The Appeal of Alternative MedicineComment on this article?
We need to be careful about categorising people in this way into two groups. (It has been said that there are two types of people: those who categorise people into two groups, and those who don't.) All the same, after making due allowances for over-schematisation, I think James was on to something important here. But let's recast his idea in more modern terminology. We could label the two mind-sets Head and Heart or, even more fashionably, Left Brain and Right Brain, and indicate the kinds of ideas they favour, as in the following table.
In relation to medicine, this becomes:
And, of course, for many people, all these polarities are quite simply summed up as:
Reversing the trendFor the last several hundred years, Western thought has been dominated by left-column attitudes, but today there is a trend towards reversing this trend and proclaiming the value of right-column thinking and activities. Alternative medicine is often claimed to be more intuitive, more concerned with "caring", than alternative medicine. For this, and for many other reasons, it would certainly figure as a right-column, right-brain, phenomenon and I have no doubt that this is an important part of its appeal for many people.
Orthodox medicine, in contrast, is thought to be over-intellectual and rational. But you may have noticed something odd about the table. I have listed "alternative" and "complementary" as polar opposites, whereas you might have thought that they were more or less synonymous. The reason for this is that the two terms imply different attitudes towards orthodox medicine. Whereas "complementary" implies a fairly amicable relationship between orthodox and unorthodox medicine, "alternative" implies a rejection of the conventional approach and the substitution of something entirely different.
When one listens to some of the more radical advocates of alternative medicine one often gets the feeling that they are saying medicine is too important to be left to the doctors. And doctors who use alternative medicine themselves often seem to be regarded as the worst of the lot. Hahnemann, the founder of homeopathy, spoke contemptuously of "half-homeopaths", meaning doctors who used orthodox medicine together with homeopathy; nearly 200 years later this practice attracts the same scorn from the ultra-committed.
'Orthodox medical training makes you narrow-minded'The standard medical training is supposed to condition you to think in the left-hand column (assuming, that is, that you were not initially selected for medical school precisely because you thought like that, which you probably were). A remarkably clear statement of the alternative position appeared recently in The Homoeopath [1990, 10, 110-113]. Its author, Dr Denis MacEoin, is an academic who is not professionally involved in homeopathy; however, he feels strongly on the subject, as he indicated in his response to a talk given by a senior homeopathic doctor at a seminar on the relations between medical and non-medical homeopaths. The doctor wished to show that orthodox medicine and homeopathy were complementary, not alternative. Most of the audience, one gathers, approved of the sentiments expressed; not so Dr MacEoin. He was entirely hostile to any attempt to integrate the two brands of homeopathy.
Orthodox doctors, and this often includes those with a smattering of homeopathic training, are not competent to lay down the parameters for the management of a homeopathic case. It is axiomatic that homeopathy represents, in the broadest sense, a philosophical and clinical contradiction of allopathy and a system of medicine in its own right.
MacEoin correctly identifies the dilemma that has always faced homeopathy. Either it tries to go it alone, and risks isolation, or it tries to integrate itself with orthodox medicine, in which case it risks being taken over. MacEoin has no doubt that independence is the right course, and he believes that this will eventually lead to a situation in which homeopathy will become "a distinctive, broadly-based medical system capable in the fullness of time of usurping the current role of allopathy...".
There must, he insists, be no compromise on essentials: "to seek for anything less than freedom to pursue the goal of raising homeopathy to the status of a primary system of medical treatment to which surgery and drug treatment will be complementary would be to betray the vision of generations of homeopaths and the hopes of thousands of patients like myself." Other homeopaths make the same point. Peter Morrell, in an article entitled Homeopathy as a Medical Heresy (Student Homeopath, April 1996), insists on the heretical nature of homeopathy, which he regards as its chief recommendation. Doctors, he holds, are unfitted to be true homeopaths.
Like "closet heretics", many homeopathic doctors have "swallowed their pride", been awarded their degree in allopathy just so that they can then become practitioners of an heretical medical system, and turn their backs forever on allopathic medicine as such. That has been the overwhelming pattern of history. But they have still retained aspects of their training as doctors that they can never shed -- such as their status in society. In effect, therefore, they are only partial heretics."
Even doctors acknowledge the problemIn a recent book on the relationship between orthodox and alternative medicine. Robert Buckman and Karl Sabbagh drew a fairly sharp distinction between the respective attitudes to consultation of conventional and alternative practitioners (whom they tend to call healers).
The typical conventional consultation, they believe, is brief ("rushed"), depersonalized and institutionalized. The patient may see a different doctor at each consultation. The doctor is trained to interpret the patient's symptoms in terms of the underlying pathology, and will probably have little patience with symptoms that don't appear to contribute to the diagnosis and are therefore "irrelevant". The doctor may have poor empathy and will probably be fairly uninterested in the patient's social and emotional problems. If the doctor is uncertain about the diagnosis or the prognosis, he or she may say so frankly to the patient, and may also not be excessively optimistic about the outcome.
The alternative practitioner, in contrast, gives the patient plenty of time -- often an hour or more on the first consultation. (Of course, this is nearly always a private consultation.) The setting is comfortable and personalized. The patient will usually see the same person at each consultation. Empathy is usually a central part of the practitioner's skill, and the patient's individual characteristics are regarded as central to the illness and its treatment. The patient's social and emotional circumstances are also considered important. The alternative practitioner is nearly always certain and confident about everything and is almost invariably optimistic. Commenting on these differences, Buckman and Sabbagh say:
It seems to be a fact of life that the attributes [of the alternative consultation] are those that human beings want from a healer. They are certainly the qualities that most conventional doctors possessed until the 1930s or so, and which some doctors have today and use. Unfortunately, many contemporary doctors were never told about these skills or about their usefulness in helping patients -- which is why, when we look at the list of qualities we want from a healer, many conventional doctors seem to be deficient in several categories.
Homeopathy is differentThere is a good deal of truth in this analysis. Patients who attend the homeopathic hospitals often complain that they have been seen by a consultant in another hospital who didn't listen to them, and sometimes didn't even look at them. If you say: "But didn't you ask him what he thought?" they often reply that they hadn't done so because they were sure it wouldn't do any good or they wouldn't get a useful answer. Whether this was true or not, it is certainly how they perceived the situation.
The important thing to understand, however, is that at least some of the unsatisfactory aspects of many conventional consultations could be mended. The skills needed to talk to patients are not entirely innate; even though there are certainly temperamental differences among individual doctors, teaching these skills is possible and indeed it is now being done in medical schools. Alternative practitioners, however, do often seem to be people who have a natural ability to form warm human relationships, and it is no doubt largely this that led them to take up the therapy they practise.
Another side to the questionSo far, then, the alternative practitioners seem to have come out ahead. They are more empathic, more "caring", better able to give many patients what it is they are seeking. But, as Buckman and Sabbagh also realize, there is another side to all this. The alternative practitioners don't just extend tender loving care to their patients; they also provide them with a complex web of belief systems. These are discussed in other essays on this page.
ReferencesBuckman R, Sabbagh K. 'Magic Or Medicine: an investigation of healing and healers', London: Macmillan, 1993.
Coward R. 'The Whole Truth: The Myth Of Alternative Health'. London: Faber and Faber, 1990.
European Commission. 'COST Action: Unconventional Medicine'. First Annual report 1993-94, 1995.
Inglis B, West R. 'The Alternative Health Guide'. London: Michael Joseph, 1983.