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|Looking for 'There' There|
Looking for 'There' There
Making sense of the claims for mind-body medicine
By Richard Handler
The Cure Within: A History of Mind-Body Medicine
W. W. Norton. 336 pp. ISBN: 978-0-393-06563-3
A centerpiece of Anne Harrington's The Cure Within: A History of Mind-Body Medicine is a story from a 1957 psychiatric journal that radiates questions and puzzles. It concerns a certain "Mr. Wright," who had a diagnosis of lymphosarcoma—cancer of the lymph nodes. According to Harrington, "Tumors, some the size of oranges, infested his neck, groin and armpits." He'd ceased to respond to conventional therapies, but in the hospital, he'd learned of a new experimental drug called Krebiozen and was "persuaded that it would be his miracle cure." He begged his doctor for an injection, which was administered on a Friday. On Monday, the doctor was greeted by Mr. Wright "walking around the ward, chatting happily." The tumors had "melted like snow balls on a hot stove."
Was this surprising reversal due to the powerful new drug? Blind luck? A miracle?
Mr. Wright continued his stunning recovery until he read conflicting stories about Krebiozen's effectiveness in the newspaper. His confidence undermined, he relapsed, but his crafty doctor convinced him that the original injection had been defective, and administered another one. This time, however, it was distilled water. Thinking he'd gotten the real thing, Mr. Wright recovered even more dramatically than after the first injection. He was sent home, a "picture of health."
Some time later, while convalescing, Mr. Wright read in the paper that the august American Medical Association had denounced Krebiozen as a worthless drug. He relapsed once again, was admitted to the hospital, and died two days later.
This story underscores some of the fundamental questions underlying mind-body medicine: how much control do our minds have over our physical well-being? How can we best marshal our emotional resources to help us prevent and recover from disease?
We've all experienced the influence our minds have over our bodies. We've all seemingly held back a cold during an exam or project, only to get sick the day after, during the start of our vacation. We've all read accounts of husbands and wives dying of a broken heart following the death of the beloved partner. We all know that people, especially men, sometimes don't live long after they retire and begin to feel bored, restless, and useless.
In self-help literature, we're told that our minds have great power, as great as the doctors who lord it over us. When we're in dire straights, we want miracles, whether self-generated or from some unseen power. Harrington, who teaches the history of medicine at Harvard, is well aware of this dilemma. She knows patients want to give meaning to their disorders, their illnesses, and, yes, their health. Who wants to believe that a dramatic, spontaneous remission is just an anomaly, a fluke?
Harrington is also well aware of how impersonal conventional medicine often is, and that 60 million Americans use complementary therapies and spend $40 billion annually in search of an alternative healing experience. Although traditionalists have long resisted giving these treatments legitimacy, increasingly a stamp of medical approval has been placed on once seemingly bizarre beliefs and practices.
The bridge between peoples' attitudes and beliefs and their health has been explored by Bernie Siegel, a surgeon at Yale University. The notion that repressed or unpleasant emotions could cause cancer had been floating about for years in the cultural ether. Norman Mailer, a writer ever alert to the zeitgeist, even used this argument in 1960 after he stabbed his wife at a party. Had he repressed his rage, he claimed, he'd have developed cancer. Siegel added to this vague cultural notion the belief that some repressed people were "cancer prone."
"Cancer might be called the disease of nice people," he wrote in his 1986 bestseller, Love, Medicine, and Miracles. The ones who died were "emotionally repressed, nice but not authentic." All told, "there were no incurable diseases," he added, if only an individual had the right attitude. So who were the people best able to fight illness? Those who are "openhearted, feisty and in touch with their needs."
As Siegel proclaimed: "It's my main job as a doctor to help you develop into a new person, so you can resist the unwanted, uncontrolled development of illness." No wonder the book sold two million copies and he became a New Age pinup, with his smiling face and shaven head.
According to Harrington, Siegel's vision has been a lifeline for some patients; but for others, it's been a recipe for horrible guilt. Although she bends over backward to remain dispassionate, she can't hide her irritation with the good doctor. In at least one standard, randomized trial, she tells us, dealing with repressed issues made no difference to how long patients lived.