungry senior man in the diner who's only ordered a cup of coffee and pleads with his eyes, and who, though he gets one meal, clearly misses others? Nothing works as we would like; pray and be healed, think positively and be cured. If only it were so easy to try harder, run faster, do more. But I do know this. Physicians, alternative practitioners, and patients have got to stop dismissing each other and start listening. None of us has all the answers. And it's not enough to just "think positive."


The Goldfish said...

Beyond the false conclusions built on any correlation between impairment and stress is the idea that if stress is compounding or contributing to illness, then that's a simple relationship that the individual can act easily act upon, by, as you say, "thinking positive".

The link between psychological factors and mental illness is much more obvious, but individuals still have limited control over their health.

FridaWrites said...

Yes, rare is the person who can will himself/herself out of depression or other illness.

Elizabeth McClung said...

I would love to HAVE control over my illness, but much like rape - it isn't happening to me because I deserved it, or dressed in a particular way, or "was asking for it" -

A British study compiled 26 studies and found the same thing, how long you live with cancer has nada to do with your attitude.

Here is the reality I have found: ""Patients in my support group joke, 'Am I living longer yet?' They grieve deaths when they occur, but feel they grow stronger doing so," said Spiegel. "They joke about the prison of positive thinking. The connection between mood and cancer is not about 'positive thinking,' it is about managing the very real stressors of life-threatening illness."" - being there, having support networks, surviving.

But yeah, I do it too - funny that you prayed for the surgeon's health - I would do that too - only I also look for a surgeon who is so OCD about that procedure that any failure would bring about such great frustration they couldn't stand it to know they had failed in any way (aka - I look for bad social skills combined with an terrible bedside manner where all they want to do is look at the potential surgery site - as well as high ratings.).

Sounds like you got the right surgeon, and his health WAS good.

So can we all burn our copies of Spontanous Healing?

FridaWrites said...

What I'm wondering is whether patients end up feeling guilty/depressed not just because of a bad outcome, but because people imply it's their fault. I'll make it my little mission to divest other people of that false belief. To clarify, it's my internist who focuses on my need to self heal, not the spine doctors.

My spine doctors are in most regards well above average in people skills. Luckily I've not had a failed back surgery, and the other doctor says he had really hoped his procedures would help. A personal investment in outcomes probably really does lead to better outcomes. I thought my PT was thinking I wasn't doing enough last fall, but he confessed he always feels really bad when outcomes aren't as expected and does take it personally. Maybe I should share this idea with him, too. There's only so much they can do.

I have to hope as much for their steady hands and no "oops" than how my body reacts. He seemed to have slept more than I did, which was good.

Spontaneous Healing-->Spontaneous Combustion. Sometimes I've worried about spontaneous combustion if I've had medicine containing alcohol and have a heating pad on (legend says alcohol + heat + fat leads to internal candling).