I believe that medicine’s potential is much more than the version we see in the world today. A doctor should be an educator with the goal of bringing patients to a place of deeper understanding of who they are in the world. To me, medicine is ultimately about self-empowerment through self-knowledge and growth.
COVID remains quiet in the Berkshires (9 cases this past week), but we have surged in the state.
Massachusetts barely made the top 20 list for states with lowest COVID incidence. We are almost always single digit (top 6 or 7)
Worcester is the worst County in New England with over 400 cases this last week. They are in the red zone!
This corresponds with a country wide surge.
Lots of questions and concern; right, Fishies?
Yes, lots of questions, like this one: why are you calling us “Fishies?”
I call you that not because I have an acute case of COVID cognitive disruption. It’s because I have an metaphor swimming around in my head. Picture a fish tank. Now picture a fish tank with murky water in it.
If you have a fish tank with dirty water and at-risk fish inside, the most important intervention is to clean the water. If you treat the fish without cleaning the water you won’t get anywhere at all.
Cleaning the water achieves your objective: the best possible outcome. It’s the truest solution. Treating the environment treats the organism. This metaphor is often used to discuss how an illness should be viewed in context of its milieu: focus not just on the ill person but the environment they in which they live and not just the germ but the condition of the host.
We will come back to this.
John Snow Memorandum
A new manifesto came out this week in response to the Great Barrington Declaration. (By the way, regardless of what you think about it, can you believe that Great Barrington is basically being discussed in every corner of the globe? I’m amazed! Notorious or not, we are worldwide!)
The John Snow Memorandum was written by a group in London and was signed by 80 epidemiologists. They published it as an open letter in The Lancet this week; it states that the “renewed interest in a so-called herd immunity approach” is a “dangerous fallacy unsupported by scientific evidence.”
Who is John Snow?
John Snow the “father of epidemiology”, a London physician who started the science of epidemiology in 1854 by tracking a local spread of cholera.
The new letter is a counter manifesto in direct response to the Great Barrington Declaration, which called for allowing COVID-19 to spread among less vulnerable groups, a strategy they called “focused protection.”
The new letter says a vaccine is needed to end the pandemic and “empirical evidence from many countries shows that it is not feasible to restrict uncontrolled outbreaks to particular sections of society.”
What is needed are “effective measures that suppress and control transmission” and that are widely implemented. “Continuing restrictions will probably be required in the short term to reduce transmission and fix ineffective pandemic response systems,” and “suppress SARS-CoV-2 infections to lower levels.” The authors acknowledge that lockdowns have been disruptive for the economy and difficult for individuals. The John Snow Memorandum cites Japan, Vietnam, and New Zealand as models of “robust public health responses,” demonstrating that the steps these countries took “can control transmission, allowing life to return to near normal.”
Tis the season for manifestos!
So, that all being said, I felt inspired. Since we were on the topic of writing manifestos, I decided to write one of my own. I decided to write about something bigger than COVID, but which could inform the questions around COVID. I’m calling it the Pine Street Proclamation. Why? Because the Berkshire Center for Whole Health is on Pine Street, and I like alliteration.
Pine Street Proclamation
Written by: Yours Truly on 10/22/2020
John Snow may be the father of epidemiology, but I am the father of Maya, Mabel (Happy Birthday!) and Calvin.
Mission and Purpose: To honor Medicine’s highest aim.
I. First Principle: To put patients first. It’s called patient-centered care. Everything starts here. Doctors and nurses and secretaries are here to serve those in need of help. Any health system worth a grain of salt recognizes it is here for the patient and acts accordingly. The patient should experience this when partaking in the system’s offerings. They should experience themselves at the center. The patient-doctor relationship is the basis of healing and is at the heart of patient-centered care. We reject paternalism, egotism, blaming, patronizing and the like. The whim of the patient is not served, rather their growth and further connection to their self is nurtured.
What’s needed: To really listen to the patients. Nurses and doctors do best when they realize there is much to learn from the patients. To recognize that one size doesn’t fit all. To honor a patient’s autonomy, individuality and freedom.
II. Second Principle: To be in recognition that the human body is a temple. It’s a sacred zone. Life and consciousness are hardly understood, and therefore the human being is hardly understood. With that acknowledgement we need to proceed cautiously and humbly with any bodily interventions.
(Quick return to the fish tank: with knowledge from natural science, we should take as our main effort to learn what clean water is and change the water in the fish tank, ie, work with the environment with our natural scientific discoveries. It’s insane to treat the fish with medicine and leave the murky water, especially when the fish medicine is derived from the same thinking that toxified the water in the first place.)
What’s needed: To acknowledge the existence of a large number of modern interventions and approaches that don’t serve the human being and to be mindful that many things in the standard of care won’t be there long and don’t belong there.
III. Third Principle: Creative solutions are needed. They won’t be found in the history books. They are here in the now waiting to be found and nurtured. They are born in our times, to meet the needs of our times.
What’s needed: A different type of thinking will reveal the medicine needed to treat illness thoroughly. A heart-based thinking that values the healing in connection and true artistry is key. The human being as part of the treatment can’t be subtracted from the equation.
Restatement of Medicine’s aim:
Medicine’s aim is not to keep the economy healthy by keeping its workers in the workplace a maximum number of days per year, nor is it to extinguish symptoms without growing understanding.
It is to stimulate all who are treated into a deeper understanding of themselves. To practice in a way that honors how health and illness would be approached if we grasped the human being in all its magnitude and mystery.
It honors a person’s intuition about their health and a doctor’s trained intuition about their patient. It believes in the healing powers of the human body, and also the power of a high quality, deliberated and intentional medicine.
A patient has a responsibility to engage in their process with an open mind, a willingness to learn and work hard at it, and a curiosity about their potential.
Medicine has suffered. It hasn’t been in its true place. It lives with the pain of the tragedy of unfulfilled aspirations.
We all suffer immeasurably less when we strive to honor medicine’s great capacity to shape culture and truly serve humankind.
Knowing that the spirit of medicine is best served when medicine is individualized, and uses interventions which are truly and deeply deliberated; and in acknowledgment of the fact that medicine has deep flaws in its current influences, aims and understanding; and that many of today’s best practices will be thrown out in the future, I ask — how could anybody force a medicine on a person, let alone a population?
Health freedom. Many of my colleagues think health freedom is the biggest topic of the day. I don’t think mandated medication makes any sense. And I think the tendency to make the brewing COVID vaccine mandated by law is not the right thing. There are growing groups of people forming community groups to support efforts to live in a world with health freedom. Dr Christiane Northrup calls them Freedom Pods. If anyone is interested in learning about local efforts to this aim don’t hesitate to reach out.
Now back to our regularly scheduled and ongoing debate between Great Barrington and John Snow. Thanks for joining me and reading along.