Thursday, November 15, 2012

At the Crossroads



Sam is a hypothetical surgical technician. He is about forty-three and has a life that he enjoys. He works full time to support his family, never liked much to read, but is always seeing the new movies as soon as they are released. He is knowledgable and skilled in his work. The entire OR staff enjoys working with Sam.

One day Sam feels a lump. It is cancer. For someone with his training, he knows more than the lay person what type of treatment his cancer entails. It is debilitating, forces him to take time off work, and the success rate, based on what he has seen at work, is not as great as testicular or Hodgekin's Lymphoma, in other words, it is not a slam dunk. He is in it for the long haul.

Sam faces a dilemma. Everyone has a recommendation, from the family member who supports alternative medicine to his surgical oncologist who is his friend. How is he to make an informed decision? If he looks at oncology sources, they will encourage cure at the cost of painful treatments that will make him feel sick and lose his hair in the goal of eradicating disease. They will cite evidence based medicine to direct his care. If, on the other hand, he looks into holistic healing, the focus will be on relieving his suffering, treating him as a whole person (instead of a patient with disease), and focus on healing. Detoxification is a word commonly used in this kind of approach. The studies are weaker, statistically, but in his mind the focus is on his life instead of his cancer.

What we have here are two conflicting ways of looking at healing. Conventional medicine is based on measurement, observation, and the scientific method in a Newtonian Approach. Holistic Medicine, which is not readily measured and considered less effective because of this, may very well be a Quantum Paradigm: measurement itself produces observation effect and 'distortions', making the whole truth difficult to quantify and write papers.

As a sovereign patient, Sam has the right to make autonomous decisions for his health based on sound information, and not fear.

Option 1: Convention Medicine at a large facility
Option 2:  Conventional Medicine at a smaller community hospital near home
Option 3: Conventional Medicine at a Large Nationally important Cancer Center, possibly relocating
Option 4:  Allow disease to take its course. Palliative care only.
Option 5: Alternative Medicine instead of Conventional Medicine
Option 6:  Complimentary Medicine along with Conventional Medicine
           A: Do not tell Conventional Providers  about Complimentary Treatments
           B:  Openly discuss Complimentary Treatments  with Conventional Provider
Option 7: seek Integrative Medicine (example at Cleveland Clinic http://my.clevelandclinic.org/departments/integrativemedicine/about.aspx)

What makes sense? Itis a personal decision, one with far-reaching ramifications. Without having this kind of conversation with a knowledgeable coordinator of his care such as his oncologist, he may choose an option out of a sense of needing not to offend, or perhaps please, someone else in the treatmentof his life-threatening illness. Time is of the essence. Open communication is vital to all people in Sam's life about his treatment plan, from family to acupuncturist.

We all wish for Sam to have as positive experience as possible in light of his serious condition. Only Sam can decide for himself what is truly right for him.

A wise doula once said about childbirth: the important thing is to make an informed decision every step of the way.

Here are some resources:
http://nccam.nih.gov
/http://www.cancer.gov/
http://www.cochrane.org/cochrane-reviews
http://www.mskcc.org/
http://www.webmd.com/balance/what-is-alternative-medicine

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