Faith and Healing

In case you've missed it, I'd like to draw attention to Jerome Groopman's recent Sunday book review piece from The New York Times (Jan. 27, 2008), "Faith and Healing:" http://www.nytimes.com/2008/01/27/books/review/Groopman-t.html?_r=1&oref=slogin

Groopman recently authored a fairly decent book (it was favorably reviewed in The New York Review of Books) entitled, How Doctors Think (2007), although I happen to think Kathryn Montgomery's How Doctors Think: Clinical Judgment and the Practice of Medicine (2006), is the more interesting and edifying of the two books. Read either or both, but do so in conjunction with Alfred I. Tauber's Patient Autonomy and the Ethics of Responsibility (2005).

I digress (and not for the first time), so back to Groopman's review. The title under consideration is by one Anne Harrington: A History of Mind-Body Medicine (2008). Being a student of religious worldviews and worldviews in general, it's perhaps understandable that I'd be drawn to a review that entices us with the heading "Faith and Healing." Groopman informs us that many of his patients broach the issue of, or are intimately familiar with, therapeutic modalities that fall under the heading of "alternative and complementary [and integral] medicine." By my lights, Groopman is to be thanked for not being dispositionally skeptical (or contemptuously dismissive) regarding forms of healing that fall outside the rubric of (Western) biomedicine. And please don't infer from that remark that I am, in turn, dismissive of biomedicine, I'm not, for one has only to read Paul Thagard's important book, How Scientists Explain Disease (1999), to appreciate biomedicine's contributions to the sciences and arts of healing. Still, despite a compelling narrative of medical success on many fronts, patients remain dissatisfied with the biomedical approach to healing what ails them:

"Some 60 million Americans use these therapies in the effort to combat serious diseases like cancer and AIDS, as well as the normal physiology of aging. In the United States, office visits to providers of complementary and alternative medicine now outnumber visits to primary care physicians. The costs of such care approach $40 billion dollars a year. Books, talk shows and Web sites present riveting testimonials of clinical benefits from Eastern breathing techniques, dietary supplements, positive thinking and prayer."

People are voting, and not just for presidential candidates. Harrington too acknowledges that “Quite often, [the] physicalist way of thinking about illness works," and so we come to the heart of the matter:

"Sometimes, of course, standard treatments don’t work or simply don’t exist. And sometimes tests fail to uncover any physical cause for a patient’s suffering at all. But such failures, Harrington argues, explain only part of the widespread dissatisfaction with mainstream medicine. Of equal or greater import, she writes, is medicine’s failure to address the 'existential' aspect of illness, to answer the questions 'Why me? Why now? What next?' Doctors usually frame their answers to such questions in language that forgoes any meaning for the individual. Whether cancer will return is a matter of statistical likelihoods derived from the study of large groups of patients — or, in lay terms, 'bad luck.' There is no meaning in randomness, and for the patient no sense of control. Perhaps someday genomic research will help predict the particular behavior of each individual’s cancer, but for now doctors cannot say with any precision who will relapse or why."

In short, biomedicine does not treat the myriad illnesses of the body and mind in an integral or holistic fashion that addresses the sickeness of an individual qua person, and many patients sense this, if only intuitively or inchoately. What is more, there is often the belief, right or wrong, the result of a placebo effect or not, that an attempt at healing that combines sensitivity to existential issues with therapeutic modalities gleaned from the menu of alternative and complementary medicine will work, that is, will restore the person to a state of health if not human flourishing.

Read the review, or better, Harrington's book. Although I see things a bit differently than Groopman, I'll let him have the final word:

"Harrington concludes with the questions that her students at Harvard regularly ask: Which mind-body narratives are 'true'? Are all the stories we tell ourselves about illness equally valuable? Harrington has already answered these queries in part in the voice of the woman with breast cancer in the Stanford study. Yet, she has still been 'haunted' over the years by unusual events, like the case of a man whose tumors seemed to melt 'like snowballs on a hot stove' in response to a 'worthlesss' cancer treatment that he nonetheless believed in. The physicist Freeman Dyson once noted that, to a scientist, an event like the spontaneous remission of a tumor is viewed as occurring at the asymptote of probability, one in several million, but through the eyes of a believer it becomes not mathematics but a miracle. Harrington shows us that, whatever science reveals about the cause and course of disease, we will continue to tell ourselves stories, and try to use our own metaphors to find meaning in randomness."

Well, it seems I want final say: "randomness" is a descriptive term (with normative implications) a physicalist or naturalist won't hesitate to invoke, but those of a religious or spiritual orientation (yet a Stoic naturalist could be said to practice a spirituality that is non-religious, or so a John Haldane  or a John Cottingham would argue) will probably prefer a different word here, however much perception will suggest chaos or randomness in the first instance, such phenomena being temporary or localized but no less part of a greater pattern, some telos, and so on. In other words, it's not about finding meaning in randomness, for in the greater scheme of things there is no randomness (or chaos) for those wont to find spiritual meaning in their lives. Or so it seems to this student of religious worldviews.

Patrick S. O'Donnell