“We Need Scientific Proof!”

This is what a young resident told me the other day after I finished frying the synapses of my ER bud, Mark. Mark has been a happier camper since I started giving him a weekly Reiki treatment, and the resident was puzzled as to why. He simply couldn’t wrap his brain around the idea of energy treatments via my hands would send his formerly high octane boss into Nirvana.

He fell into the same trap that all good scientists do; he wanted to disseminate Reiki in order to understand its scientific properties, like one would do with a medicine. Problem is, there is little about Reiki that will satisfy our current definition of science. I tried equating Reiki to love – you can’t disseminate love either and, while there are some who question its existence, most of us accept it as part of our DNA. The resident was having none of it.

We were at a standstill until it hit me; he knows zip about the foundations of complementary alternative medicine principals, so it’s impossible for him to process the viability of Reiki. It’s like love. Until you’ve flipped both sides of the coin and have been in love, it’s impossible to make any judgments about it one way or another. Hampered by the lack of fundamental understanding, this resident is listening to a foreign language.

The way I see it, this resident is representative of the dichotomy currently taking place in medicine. Because many scientists don’t understand CAM principals, they want the ability to reduce holistic systems down to their most basic physical mechanisms like they do with medicine. Thing is, CAM can’t be measured following the traditional scientific rules, so the data becomes minimized, obscured, or distorted. I’m no longer puzzled over responses such as this young resident because I have friends like Mark who offer little in the way of scientific verification other than he “feels reeeal good.”

With friends like this, who needs enemies?

It doesn’t pay to get behind in my email. I opened up my NIH NCCAM newsletter to discover that the NIH, in all their wisdom, appointed a new director to NCCAM (National Center for Complementary and Alternative Medicine). This, in itself, is no great shakes, but they appointed someone who knows squat all about integrative medicine. This makes as much sense as appointing a radiologist to be the new director for Cardiothoracic Surgery.

Why would they favor someone who has no experience with integrative medicine over the many qualified docs who use it in their practices every day? It’s been mandated that 50% of the members should be licensed in the disciplines that NCAAM are supposed to study, yet they are woefully short of that at 25%. Is this payback for Congress passing legislation that enacts the study of complementary alternative medicine and shoving it down their throat?

With health reform being bandied about with our morning Cornflakes, one would think methodologies that concentrate on preventative viability would create some level of priority. Then again, we are talking about a government entity. There’s a great article that goes to the heart of this.

Ah well, I know of a number of docs who would cheer this appointment.

NO! Say in ain't so

I'm bereft. No, I haven't been slimed by my beloved docs recently about integrative medicine. It's worse. Much worse. Jessie L. Marin / Ed Green is leaving Law and Order. How can this happen? This borders on a national tragedy, and I'm ill prepared to cope. I love Ed. He's so cool and always gets his perp. This calls for the heavy artillery. Quick, someone hand me my therapeutic smelling salts, my Reiki mentor, some acupuncture needles, a biofeedback technician, my favorite guided imagery tapes, and a yoga mat.

Um, just how sick am I?

I know I believe in all kinds of homeopathic healing options and everyone is sick right now, but this Neti pot thingie sends me into fits of giggles every time I watch it. I'm not sure if it's her calm demeanor while mimicking my favorite favorite plaza fountain that spazes my bladder, or the serious art of toe touches. Either way, I'm certain that if the office folks caught me doing this, they'd fit me for a designer straight jacket.

“Why Reiki?”

My friend Mark, an ER doc, sat across the table from me and finished his Coke, making that disgusting slurpy noise when the straw hits the bottom of an empty glass. “I really liked your book, but, geez, why Reiki? It’s so, so –”

“Out there?”

He laughed and nodded. “Out there. Definitely.”

I shrugged. “Why not?”

“Because, like I said, it’s out there.”

“Look, Mark, you’re equating ‘out there’ as ‘not viable,’ and while my book doesn’t set an agenda, it is an entertaining invitation to think outside the box. I think docs who integrate alternative forms of healing to their practice is an intriguing idea. It’s controversial, to be sure, but it also gets people talking on both sides of the aisle about the future of health care and the various paths that care might take. This sells books, and, as an author, this makes me happy.”

“So it’s all about sales.”

I toss my straw wrapper at him. “Well, yeah, it’s about sales, stupid – I’m an author. But it’s also about making the reader go, “hmmm.” Integrative medicine is happening, as you well know. The first rule of writing is to write what you love and what you know. I love the whole doctor thing – what makes you tick, how you handle controversial ideas, and how your biases or personal journeys affect your patients’ care. What better idea than to bring two explosive ideas together – docs and integrative medicine? I’m very good at getting under the white coated curtain to humanize docs. I chose Reiki, in particular, because it’s one of the least understood forms of alternative healing options but produces some of the most interesting results. It’s also easy for docs and nurses to do while they’re working.”

“Yeah, I know, I know,” he said, rolling his eyes. “The old laying of the hands bit to spread energy around. So what’s it accomplish for the patient?”

“Let’s put it on a simpler level. It’s been cold lately, right? And we humans work better when we’re comfortable. So rather than heating empty rooms in the entire house, I close vents and doors and trap the air in the rooms where we’re occupying. That means the guest room is freezing, and so is the library. Our bodies are the same way. Energy surrounds every living cell, but energy gets trapped and doesn’t flow properly. It affects our health. Reiki goes in and opens the doors and lets the warmth flow in all the rooms.”

Mark stared at me. “Do you have any idea how ridiculous you sound?”

I thought of some of the internet docs I know and seminars I’ve attended. “Yeah, Mark, I know how ridiculous I sound. I felt the same way when I first heard about Reiki. My original manuscript had Reiki as a mere footnote. Through my research phase, I encountered it on a more personal level and became intrigued. The more I learned, the more curious I became. After a few shots of this energy stuff, and I had to know more. It took my book in a whole different direction. The fact that I was an ardent skeptic shouldn’t be ignored. I made them prove it to me.”

“Yeah, but that’s the point. You can’t prove Reiki works.”

“I know how I felt. I saw verifiable changes through how relaxed I felt. I nearly soiled myself to realize I no longer needed my meds. That strikes me as fairly compelling proof. And no one could explain it.”

“But you can’t guarantee results.”

“You can’t guarantee results with hypnotherapy, either, but it’s been widely accepted for years. And now I’m hearing that guided imagery is being elevated beyond the X-files category? I’ve seen some great things happen with guided imagery on cancer patients, but come on, no one can guarantee its efficacy. Even so, you guys have decided to give it its due? It’s selective. And it’s like you say; Reiki is ‘out there.’”

He shoved his drink away and folded his arms. “Okay, fry me.”

I blinked. “Huh?”

“Fry me. Go on, give me a Reiki treatment.”

I looked around the crowded restaurant. “I can’t do it here.”

“We’ll go back to the hospital.”

So we went to the hospital where he found an empty exam room. I had him lie on the exam table and relax while I took some deep cleansing breaths. It took mere seconds to feel the trademark warmth pulsating through the palms of my hands. I placed my hands on his forehead and the top of his head.

“Why there?” he asked.

“Beats me. Seems to be where my hands want to go.”

“It’s hot.”

“Yes, Mark.”

“Feel gooood,” he said, sounding slightly mushy. “Oh wow…”

Within minutes Mark was snoring. I zoned out, too, which is common. It’s not falling asleep, but rather, going into a meditative state where you’re semi-aware of your surroundings.

The energy subsided, and I woke up. Half an hour had gone by. I removed my hands from Mark’s head, and he woke up slowly.

“I feel like a freaking million bucks,” he said, stretching. “I also feel like I’m on another planet. Will I be able to do my job?”

“You’ll do just fine. I promise.”

He called me later that night, after his shift. “Um, so, like, when can you do this Reiki shit again? I had the shift of my life.”

“Slow night?”

“Are you kidding? We had our usual pile up of death-defying teens driving Daddy’s expensive cars, drug seekers, sniffles, flu, illegals – the usual. But none of it bothered me. I handled my cases and dealt with the usual administrative crap that prevents me from practicing medicine the way it should be practiced – and it rolled off my back. I flew through my shift with a smile. A freaking smile! I never smile. Not anymore. Whatever you did to me, I want it again. Yeah, yeah, I know what I said earlier today, but I’d like to see if my shift was a fluke or whether you really got something here.”

“So now you’ve answered your own question,” I said.

“What question?”

“You asked me today, ‘why Reiki?’ for my book. Now you know. Now go forth, young Grasshopper, and tell your colleagues that we aren’t to be feared, but embraced.”

“Yes, Great Yoda…”

“I need it, but I don’t want to pay for it!”

I liken universal health care (and government in general) to my kids. Back when they were young, we paid for everything. As a result, they “needed” this and “needed” that. It got out of hand, and my husband and I realized we were creating little entitlement junkies. It was time to teach them a serious life lesson about responsibility. We gave them chores that allowed them to earn money for their “needs.” As I suspected, our jaunts to the mall still consisted of those same “needs,” and it was a lovely moment when I reminded them that they had their own money.

“WHAT?” they screamed? “You want US to pay for that Barbie/G.I. Joe with OUR money?” The indignation nearly melted the paint off my car.

“Absolutely,” I replied, enjoying the moment. “This is called fiscal responsibility. Money doesn’t grow on trees, and you have to spend your money wisely. Ask yourself whether you really need this toy. Of course Dad and I pay for your basic needs, but if you want to add one more Barbie/G.I. Joe to the bursting-at-the-seams toy box that’s filled with hardly-used toys, then knock your bad selves out. Only you’ll have to do it with your money.”

“It was a lot more fun when Mom bought all the toys,” they grumbled while deciding they didn’t really need a new toy after all.

And that’s the way I see this push for a national health plan. Spending is a lot more fun when the government can raid our wallets via taxes and garnished wages (if Hillary gets her way) in order to provide something that “feels good” but is structurally unsound. Just like my kids, there’s no accountability or concern for quality. Anyone been through the DMV lately? But where I was able to reign in my kids’ spending habits, we continue to vote in politicians who foster wasteful pork barrel spending so that “the little people” will continue to support them. And they use my hard earned money to do it.

I noticed that when my kids paid for toys with their own money, they took better care of them. They made sure the toys were put safely back in their toy chest, kept clean, and in good working order. Toys that we’d bought were left outside for the dog to eat and barf up on the carpet at three in the morning.

Being a parent isn’t a popularity contest, and I’ve made thousands of unpopular decisions in their lives. But I said no to my kids because I wanted them to understand that they are responsible for controlling every aspect of their lives – that, for example, it’s no one else’s job to ensure that they have medical insurance or even pay for their medical care. If you’re sick, you go to the doctor and you pay for it – just like you do when you buy a new G.I. Joe.

Why on earth can’t we say no to the politicians who promise Coke in the drinking fountains and “free” health care for all? Since it’s “somebody else’s money,” there is no incentive to be fiscally responsible. They’re Robin Hood on crack, and they’re killing our free will along with our overworked ER docs. How long will it take until our ERs become every bit as inefficient as the Department of Motor Vehicles and my kids’ toy box?

And what about the docs? If you listen to the politicians, they are always talking about how doctors “make too much money.” Docs are already making less because insurance companies have decreased their payouts. None of my doc friends went into medicine for the money, but my GOD, considering what they go through to become docs, I think they should make whatever they damn well like. But then again, I believe in a free market and healthy competition to keep spending in control.

In my personal circle of friends, three docs left the ER, and one left medicine all together. Multiply this across the nation, and you have a serious strain on the medical community. I understand that many who aren’t insured aren’t lazy or looking for a free ride. But looking at my tax bill, I find it difficult to contain my frustration and anger. I thought very hard about my future and took special care to get a good education and seek jobs that offered good insurance. When we were unemployed a long time ago, we still paid for our insurance. It ate at our savings, to be sure, but we viewed medical care as vital as breathing. If I worked hard and thought ahead so I wouldn’t be a burden to society, why can’t others? Isn’t this responsible? It’s not my neighbor’s job to see that my kids got their puppy shots and check-ups. And can someone please tell me why I have to pay for someone who’s in this country illegally?

Nothing is “free.” The money has to come from somewhere, and that ‘somewhere’ is our out-of-control taxes. The more we make, the more we pay because it’s our “duty” to take care of those less fortunate. Is it also my duty to pay until my personal money tree has been picked clean?

It’s a given that the government is all too willing to step in and to implement their social programs funded with our sweat. It’s all about control and votes. But I think what bothers me the most is society’s compliance in letting it happen. How many people out there have long forgotten our independent American spirit that believed in making all things possible through our own hard work? We make our lives happen – not the government.

Many are unwilling to take personal responsibility for their lives and expect those who produce to pick up the tab. If you have a cold and fever, do you go to your PCP and get checked out – knowing you’ll have to pay for the services up front – or do you clog up the ER and get treated for free? If you live in any American city, the answer is yes.

In the end, I’m less concerned about the reasons why people have this “it’s your job to take care of me” attitude. I’m more concerned with protecting what little I have remains mine. And my kids? They buy their own toys.

Object lesson

“Mom, Dad, what’s socialism?” #1 Spawn asked us over dinner years ago.

Hubby replied, “It’s the distribution of wealth. It takes money from people who have more money and give it to those who don’t have as much.”

“Who makes that decision?”

“The government.”

“Why do they do this?”

Ah, the sixty four gazillion dollar question. “Socialists believe that everyone should be equal.”

#1 Spawn’s face screwed up. “Well, that’s not a bad idea. There are people who can’t eat, or don’t have anywhere to live, or can’t see a doctor. If a rich guy has a big mansion and fifteen cars, why shouldn’t they help poorer people?”

“Do you think it should be forced?” hubby asked.

“Well, if the richer guy isn’t willing to share, then, yeah, the government should tell him to share.”

“Okay, let’s put this to a practical application,” hubby said. “How much money did you earn last week washing cars and mowing lawns?”

“Thirty dollars,” our budding young socialist replied.

Hubby then looked at our other two spawn. “How much money do you two have?”

#2 Spawn puffed out his chest. “Fifty-five cents.”

#3 Spawn, only four, said, “What’s money?”

“Okay,” hubby said, “#1 Spawn, you have thirty dollars. Let’s pretend I’m the government, and I’m telling you that you have to give #2 and #3 Spawn seven dollars each so they can go to the movies.”

#2 and 3 Spawn were thrilled beyond words.

The response was predictable. “Why?” #1 Spawn screamed. “I earned that money!”

“But they don’t have any money.”

“Well then they should go out and mow lawns and wash cars like I did. Then they can do whatever they want. They can’t have my money!”

“But I thought you said that people who don’t have as much as the rich guy should be forced to share.”

“I lied!”

Hubby smiled. “Relax, I’m not going to force you to give them any money. But what you need to know is that this is exactly what the government does. We’re now forced to hand over a lot of our money over to the government who, in turn, gives it to people who don’t have as much. And it doesn’t matter whether we like how they’re spending our money or now. We still have to pay it.

“What are some of the things you don’t like?” #1 Spawn asked.

“Well, you know how Uncle Mark is an emergency doctor? He has to treat people who can’t or won’t pay their medical bill. And he also has to treat people who aren’t in this country legally. Since neither of these groups have health insurance or money, they clog up the emergency room so people who have real emergencies have to wait a long time to be seen. These people use Uncle Mark as their personal doctor, like when we go to Dr. Bentz for the flu.”

“So he works for free?”

“Well, the hospital pays him, but the hospital doesn’t get any money from these people. Someone has to pay for all the medicine, equipment, and hospital staff, so we end up paying for it in higher taxes and insurance fees. And Uncle Mark is busy, even when the insurance companies decide to pay less for treatments.”

The dawn began to light on #1 Spawn. “So the government takes money out of your paycheck to pay for someone who can’t pay their bills.”

“You got it.”

“So, we’re socialists?” #1 Spawn asked. “I thought that was like Russia.”

“We’re not like Russia,” hubby said. “But we’re on that track.”

“So what will happen to us?”

“We’ll have to work twice as hard to keep up with taxes and keep a good life for us as well.”

“That’s not fair. Those people have to plan ahead, like Mom told me to do when I had that term paper last semester.”

Hubby shrugged. “Can’t disagree with you.”

#1 Spawn speared a piece of broccoli and stuffed it into his mouth before patting his wallet. “Socialism sucks.”

#2 Spawn piped up. “Does this mean we aren’t going to the movies?”

“Get a job and pay for it yourself,” #1 Spawn sneered.

New employee to the rescue

Yessiree, I’ve been wishing for extra help for my day job – someone who would answer phones, take messages, file, be my all around gopher. My prayers have been answered…

Scroll down…

Yep, she’s tops. Her name is Lola. Pay comes in the form of walkies and kibble. Wish I could convince our editors and cover designers to charge the same fee.

You’re wondering if your eyes are deceiving you. Is that a diaper she’s wearing? Why yes, yes it is. She’s in heat. You just haven’t lived until you’ve diapered a dog. I wonder if she gets PMS? Or cramps? As long as she doesn’t ask for a day off on account of “the Curse,” I’m good.

P.S. This is my son’s dog. Cute as a bug’s ear. But can’t staple worth a tinker’s damn.

Scutmonkey scores!

How excited was I to read this in Publisher’s Marketplace?
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Columbia-Presbyterian anesthesiologist and The Underwear Drawer blogger Michelle Au's SCUTMONKEY, a meditation on life as a medical resident, wife and mother, to Emily Griffin at Grand Central, by Sharon Bowers at The Miller Agency (World).

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Scutmonkey scores big, and, as one whose day job encompasses the publishing world, I couldn’t be more excited. I spend my early mornings looking forward to reading Scutmonkey’s cartoons and blog. All I can say is, congrats Michelle/Scut. You landed yourself a great deal. Welcome to the insanity of publishing.

Because I Said So

There is a perception that docs who believe in integrative forms of medicine must be flawed in some manner, that they’ve been taken hostage by “conversion phenomenon.” And because William T. Jarvis, Ph.D. said so, it must be true. What’s worse; this misinformed article is being waved in the air as the great defender to those who decry the evils of alternative medicine. These medical professionals have suffered nervous breakdowns, have low self-esteem, are paranoid, going through a divorce, or are in the midst of a mid-life crisis. I find this every bit as comical as I do pathetic. Why, for the love of all that’s sacred, would anyone refer to a ten-year-old article where the most recent references are from 1987? This is supposed to be compelling? I’ve heard those very same reasons as to why democrats exist. The article is pure bunk.

When I think back to 1998, I remember the medical world laughing hysterically at biofeedback and guided imagery as something the Birkenstock and tie-dye-wearing community would embrace. Certainly not respected doctors. Flash forward to 2008. Now we’re hearing that biofeedback, hypnotherapy, and guided imagery are not only acceptable, but they’re no longer “alternative medicine.” Huh? Don’t get me wrong, I’m thrilled at the acceptance of these modalities. What surprised me is that they are now being called mainstream. As defined by NIH:

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Complementary and alternative medicine (CAM) is the term for medical products and practices that are not part of standard care. Standard care is what medical doctors, doctors of osteopathy and allied health professionals, such as registered nurses and physical therapists, practice. Alternative medicine means treatments that you use instead of standard ones. Complementary medicine means nonstandard treatments that you use along with standard ones.

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Obviously many things have changed in the ten years since Dr. Jarvis penned his fantasy. Not unexpected because medicine changes at an alarming rate, as does professional opinion. But I’d like to know if this transformation from alternative/complementary to standard care happens by agreement. If so, who is the governing body? How many make a quorum? What is the litmus test? How did they come to this agreement? Who votes?

Admittedly, I’m confused. On one hand, I have docs telling me about the dreaded “conversion phenomenon,” and that no sentient doctor would be so taken in by this lunacy. On the other hand, I see what was once “alternative” is now standard care, such as hypnotherapy, biofeedback, guided imagery. What’s worrisome is that there is a vocal community within medicine who don’t agree and there are a lot of darts being lobbed back and forth. This is fine if that’s what floats their boats. But you know what, this ultimately affects patient care. Where some docs may prescribe a drug, another may prescribe biofeedback. Who’s the winner of this scenario?

Response

I get comments on my blog. Since there was so much to address with this particular one, I decided to turn it into a separate post.

“This post should be titled, "Attack of the Straw Men."
No, I prefer it the way as is. What I don’t think the world needs more of is condescending platitudes.

“…you're mixing apples and elephants. Hypnotherapy, guided visualization and biofeedback (essentially relaxation therapy) are qualitatively different from Reiki, acupuncture and chiropractic (magical thinking in lieu of any plausible scientific basis.) Lumping them all together is a "Trojan Horse" strategy, per Orac, via Dr. RW (see comments section from this post for the full quote)”
Not sure who put Dr. RW in charge of all convening opinions, but according to Panda and others, this is an all or none proposition. It’s either science based medicine or it’s hooey – there is no in between. Now I’m being told that some alternatives are now suddenly deemed “okay” by the medical community – going so far as to question why they were even called “alternative” in the first place? I don’t believe this for a minute. Acceptance from the medical community comes in degrees, and it’s based solely on the fact that some methods are easier to swallow than others.

You’re now giving Biofeedback its due? Why? It’s mind/body medicine, after all.

Biofeedback as taken from the Mayo Clinic:
Biofeedback is a type of complementary and alternative medicine called mind-body therapy. It's designed to enable you — in mind-over-matter fashion — to use your thoughts and will to control your body. Biofeedback is based on the idea, confirmed by scientific studies, that people have the innate potential to influence with their minds many of the automatic, involuntary functions of their bodies.

Guided Imagery (visualization), as defined by Web MD:
Guided imagery is a program of directed thoughts and suggestions that guide your imagination toward a relaxed, focused state. You can use an instructor, tapes, or scripts to help you through this process. Guided imagery is based on the concept that your body and mind are connected. Using all of your senses, your body seems to respond as though what you are imagining is real.

Hypnotherapy as defined by University of Maryland Medical Center:
Hypnotherapists typically use exercises that bring about deep relaxation and an altered state of consciousness, also known as a trance. Many people routinely experience a trance-like state while they are watching television or sitting at a red light. A person in a trance or deeply focused state is unusually responsive to an idea or image, but this does not mean that a hypnotist can control his or her mind and free will. On the contrary, hypnosis can actually teach people how to master their own states of awareness. By doing so they can affect their own bodily functions and psychological responses.

This is mind/body medicine, folks, alternative medicine. And this is okay with you? I find the irony staggering. There is no more “science” to these alternative healing methods than there is with acupuncture, reiki, and chiropractics. The only way to determine the level of healing is asking the patient how he feels. By all admissions, this isn’t acceptable.

I’m confused as to how guided imagery can be easier to accept than Reiki, acupuncture, or chiro. At least with chiropractics, you have the benefit of x-rays. It’s pretty easy to see if a disk or hip is back in place after the course of treatment.

The truth of the matter is that the fraction of docs who don’t believe alternatives have any place in medicine have never done the research. They go to the sites and literature that only support their bias. How can I make such an inflammatory statement? Because of the many docs I researched who do use integrative medicine in their practices. I’ve been told time and time again that the literature is out there. It’s just that the docs aren’t listening. Or they’re being selective.

A key issue is that when looked at scientifically, the data you speak of for CAM are far from compelling.
Then why and how is it that biofeedback, hypnotherapy, and guided imagery get a pass, according to Orac and Dr. RW. They’re alternative medicine, no matter how one tries to justify it. You simply cannot rewrite the rules to fit your needs, and that’s exactly what it sounds like you’re doing.

The "respectability" of those promulgating it is irrelevant.
Are you kidding me? First I’m told that “some” alternatives are okay. Now you’re telling me that the opinions from respected and renowned docs who utilize integrative medicine in their practices are irrelevant. Why are their opinions irrelevant? They earned their reputations because they were recognized as being superior at what they do. This appears to be a case of, “I don’t like what I’m hearing on this particular issue, so I’m going to dismiss it, regardless of who said it. But, boyo, his opinions on heart valve surgery is bang on.” This is talking out both sides of your mouth.

Basically this comes down the fact that many docs will never see eye to eye on the integrative issue. The methods of dismissal are akin to politics – if one talks it up or down enough, it becomes real “because I say so.” That’s not reality, and thankfully, there are many, many docs who disagree with you because they’ve had success with alternatives and use any number of those methods in their practices - including Reiki, acupuncture, and stuff I've never even heard of. The face of medicine is changing to include other forms of healing.

As I've said a million times, I would never proscribe anyone turning their backs on their docs. But I don't believe that docs know everything there is about how the mind and body integrate in healing. Some things are, indeed, seemingly magical because there's no science that can back it up. But that doesn't make it irrelevant. It makes it compelling.

Is It Real?

Yesterday’s paper had a long article about fibromyalgia and the controversy over whether it’s a made-up affliction or real, which begs the question as to how the medical community defines disease. Can disease only be defined by the ability to measure it with medical testing, or are the symptoms enough to give it disease status? For a non-medical person like me, this question falls under the classification of, “if a tree falls and no one is there to hear it, is there noise?”

On one hand there seems to be an agreement among the medical community that if a consistent set of symptoms exists in a high enough populace, then a “disease” or “syndrome” is added to the books – regardless of whether there is a test to measure its existence. I’m good with that. I believe we can have afflictions that science has no means of measuring yet.

But what happens when science changes their mind and decides that a disease isn’t a disease after all – as with fibromyalgia? Frederick Wolfe, the lead author of the 1990 paper that defined how to diagnose fibromyalgia, now believes that fibro is a physical reaction brought on by stress, depression, and economic and social anxiety. Yikes. What was real for 18 years is now bunk. Just like that.

This article made me think about other afflictions that are void of scientific testing, and the only barometer is a populace suffering from the same symptoms. Attention Deficit Disorder is a big ticket item. And what about that real heart breaker – Restless Leg Syndrome? (I can’t help but wonder if Big Pharma came up with that one on their own – the idea of it is just too silly to contemplate)

What’s interesting about these syndromes and disorders is that the drugs invented to ease patient suffering are as enigmatic as the disease itself. According to the medical articles I’ve read, no one seems to know how or why Lyrica or Ritalin, or Concerta work. The general acceptance of these drugs seems logical in a convoluted way because there are no medical tests to diagnose the problem in the first place. But the drugs are, nonetheless, prescribed by a community that normally says, “it must be scientifically proven.”

But what has me really puzzled is that the medical community is willing to accept an affliction as being real even though there is nothing to prove its existence other than collected data by respected scientists. They’re also willing to accept its pharmaceutical magic bullet, yet they turn their noses up at integrative healing methods – something that has no side effects. I can’t help but see a double standard at play. Hypnotherapy, Reiki, guided visualization, biofeedback, acupuncture, and chiropractic is reviled as a group of snake charmers who are out to fleece granny out of her last dime – even when its advocates are respected docs who have provided equally compelling data. Puzzling.

The Chicken and the Road

Since I have the tendency to wander south of Esoteria, it’s no small wonder that I would finally ask, “Why did the chicken cross the road?” I took my question to a number of folks for their feedback. Their answers:

DR. PHIL:
The problem we have here is that this chicken won't realize that he must first deal with the problem on 'THIS' side of the road before it goes after the problem on the 'OTHER SIDE' of the road. What we need to do is help him realize how stupid he's acting by not taking on his 'CURRENT' problems before adding 'NEW' problems.

OPRAH:
Well, I understand that the chicken is having problems, which is why he wants to cross this road so bad. So instead of having the chicken learn from his mistakes and take falls, which is a part of life, I'm going to give this chicken a car so that he can just drive across the road and not live his life like the rest of the chickens.

GEORGE W. BUSH:
We don't really care why the chicken crossed the road. We just want to know if the chicken is on our side of the road, or not. The chicken is either against us, or for us. There is no middle ground here.

COLIN POWELL:
Now to the left of the screen, you can clearly see the satellite image of the chicken crossing the road...

ANDERSON COOPER - CNN:
We have reason to believe there is a chicken, but we have not yet been allowed to have access to the other side of the road.

JOHN KERRY:
Although I voted to let the chicken cross the road, I am now against it! It was the wrong road to cross, and I was misled about the chicken's intentions. I am not for it now, and will remain against it.

NANCY GRACE:
That chicken crossed the road because he's GUILTY! You can see it in his eyes and the way he walks.

PAT BUCHANAN:
To steal the job of a decent, hardworking American.

MARTHA STEWART:
No one called me to warn me which way that chicken was going. I had a standing order at the Farmer's Market to sell my eggs when the price dropped to a certain level. No little bird gave me any insider information.

DR SEUSS:
Did the chicken cross the road? Did he cross it with a toad? Yes, the chicken crossed the road, but why it crossed I've not been told.

ERNEST HEMINGWAY:
To die in the rain. Alone.

JERRY FALWELL:
Because the chicken was gay! Can't you people see the plain truth? That's why they call it the 'other side.' Yes, my friends, that chicken is gay. And if you eat that chicken, you will become gay too. I say we boycott all chickens until we sort out this abomination that

the liberal media white washes with seemingly harmless phrases like 'the other side. That chicken should not be crossing the road. It's as plain and as simple as that.

GRANDPA:
In my day we didn't ask why the chicken crossed the road. Somebody told us the chicken crossed the road, and that was good enough.

BARBARA WALTERS:
Isn't that interesting? In a few moments, we will be listening to the chicken tell, for the first time, the heart warming story of how it experienced a serious case of molting, and went on to accomplish its life long dream of crossing the road.

JOHN LENNON:
Imagine all the chickens in the! world crossing roads together, in peace.

ARISTOTLE:
It is the nature of chickens to cross the road.

BILL GATES:
I have just released eChicken2007, which will not only cross roads, but will lay eggs, file your important documents, and balance your check book. Internet Explorer is an integral part of eChicken. This new platform is much more stable and will never cra...#@&&^(C% ..! ..... reboot.

ALBERT EINSTEIN:
Did the chicken really cross the road, or did the road move beneath the chicken?

BILL CLINTON:
I did not cross the road with THAT chicken. What is your definition of chicken?

AL GORE:
I invented the chicken!

COLONEL SANDERS:
Crap, I missed one?

DICK CHENEY:
Where's my gun?

Reading the bathroom walls

As seen on the stall wall in a particularly grungy gas station bathroom in Barstow where mold and grime have replaced paint:

For a good time, read M.D.O.D.

See guys? You’re moving up in the world.

“Inties” vs “Alties” – thar be a difference

Alternative and traditional medical care combine to heal middle-age figure skater. This article is a prime example of why I find integrative medicine so powerful. Alternative medicine is invariably exclusive from medicine, while Integrative medicine believes in playing alongside traditional medicine in order to obtain the best of both worlds. What's not to love?

“I did some digging to find a solution. After much research, I turned to the Susan Samueli Center for Integrative Medicine at UCI… because of what it stands for: "Wellness through knowledge." This is the basis on which they work with their patients.

Their medical practitioners follow research-based techniques to get at the core issues of an illness or injury – not just mask symptoms with drugs (a remedy other doctors had tried with me in the past). My practitioner explained that the center strives to provide care which allows the body to heal itself — a natural approach that I liked and felt good about.

The center is "integrative" because it combines the efforts of traditional western medicine with alternative or integrative approaches— a combination that proved to be a winning formula for me!”

Obecalp – the new wonder drug?

I love reading medical blogs – it’s how I spend my early, early mornings before my day job kicks me in the lower forty and tells me to quit being a slacker. One such blog led me to read a frightening article about how a Gulf War veteran was given “Obecalp” as part of his treatment. When the veteran didn’t find any relief, he got to checking things out. Obecalp is placebo spelled backwards. To say the least, I’m amazed that anyone would do this to a patient.

The veteran was duped. No matter what kind of treatment a patient receives, he’s gotta be told. Full disclosure, ethics, and all that. To do anything less is fraud, in my opinion. After all, it’s not like this vet was taking part in a clinical trial.

The article goes on to say that regular docs have been found to prescribe placebos in place of medicine. I can understand docs’ temptations to do this, say in cases where a patient wants antibiotics for something viral just to shut them up. I had no idea this practice actually went on. I know that every one of my doc friends would be disgusted that a colleague would destroy the doc-patient trust.

Ironically enough, I’m informed by docs on a near-daily basis that integrative healing options are nothing more than placebos, so I do see the paradox of my outrage. However, the difference is that the patient knows exactly what’s going on in a professional setting. Well, okay, there was that time I fried my father-in-law’s synapses with a rousing Reiki session that he knew nothing about. In my defense, I don’t hang out a shingle that says, “Reiki Master” and get paid for my services. This was more a drive-by shot of Reiki which produced some incredible results that puzzled the gas out of his doc. But that’s for another post.

I’m wondering if my doc prescribes Obecalp for me if it’s okay to let the air out of his tires. After all, I really like the guy. Maybe I’ll just Reiki his cat as payback.

(Thanks for the links, Sid)

Universal health care...I'm scared

This article in this morning’s paper says it all regarding universal health insurance. What really galls me is something we already know: health care will be rationed, the docs will be overwhelmed, and their reimbursements will dwindle. To that end, I was oh so pleased to see that my insurance company actually cut a check to my doc for $0.67. In their defense, they also cut him a check for the princely sum of $30 for my doc visit.

Just to stick my foot in a pool of hungry sharks, this begs the question of how this type of overburdened and rationed health care will drive up the integrative care business.

Balance

“Number 4 Spawn,” my mother said not too long ago, “always make sure that you keep a sense of balance in your life.”

Thinking she was alluding to the fact that I’d single-handedly eaten all the fudge she’d made for the holidays, I went into mega remorse mode. “Look, Ma, I’ll make more fudge for everyone. It was an accident. You always put nuts in the fudge, and, well, I hate the nuts. But this was pure fudge – as God intended it – and…”

“Forget the fudge,” she said. “It’s your life I’m talking about.”

Mom is good at handing out sage tomes of wisdom that make me think. What’s uncanny is that she does this at the times when I need to hear it the most. This time was no different because I’ve been experiencing a crisis of faith. No, not the dogma kind – I believe in the Cosmic Muffin and all that – but the foundations of where I stand with integrative healing. It’s kind of like when Mary Katherine Albaugh kept telling me I had bird legs when we were freshmen in high school. I heard it so much that I began to believe I really did have bird legs.

I love medblogs and read them religiously because I respect the docs who author these blogs. They have great senses of humor and make my morning cuppa a joy. Until talk turns to integrative medicine. Then my cyber heroes turn into people that shake me to the core. It’s not that I don’t believe that we all aren’t entitled to our opinions. And it’s not like I don’t share some of their same concerns. It’s the vehemence and absolutes in which they attack something I love. With them, there is no gray area, or “let me consider the possibilities.” It’s a case of “anyone who believes in integrative healing options is full of shit.” I know it’s not personal – at least I’m pretty sure it isn’t. Well, okay, there was that one blog that got really ugly, and I don’t go there anymore.

But in reading these blogs that deride integrative healing with tsunami force, I found myself questioning my own beliefs. Since derogatory vitriol was all I heard, my perspective became skewed. Not every doctor feels this way, and I needed to remind myself of this fact. Salvation came from the strangest place – a submission. A well-respected neurosurgeon submitted an enticing manuscript about his journey to integrating alternative healing options into his surgical career. We’ve exchanged a number of emails, and I found it refreshing to hear a doc whose world is steeped in science let words like “spirit” and “karma” slip off his tongue with ease. Within a day, I felt a cosmic sigh leap from my lungs. I felt grounded and more at peace with my writing and my direction.

Mom was right. My world had been out of balance, and I allowed my empathy for docs’ concerns to override the amazing stuff I’ve seen over the years. Thanks, Mom.

And, Mary Katherine? Just so you know – I have great legs.

Where I Stand on the Issues of Integrative Forms of Healing

After writing my book and going out on the discussion circuit, I received a small, but not unexpected backlash from docs regarding its premise of selected integrative healing options being mainstreamed into the hospitals. I took great pains to not make this an agenda book because I see where there are legit concerns surrounding integrative medicine. Much needs to be said regarding this issue, and I felt my book opened the door to getting the pros and cons out there.

I became acquainted with Reiki during the research phase of my book. Reiki, initially, was a mere footnote in the book until it made a huge impact on my own health. No one was more dubious and skeptical than I. Healing energy that pours through one’s hands? Give me a break. It wasn’t until my docs had to take me off my meds for reasons they couldn’t identify that I realized something big had happened to me, and that maybe we don’t know everything there is to know about healing. I felt it an intriguing (and controversial) premise for my book.

There’s a line from my main character in my second book that sums it up: “For a profession where knowledge is power and new discoveries await us at every turn, we doctors certainly are a close-minded lot.” Those words came from my imagination before my first book came out. I had yet to discover how prophetic those words would be as I encountered over-generalized bias.

Most comments I’ve encountered run along the same lines; integrative medicine preys upon the ignorant, gullible, and desperate who stupidly shell out thousands for fake cures. There is truth to this comment, and this is something I play up in my book. For every honest alternative healing option, there are dozens of fake ones. I understand docs’ anger over this because people are dying or getting sick from curable diseases.

But rather than denigrating the uses of alternatives, the crux of the debate should center on the need for patients to always go to their docs. Integrative /alternatives/ CAM, whatever label you use, is not a replacement for medical care. It’s an addition, and patients need to always communicate with their docs about what forms of alternatives they’re using.

But docs shoot themselves in the foot by lashing out. How forthcoming is a patient going to be if they’re laughed at or told they’re stupid? When my doc and I came to the conclusion that I could no longer tolerate my meds - we scratched our heads until I realized the only change in my treatment was Reiki. If I had felt for one minute that I was going to be subjected to humiliation, I would have kept my mouth shut. A doctor's reaction/ belief system is very influential to the doctor-patient relationship, and I worry about about eroding communication to the point of silence.

Why do I say this? I researched many people who use various forms of alternatives, and most reasons given for shunning their doctors was that their doctors had at one time or another made them feel like fools for using Reiki or a chiro, or acupuncture, etc. I recommended they find new docs. They shook their heads and said they were in far better hands. Now that scares the shit out of me.

I’m not saying that Reiki, chiropractic, or acupuncture will cure all disease for everyone because no one can guarantee that. Because of this, I see why many docs are skeptical. But as long as patients continue to be under a doctor’s care, I see no reason why alternative healing options can’t be considered viable. And I see no reason why docs shouldn’t expand their horizons to do some unbiased research. There is plenty of solid information out there, many from well-respected mainstream docs and surgeons.

So that’s where I stand. I believe in integrating alternative healing options into science-based medicine to create a united front against disease. I believe in being cared for by my docs. I believe integrative/ mind-body medicine isn’t going away because there's too much out there that supports its use. I believe docs can either close their minds to the notion that they don’t know absolutely everything about how the body heals and how the mind contributes to wellness, or they can hold fast to their beliefs and risk losing open communication with their patients.

Nuthin' says the holicraze like baking

I would love to take credit for this, but, alas, it came to me in an email. Since I’m such a stellar cook, I think I’ll try this tonight…

1 cup of water
1 tsp baking soda
1 cup of sugar
1 tsp salt
1 cup of brown sugar
lemon juice
4 large eggs
1 cup nuts
2 cups of dried fruit
1 bottle Jose Cuervo Tequila

Sample the Cuervo to check quality.

Take a large bowl, check the Cuervo again,
to be sure it is of the highest quality,
pour one level cup and drink.
Turn on the electric mixer...

Beat one cup of butter in a large fluffy bowl.
Add one teaspoon of sugar...Beat again.
At this point, it's best to make sure the Cuervo is still OK,
try another cup ... just in case.

Turn off the mixerer thingy. Break 2 leggs,
and add to the bowl, and chuck in the cup of dried fruit.
Pick the frigging fruit off floor.

Mix on the turner.
If the fried druit gets stuck in the beaterers,
just pry it lloose with a drewscriver.

Sample the Cuervo to check for tonsisticity.
Next, sift two cups of salt, or something.
Who giveshz a sheet?
Check the Jose Cuervo.

Now shift the lemon juice, and strain your nuts.
Add one table. Add a spoon of sugar, or somefink.
Whatever you can find.
Greash the oven.

Turn the cake tin 360 degrees and try not to fall over.
Don't forget to beat off the turner.
Finally, throw the bowl out,

finish the Cose Juervo,
and make sure to put the stove in the dishwasher.

CHERRY MISTMAS

Writing Atrophy

I read an article yesterday where a writer was giving pointers surrounding his success. One of his points really spoke to me: Write every day.

Of course, he’s right. I tell this to new writers whenever I speak at writers’ conferences. It doesn’t matter if it’s five, five hundred, or five thousand words. Write every day. If you don’t, your story and characters will atrophy. And so will your writer’s brain.

Finishing the article, I felt my head recede into my shoulders as the tiny translucent-winged pixie who sits on my left shoulder began her harangue: “See, you literary wasteland? I warned you about letting your day job interfere with your writing - that you’d move further and further away from your story. That’s why NaNoWriMo exists. But, no, you’re too cool for school. You suck. If you don’t immerse yourself daily into your main characters, you’ll lose the emotional flavor that defines your writing. Is this how you won a major writing award, you excuse for an ink slinger? You’ll lose the grasp and tightness of your plot. You’ll erode. You’ll crack and wither…”

I flicked the pixie off my shoulder and sent her flying across the room, where she landed unceremoniously in the dog’s water bowl. Shaking the water off her wings, she stuck her tongue out at me. “Bitch.”

“Nag,” I replied.

I wonder if my fellow writing buddy, Dino, has this problem…Either way, I’m off to go write.

About the angel tree topper...

Long ago and far away, Santa was getting ready for his annual trip....
But there were problems everywhere. Four of his elves got sick, and the trainee elves did not produce the toys as fast as the regular ones so Santa was beginning to feel the pressure of being behind schedule. Then Mrs. Claus told Santa that her Mom was coming to visit. This stressed Santa even
more.

When he went to harness the reindeer, he found that three of them were about to give birth and two had jumped the fence and were out, heaven knows where.
More Stress.

Then when he began to load the sleigh, one of the boards cracked and the toy bag fell to the ground and scattered the toys. Totally frustrated, Santa went into the house for a cup of coffee and a shot of whiskey. When he went to the cupboard, he found the elves had hit the liquor and there was nothing to drink. In his frustration, he dropped the coffee pot and it broke into hundreds of little pieces all over the kitchen floor. He went to get the broom and found that mice had eaten the straw it was made from Just then the door bell rang and Santa cussed on his way to the door. He opened
the door and there was a little angel with a great big Christmas tree.

The angel said: "Where would you like to put this tree, fat man?"

And that my friends, is how the little angel came to be on top of the Christmas tree.

Merry %*&#$ Christmas

This is not for "little ears."

Fridays are supposed to be my day...

This is a perfect summation of my day...and it's still early.

There are no words...

I just found out that my son's best friend in basic training was killed in Iraq by an IED. He was a goof of a Texan who made my son laugh. He was as big as a tree but could sneak under any bunk and tie the shoelaces of an unsuspecting Private before yelling, "Fire!"
Here's to you, Limone. Godspeed.

One Smart Dog

Is there anything cuter than a dog and a baby? This dog gives a step by step instructions on how to properly hug a baby.

1. First, spy a baby.

2. Second, be sure that the object is indeed a baby by employing classic sniffing techniques. If baby smells of powder and the wonderful aroma of wet diapers, this is indeed a baby.

3. Next, flatten the baby before actually beginning the hugging process.

**Note: The added slobber should help in future steps by making the 'paw slide' easier.

4. The 'paw slide' Simply slide paws around baby and prepare for possible close-up.

5. Finally, if a camera is present, execute the difficult and patented 'hug, smile, and lean' so as to achieve the best photo quality.

This dog swears that if done properly, this methodology will guarantee a dog a warm, dry,climate-controlled environment for the rest of their life.

What's for dinner?

I have a mountain of work staring at me, but I don't feel like doing any of it. It's Friday - my favorite day of the week. Rather than work, I'd rather tell jokes.


















A man kills a deer and takes it home to cook for dinner. Both he and his wife decide that they won't tell the kids what kind of meat it is, but will give them a clue and let them guess.

The kids were eager to know what the meat was on their plates, so begged their dad for the clue.

"Well," he said, "It's what mummy calls me sometimes."

The little girl screams, "Don't eat it, Don't eat it, it's an ass hole!"

Things that make me go, "awww..."

The pictures are real (taken from a zoo outside Bangkok), but the story accompanying them in various emails is not. For the real explanation, go to snopes.com. I've always wanted to write a novel about something like this but, alas, three other books await their completion...

Frankie knows best

This is in honor of all those who will be taking to the skies over the Christmas holdaze. Damn, no one can sing it like Frankie…

Getting the Spirit...

By golly, I’ve been elfed!