Healing HealthCare Through Philosophy

Dr. Mark Zlomislić (Zlow Miss Litch)

My title presupposes that there is

something wrong with the Healthcare

System; with the Healthcare Profession and

that it can be healed through the introduction

of philosophy. This is a big claim in need of

both evidence and analysis. In what follows,

my aim is to begin to provide both.

We start with a definition. Philosophy is

a method of analyzing concepts through the

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use of evidence to arrive at conclusions,

solutions and ways forward that may have

been overlooked.

So we can ask “what does Health

actually mean? What does Care actually

mean and can there be such a thing as

Healthcare? What kind of profession needs

to be created to uphold this field of

concern?”

My approach today comes from the

French philosopher Michel Foucault who

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spent his life analyzing how institutions

discipline human beings. What he wrote in

his book, The Birth of The Clinic will

concern us today.

His central point deals with how the

medical gaze reduces Persons to Objects.

The medical gaze is how physicians,

surgeons, nurses and healthcare

practitioners, look at the person who is ill,

sick or dying. This medical gaze for

Foucault, denotes the dehumanizing medical

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separation of the person’s body from the

person’s identity.

Of course, we have felt this medical look

or gaze reduce us to an object- a thing that

can be reduced to a series of numbers,

injected, cut, examined, explored and treated

rather than as a subject; a person who should

be cared for with concern, encouragement,

compassion and integrity.

The first point is this: the medical

profession cannot be concerned with health

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or wholeness if it already fragments and

divides the person into various biological

systems. The medical profession acts as if

the human body is the sum of its parts.

While I have a body- I cannot simply be

reduced to Body alone. The distinction here

is between what I have and what I am. I

have hands but I am not my hands. I have

eyes but I am not my eyes, etc.

The second point is that the healthcare

profession is reductionist rather than

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holistic. Whatever is reduced is already

fragmented and therefore not whole. If it is

not whole, it cannot be healthy. Here I

follow the definition that wholeness equals

health and that to be healthy is to be whole.

I think it is clear that the method of

investigation, diagnosis and treatment are

derived from a model that reduces the

person to an object or artefact.

For example, when I am treated by an

Ear specialist, I am reduced to an Object-Ear

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that does not properly function, that requires

injections and so forth. I am not treated as a

Person who cannot hear or as a Person who

has ear related difficulties. I am reduced to

this Object-Ear that is not functioning

according to biological parameters. The

same process of reduction is at work in any

sickness, disease or ailment.

Foucault showed that at the beginning of

the 18th century physicians were viewed as

sages or wise persons who could abolish

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sickness and disease. Here we are three

hundred years later and the physician is no

more a saver of bodies than the medieval

priest was a saver of souls. Perhaps real

healthcare can save Persons?

The constant for Foucault, that links the

medieval and modern periods together is

that of manipulation. The body becomes a

target for pharmaceutical, medical/surgical,

technological and therapeutic manipulation.

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 This manipulation might be justified if

physicians and surgeons acted from a

position of truth rather than one of untested

belief.

I will provide two examples to

illuminate these claims. The first is

pharmaceutical and the second is personal.

The pharmaceutical deals with symptoms

rather than causes. So if you are having

anxiety and are having trouble sleeping you

are usually given Ativan. Of course, you

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may fall asleep easier, but you will have to

deal with the side effects of drowsiness and

dizziness etc. The ancient Greeks called this

the pharmakon effect. Each drug is a

poisonous cure that may or may not work

but is guaranteed to effect and affect you.

Yes Tylenol takes away your headache pain

but it also causes liver damage. Enbrel will

take away your inflammation but it will also

take away your immune system.

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 Philosophy teaches us to look at causes.

So if you find yourself anxious living next to

a pack of howling wolves, you might

consider another place to live or you might

consider becoming a wolf-whisperer before

you gulp down the Ativan. Of course, on the

other hand, there are circumstances where

pharmaceuticals are absolutely necessary but

more often than not, they are used to treat

symptoms rather than causes.

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 These examples show that our medical

knowledge is fragmentary and as such it

does not address the full person who is

unique and singular. What philosophy looks

for is actual truth in medicine rather than

forms of belief that do more harm than

good.

The personal example concerns my

recent diagnosis of Meniere’s- or what my

ENT specialist calls a disease. Meniere’s,

named after the French physician that

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discovered the problem, causes fluid buildup

in the inner ear. The results are vertigo,

balance problems and hearing loss. The first

specialist said, “We don’t know the cause.

These things happen when you turn 50.”

And the second specialist who taught the

first specialist said, “We don’t know the

cause but we can treat the symptoms

through injections of steroids that may or

may not stabilize your hearing, an injection

of gentamicin which will destroy your

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hearing or cutting the hearing nerve to

stabilize your balance.

Almost 200 years have passed since

syndrome was first noticed and the best

specialists in Canada want to impose less

than scientific solutions. They simply don’t

know the cause.

You can imagine the conversation I had

with the specialist that began with, “So, how

did you become a specialist in your field

when you can’t tell me the cause of what

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ails me?” Philosophy asks necessary

questions even if they answers are not

readily available.

When I told the specialist, that my

hearing opened up fully in an airplane at

30,000 feet he did not have an answer but

proceeded with another injection.

Imagine bringing your car to a mechanic

and telling them that your brakes are

squeaky and they say, “I don’t know what’s

causing it but I can put some oil on them.”

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The mechanic would be found negligent and

yet the ENT specialist is not.

Once we realize that the complex

medications we are receiving do barely

better than a placebo, it is time to re-think

what we are consuming. Of course, I am not

speaking about antibiotics, vaccines and

other pharmaceuticals that do work, but

against long-term medications that do much

damage to the body and to the health of the

person consuming them.

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 If science sets up precision as its model,

then it needs to be precise rather than offer

vague reassurances like, “This may help. We

are not really sure.”

Here is where the real issue reveals itself.

The body is more than just a fragmented

mechanical system. It must not be reduced

to a mechanism. This tin man robotic

approach may work for cars but human

persons are not vehicles.

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 Here I think that modern medicine must

move into the direction of healing persons

rather than treating patients. Of course, it is

necessary to achieve technical mastery of a

discipline but this alone does not make you a

healer. Hippocrates said it best when he

wrote, “It is more important to know what

sort of person has a disease than to know

what sort of disease a person has.”

Each case must be seen as new. This

approach would allow actual hearing to take

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place instead of the current, “Oh, Yes, I

have seen this before and this is how it

should be treated.”

Philosophy can teach the medical

profession not to reduce persons to units of

bureaucratic segregation under such

economic titles as “patient” and “client.” It

can teach the honesty of not knowing

everything but wanting to get to the cause of

things.

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 The Franciscan philosophers, taught that

humans are unique, singular and irreducible

persons rather than patients and clients.

Perhaps we need to change our language to

reflect this reality.

Health is not something to battle for. It is

not a battlefield or war zone even as

casualties pile up under ill-thought

approaches.

Philosophy teaches that the sick do not

ask for pity. They ask for encouragement;

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for the warmth of human contact and

conduct; for care that is concerned with

actual healing and making whole.

This is why the field of complementary

medicine is promising, not because it is

more scientifically advanced but because it

treats persons in their wholeness with the

aim of recovering the health that the current

medical system has fragmented into bits and

bytes.

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 To this end, I find that the Chinese

approach with its emphasis on the

complimentary nature of Yin and Yang to

hold much promise.

Philosophy shows us that the way in

which medical knowledge is currently

organized is in need of an upheaval that

could come to a vastly different conclusion

in regard to health, disease and treatment.

Philosophy teaches us how to question. It

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strengthens us against any easy acceptance

of comprehensive views.

Here there would be as much truth in my

mother’s chicken soup as there is in a

capsule of penicillin which is why I take

both.

MZ, January 26, 2017

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