The New Mind-body Paradigm

“Wherever a thought goes, a chemical goes with it” — Deepak
Chopra
Life-threatening illness is more than a crisis of the body; it
is a crisis of the soul During thirty-five years as a
hospital-based cardiologist, I have seen innumerable ways in
which patients react when faced with a medical catastrophe
Initially, most are overwhelmed, and feel as though they have
been attacked by an alien force–as if body, mind, and spirit
are under siege
Many patients become paralyzed by fear All resistance crumbles,
replaced by passivity and resignation Some go into denial,
unwilling or unable to confront the enormity of what is
happening Yet others meet the crisis by challenging it head on,
and in the process, discover within themselves the resources to
confront and overcome the gravest of circumstances At times,
these patients triumph, not because of the medical care they
receive, but in spite of it
There exists in all of us, a life force: the foundation of
organic existence In some, this drive is powerful and
passionate In others, there is ambivalence about continuing the
burdensome business of living When disease strikes, many are
all too ready and even willing to have their lives end But
passivity or resignation are not immutable reactions to a
life-threatening illness My patients have taught me that the
will to live can be awakened at any moment during its course
Medical science has largely been blind to the power of a
patient’s mind in determining the outcome of an illness Doctors
are taught to view patients as the sum of their bodily parts,
and to treat diseases by relying almost exclusively on the
marvels of medical technology Their unspoken communication to
patients is unmistakable: We will mobilize our array of
procedures and wonder drugs to save you If they don’t work, you
are beyond help
Having spent much of my career as an academic physician
directing medical research programs, I have participated in the
development of technological advances that have led to this new
patient-care paradigm While today’s medical arsenal is
invaluable in the combat against life-threatening illnesses, it
has brought about a major side effect: far-reaching changes in
the time-honored patient-doctor relationship
That bond, once an invaluable component of the healing process,
has become undermined On teaching rounds, I have always felt it
important to point out the ways in which doctors unwittingly
discourage patients from mobilizing their inner resources to
overcome an illness by implying that these elements play no part
in the outcome I emphasize how powerful these resources can be
Experience has taught me that they are comparable to any
avant-garde pill or procedure
This was dramatically demonstrated to me many years ago by a
patient named Vivian, who was suffering from progressive heart
failure The cumulative cardiac damage caused by several
previous heart attacks had forced me to admit Vivian to the
hospital three times in four months Her heart had weakened to
the point where it no longer responded to maximum doses of
intravenous diuretics and other powerful medications Edema
fluid had accumulated in both her lungs and legs
In the previous twenty-four hours, Vivian’s kidneys had begun to
shut down, making it impossible to treat the massive watery
accumulations in her body Her liver and other organ systems
were also becoming affected All therapeutic options had been
exhausted Vivian’s chances for survival were close to zero
After suffering for ten days in the Intensive Care Unit, Vivian
had had enough “Look, Doctor,” she said, “I am seventy-two
years old My husband has been dead for fifteen years, and my
daughter hasn’t spoken to me since the day he died I’m in
constant pain, and I have nothing to live for Please let me go”
Despite their estrangement, Vivian had listed her daughter Janet
as the person to be notified in the event of her death When I
asked whether Janet knew how sick she had been, Vivian shook her
head
“My daughter doesn’t know, and I’m sure she doesn’t care”
“If you wouldn’t mind, I’d like to call her”
“I don’t see the point What good would it do?” “It might not do
any good, but I think your daughter should know what’s going on
with her mother”
“Frankly, I think it’s a waste of time”
Two nights later, Janet came to the Unit accompanied by her
ten-year-old son, whom Vivian had never met
The following morning, a different woman greeted me in the Unit
Vivian looked at me, eyes glowing, and said, “My daughter is
getting married in three weeks She wants me to walk down the
aisle with her” Tears welled up in Vivian’s eyes, as she took
my hand and whispered, “I want to be there, Doctor”
Within days, Vivian’s kidneys began to open up The same dose of
intravenous medication that had been ineffective now caused a
substantial decrease in Vivian’s edema fluid After a week, her
lungs were clear By the end of week two, we were able to switch
from intravenous to oral medications, and move Vivian out of the
ICU
Three days before discharge, Vivian began gingerly hobbling down
the hospital corridor with the aid of a walker, the same one she
used to walk down the aisle alongside Janet at her wedding
Vivian not only attended her daughter’s wedding, she also lived
to attend her grandson’s bar mitzvah three years later
Every doctor has seen patients with a life-threatening illness
make a miraculous recovery after they were thought to be beyond
hope But because medical science is unable to explain these
extraordinary occurrences, their importance is often ignored
Medicine is so enamored of the apparent infallibility of science
that it has become blind to other possibilities But remarkable
recoveries like Vivian’s are possible for all of us As Emily
Dickinson wrote: “We never know how tall we can be until we are
called on to rise”

Tags | academic, advances, ambivalence, catastrophe, existence, medical, mind, organic, physician, programs, research, result, spirit, technological, unspoken