In May of this year our "Alternative Medicine Hall of Shame" newsletter enumerated some clunkers in the alternative medicine toolbox. The remedies discussed usually don't help and may do you harm. An attentive reader responded with this letter:
Dear Doctor:
I feel I have to reply to your article "The Alternative Medicine Hall of Shame." As a consummate rationalist, I absolutely agree that most, if not all of these fairly outlandish "treatments" won't achieve the results claimed by their proponents, and in fact, frequently cause more harm than good. However, I think you'll agree that hope is a profoundly important component in any health equation. Without the carrot of hope, whether that takes the form of faith in god, mainstream medicine, or in a practice outside the norm, most of us simply wither and die.What you've said in your latest installment is extremely valuable information to disseminate, but how about offering a little positive hope? What can people do as an adjunct or alternative to the AMA medical approach?
Hope is essential, and you are in the unique position of being able to offer some to a lot of people.
April Canaday
Hope Saves Lives
Section titled “Hope Saves Lives”For people in a lifeboat, hanging on in the face of death, hope may be the only thing that keeps them alive until that ship sails over the empty horizon. Hope enables the woman racked with nausea from chemotherapy to hang on until she can resume a life free of breast cancer. Hope is powerful medicine. I believe the best and most useful kind of hope comes as a gift of nature or spirit and it comes through a process of self-knowledge and acceptance. This natural hope is the real hope, and it differs from false or forced hope.
False Hope
Section titled “False Hope”Hope based on unrealistic expectations or "magical thinking" is, in my opinion, false hope. False hope is what leads the average impoverished family in America to invest some $600 per year in the lottery. In the field of medicine, false hope paves the way for people to believe charlatans. As outlined in our October 2007 issue, swindlers use fake science to sell miraculous cures, claiming corporate medicine is hiding the truth from the public. Ironically, hope for a cure can even blind the practitioner, making him jump to conclusions based on insufficient evidence. A handful of his cancer patients perk up for a while after eating his mushrooms, and he thinks he can skip over the case-controlled trials and claim victory.
Forced Hope
Section titled “Forced Hope”If things are looking bad but you don't want to give in to despair, maybe you try to force yourself to hope. Grit your teeth. Push away negative thoughts. Grin and bear it. The trouble is: it's hard to convince yourself of something you don't really believe, and the effort it takes to pretend may be cause you to sink. You just may choke on that smile.
In "The Four Quartets" an interesting and profound poem by T.S. Eliot, the poet writes about forced or false hope.
I said to my soul, be still, and wait without hope.
For hope would be hope for the wrong thing; wait without love
For love would be love of the wrong thing; there is yet faith
But the faith and the love and the hope are all in the waiting.
What does he mean by suggesting that hope is all in the waiting?
Hope That Comes From Waiting
Section titled “Hope That Comes From Waiting”In a second letter to me, April wrote about loss of hope:
In the face of the increasingly debilitating pain cycles, I increasingly find I have lost all hope that life might be fun again someday. As someone who once Lived Large and devoured great quantities of LIFE, the limits of the pain have created a hopelessness within that has become a struggle to maintain some shred of sanity and sometimes just to survive another night.
To my mind, this expression of hopelessness is what often comes before the arrival of real hope. As long as we are in denial or reaching for magical cures, true hope cannot be found. First a person must understand and accept the reality of her situation. That means looking at it carefully in all its unpleasantness and accurately assessing it. That means also recognizing we don't know as much as we think we do. The situation may not be as bad as we initially think, for instance. Or it may be worse. But where, exactly, are we? Can we be comfortable with uncertainty, a survival skill if ever there was one?
By hope, I mean a joyful openness to whatever may come. Hope is a kind of life-force springing from inside. It is a beautiful thing to see, and as a physician I have witnessed it many times. Here is an example, an excerpt from a letter written not by April, but by another patient reassuring her family members.
The thing is, I am fine. Which doesn't have much to do with the state of my health. There's also the matter of just how to define the condition---some think it's a form of cancer and some don't. . . In the meantime, I am not going to spend my time worrying about what this all means in terms of life expectancy and such. I love my life and I enjoy my life and for as long as the quality of it is tolerable I will be wallowing in the enjoyment of it and filled with gratitude for the good I have in it. Now, see---I'm fine!
We can't rush to hope. We do well not to let our hope be injected into us by some clever sales proposition promising the mirage of relief. As Eliot writes, we "wait without hope, for hope would be hope for the wrong thing."
April, in writing that she increasingly finds that she has lost all hope, hasn't fastened on the "outlandish treatments" she describes in her first letter, and she can't deny her illness, so she "waits without hope."
Hope — One Tool in the toolbox
Section titled “Hope — One Tool in the toolbox”Just knowing that we have hope in our toolbox of human capacity eases our minds. Once that is gone, life is gone. However, we have other tools in our kit that we can apply as we accept the situation as it is, as we wait for whatever is going to come next. Here are a few of them.
- Education: The more we know about the world, the better the decisions we can make, not just regarding our health, but in all areas of life. To April's question "What can people do as an adjunct or alternative to the AMA medical approach?" my answer is: plenty! But you have to do some work to find the answers. This newsletter strives to bring you information about both standard and alternative medical treatments. All of our back issues are available on this website. I encourage you to use this and other resources to learn as much as you can about achieving good health.
- Reason: If acceptance gives us facts about the world, reason helps us evaluate those facts. By reason I mean thinking things through analytically and weighing the evidence as dispassionately as possible.
- Love and social connections: Many studies have shown that people who maintain strong ties to friends and family live longer and healthier lives. When we have a reason to live, we have motivation and energy to remain healthy. In addition family and friends are a powerful resource when we are in trouble.
- Patience: We all have our areas of expertise, and that expertise did not come quickly or easily. We grew that expertise gradually, first approaching a new skill in confusion, maybe failing over and over at some task we eventually mastered. Success may not come until tomorrow, but can be built on the patient work of today.
Save the Hope
Section titled “Save the Hope”My advice is to leave hope in the toolbox until the time is right.
I will tell you that as April patiently bore her suffering, real hope came from within. She applied her problem-solving skills and found ways to cope and gain control over her illness. I'll save that story for a future issue. Meanwhile, I believe that you'll find, as did April, that your solutions will come from acceptance, grit, and an ability to see the world as it is.
Keep hope in your toolbox and remember how Richard Niebuhr began his well-known "Serenity Prayer":
God, give us grace to accept with serenity the things that cannot be changed, courage to change the things that should be changed, and the wisdom to distinguish the one from the other.
Annual Non-Profit Dispensary Report
Section titled “Annual Non-Profit Dispensary Report”The Monroe Street Medical Clinic runs a non-profit dispensary to provide remedies for our patients. Any profits we inadvertently make are donated to United Good Neighbors. Last year there was no profit.
Here is the accounting for our nutritional dispensary for the year 2007.
Income from sales ..............................49,469 Cost of goods ..................................31,719 Ordering, stocking, pricing, cashier ...........12,519 Pro-rated portion of operating expenses .........7,854 Profit or Loss .................................(2,622)
By the way, some brands of product we carry are much less expensive on the internet. You can buy Larix, for example, for significantly less than our wholesaler sells it to us. Volume, they tell us. However, when you are ill and cannot wait, we can provide it.