My Personal Journey as a Patient on
Treating, Curing, Managing and Healing
“When religion was strong and medicine weak, men mistook
magic for medicine.
Now, when science is strong and religion weak, men mistake
medicine for magic”
(Thomas Szasz, The Second Sin).
I have a recurrent
chronic venous stasis leg ulcer since ten years ago, and was hospitalized for
many months each time, but that wound, sometimes on my right, sometimes on my left
leg never healed permanently.
The last
hospitalization I had was from December
23 2020 till January 25, 2021 a total of 33 days at the height of the Coviod-19
pandemic where I slept among Covid-19 infected patients, left and right, and in
front as they came and went for days and nights for over a month.
I was supposed to
be placed into a single-room first class ward as my eligibility, but all the
first class wards have to be closed due to the Covid-19 pandemic, as I supposed
all the Covid-19 cases have to be isolated in a first class ward
So I was placed in
a common classless ward for other cases where no Covid-19 cases initially
But as more and
more Covid-19 cases came in, and the designated hospital meant for them was
full, they spilled into the first class isolated wards. But the cases were
accumulating beyond control, till they spilled from first class into my
classless ward where I have to sleep among them day-in, day-out for days and
days.
This was repeated as more new Covid-19 cases came
in.
I was supposed to be given radiofrequency
ablation surgery or the endovenous glue ablation method for my venous stasis leg ulcer, but
because of Covid-19 cases, they have to refer all surgeries for emergency
cases
Hence, all they could do for me was to give me IV
antibiotics (Unasyn -
(ampicillin sodium/sulbactam sodium) for my cellulites, followed by oral doses, all sorts of
analgesics including morphine, codeine, paracetamol, oxycodone and other opioid analgesics,
none of which has any effect on my pain.
I slept with my legs dangling beside my bed to get pain
relief where no analgesic could do the same. The other thing I got was daily dressings for my wound
During the height
of the Covid-19 pandemic, most of the specialists in my ward did not want to go
to the ward anymore for their morning ward rounds.
They all leave the
job to the medical officers and housemen to report to them.
If they do, as
with all the other doctors, nurses, medical assistants, including all the
patients, they all wore face masks day in and day out, many with face shields,
gloves and all.
I was the only
exception who refused to wear any mask while sleeping among Covid-19 patients
with other conditions for 33 days. They tested me for Covid-19 five times during
the period, but I was found to be completely free from Covid-19 infection
without wearing any mask.
A lot of the
medical staff in my ward wearing face masks, aprons, face shields and gloves
came down with Covid-19. I was the only one who wore a face mask less than 4
hours throughout my entire 33 day stay among Covid-19 patients who came and
went without getting infected.
The reason why I
refused to wear a face mask when repeatedly advised, please see here for the
reason:
https://scientificlogic.blogspot.com/search?q=face+masks+does+not+protect
and also here:
https://taionn.blogspot.com/2021/03/facts-and-figures-about-sars-cov-2-and.html
I was discharged
exactly with the same condition as I went in. My ulcer never got healed.
The previous
hospitalization over a year ago was on the other leg where I was admitted for
over 5 months. I was told by the
specialist who treated me the length of my stay in the hospital was a record any
patient.
Finally the wound
slowly, slowly the ulcer healed by itself, not with the continuously
antibiotics given to me for 5 months to manage the accompanying cellulites, and
the daily wound dressing, but I also treated myself with regular leg exercises together
with a good state of mind
Writing Case Management vs. Health Education:
As a doctor, I observed
what the junior doctors did the entire day in the ward while the specialists
come only in the morning for their ward rounds.
This was
what I observed. The housemen or house officers as we now call them now hardly do any clinical work. They
spend 99 % of their entire day clerking and writing notes, and asking the
patient the same questions over and over again as each new house officer comes
in.
The only
clinical work they do is to insert a cannula into your
arm often unsuccessfully for IV infusion of drugs prescribed by the specialists
or take blood from the vein for lab investigations as required by the
specialists.
They neither set up IV drips, monitor the flow rates, dress up
your wounds, take your blood pressure, temperature, oxygen saturation levels in
the blood with an oximeter, give the injections, or oral medication, monitor
your fluid intake and urine output..etc.
All these clinical work were done by the nurses who spent most
of their time for this, while the junior doctors spent 99 % of their time all
day long asking almost the same questions day in day out and clerking them so
that they can brief the specialists who come in the morning for their ward
rounds what they “investigated”
While they were busy writing notes, the patients just lie down helplessly
hardly attended by them
Yet, among the medical doctors they call each other as
clinicians when it was the nurses who do most of the clinical work like
monitoring the patients vital signs and functions, taking blood pressures,
setting up IV infusion, giving injections and medication, monitoring fluid
intake and urine output, bed baths, wound dressing, etc.
Physicians hardly do clinical work except clinical examinations.
Even blood tests and radiology are not done by them.
However, surgeons and anesthesiologists do a lot of clinical
work in an operation theater which of course a patient does not know when he is
unconscious
Time Wasted:
The time the medical officers and housemen spent clerking notes
would have been far well-spent by going
to their patients advising, counseling and educating them about their
conditions and how best they can help and manage themselves instead of them
lying down helplessly all day and night wondering what the doctors were doing
but writing notes?
Phone Advice from my colleagues and friends:
Many of my former colleagues are specialists doctors and medical
researchers and also friends who phoned me when I was hospitalized.
They gave me very lengthy advice over on the phone for over an
hour when I told them my experience in that hospital.
They also told me at length about their bad experiences working
with doctors as a professor and consultant in a university hospital. They strongly
advised me to discharge myself after I told them the “treatment” I was given. Many other friends through WhatsApp chats also
asked me to discharge myself or asked to be refereed to another hospital.
I thought to myself those were the reasons why my leg ulcer
never got healed if I were to just lie down on the bed, while the doctors were
so busy writing notes into numerous files, with each doctor writing different
notes, into different files as they changed duties.
No wonder after lying down in a hospital bed for 33 days, I left
the hospital with a leg ulcer exactly the same as before as when I entered.
All those time they wasted writing medical history, case
management would have being well-spent if the doctors were with the patients,
explaining them why they have the disease, and what they can do to help
themselves to restore their own health instead of relying on medicines and
drugs of all kinds in increasing numbers, because the roots causes were never
explained to them, and how they can help themselves to manage their condition instead
of depending on medications, drips and injections.
These patients would be completely healed in no time and need no
more follow up with any more medication on their discharge if they were
educated about their condition.
That bad experience I had prompted me to write this article the
differences between healing, curing, managing, treating and helping a person
who is ill, especially in lifestyles chronic illnesses
If we made a
search in Google it defines the difference between “cure” and “healing” as in
this example:
“A cure signified the banishment of
physical illness, but a healing could mean not just a
physical cure, but a repairing and strengthening of the mind and spirit to
improve the quality of life even when no physical cure was possible.”
-
Susan Howitch, Absolute
Truths
A Book I Bought:
After my discharge, and my disappointment with conventional
treatment, it prompted me to buy a good book on the practice of wholesome
medicine and health care.
I finally found one less than a week ago. It is called “Integrative
Medicine” complied by Dr. David Rakel MD who is Professor and Chair of the
Department of Family and Community Medicine at the University of New Mexico
School of Medicine, Albuquerque, New Mexico.
In this fourth edition of the book, there are 118 chapters.
They were written and contributed by 148 medical experts who are all specialists
in their various disciplines of medicine.
It has 1123 pages and tens of thousands of references from
research papers published with a forward written by Dr. Andrew Weil, MD, who is
the Director Centre for Integrative Medicine and Clinical Professor of
Medicine, also Professor of Public Health, University of Arizona, Tucson,
Arizona
They wrote about the different therapeutic modalities
available other than giving drugs and surgery.
All the authors and contributors in that book are very well
qualified doctors, medical researchers as well as clinicians who are qualified both
in conventional as well as in alternative systems of medicine
Most of the contributors there are not just an MD but also
hold the doctorate degree of PhD. They write with very good scientific, mental,
social, moral and spiritual sense
Let me quote what both David Rakel MD and Andrew Weil MD in
their opening first chapter on page 7 of the Fourth Edition on Integrative
Medicine has to say:
“Health” comes from the Old English word Hal, which means wholeness, soundness, or spiritual wellness.
Health is defined by the World Health Organization as “a
state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity”
Cure, on the other hand, refers to doing something (e.g., giving
drugs or performing surgery) that alleviate a troublesome condition or disease.
Healing does not equal curing.
We can cure a condition such as hypertension with a
pharmaceutical product without healing the patient.
Healing would facilitate changes that reduce stress, improve
diet, and promotes exercise and the increase the person’s sense of community.
In doing this we help improve the balance of health of the
body that may result in the ability to discontinue a pharmaceutical agent and
thereby reduce the need for a cure.
The authors then on to compare two trees A and B showing how
tree A is in a better state of health than tree B because of tree A ability to
be in balance with the environment.
They mentioned if a branch breaks on tree A, we can feel
comfortable that if we mend the branch, it will likely to heal well, or even
heal itself.
If a branch breaks on tree B and we mend it, the branch is
not going to heal itself because the tree was not in a state of health
The point here they emphasized is that our focus in medicine
has been on fixing the branch while neglecting the health of the tree. If we
give more attention to helping tree B find health either by removing barriers
that are blocking its own ability to heal or by removing areas of deficiency,
the branch will heal itself – we will not need to spend as much time and money
fixing the parts.
Integrative medicine is about changing the focus in medicine
to one of health and healing rather than the disease.
This involves understanding the influences of the mind,
spirit, and community, as well as the body.
It entails developing insights into the patient’s culture,
beliefs, and lifestyle that will help the clinician understand how best to
trigger the necessary changes in behavior that will result in improved health
and thus bring more value to health care delivery.
Cure and fix when able, but if we ignore healing, the cure
will likely not last or will give way to another disease that may not have a
cure. (unquote).
However my personal feeling is, we may not be even “cure” any
disease by any person outside our own body if the body itself refuses to
cooperate.
Body’s Own Healing Mechanisms:
The body is endowed
with a gift to heal itself when it is sick or injured because it is a living
body. A dead body will not be able to heal by itself
For instance, let us give a simple example.
If we have a cut on any part of the body, it will never be
able to “cure” or even heal itself no matter what cream, paste, antibiotics, lotions, or even natural substance
like honey together with all types of bandages we care to apply on it if body
itself does not wish to cooperate to heal itself
The healing process of a cut on the finger or any part of the
body goes through very highly complex physiological and muti-cellular
mechanisms.
First, it
involves clotting of the blood to prevent further bleeding. This necessitates platelets
and the release of coagulation factors, prostaglandins, enzymes, and proteins to
stop the bleeding as part of the clotting mechanism
Once bleeding stops other mechanisms becomes operative such
as the involvement of growth and cytokines factors, polypeptides, cellular
signaling to promote growth and differentiation and cellular remodeling.
It then involves fibroblasts, cascades of biochemical changes
leading to matrix formation, granulation and final epithelialization of wound.
This is just an example of a simple cut on the finger. But
there are tens of hundreds of diseases and disorders the body suffers such as diabetes,
hypertension, metabolic syndromes, infections, and even minute cellular cancers
in life that the body’s have either corrective and defensive mechanisms or
immunological system that triggers into action without us knowing it.
Yet a change in our lifestyle and dietary modification works
wonders for our body to help heal itself. Their existence will silently
disappear as they first appear without us knowing it.
Of course there are disorders like congenital, hereditary and
genetic anomalies, nutritional or other deficiencies diseases, or blindness the
body cannot correct or heal itself.
However the body is living, and because it is living most of
the time it can automatically rectify itself if given the right nourishment,
stimulant, needling, massage, mind-body control, and stress management, among
many others.
Our
living body with a soul, spirit and mind within, and its ability to heal itself
shows how complex it is, that absolutely no one from outside our own body can
do this highly complex job except our own.
“I praise thee because I am fearfully and
wonderfully made; thy works are wonderful, I know that full well” (Psalm 139:14).
“I will restore faith unto thee, and I will heal thee of thy
wounds.”
(Jeremiah 30:17).
The Measurements of Health:
If this is so, then how do we
measure the status of health as defined by WHO?
When we were in medical
research, often we go out to the community to measure their health status. Our
team including myself consisted of physicians, nutritionists, biostatisticians,
anthropologists, sociologists, psychologists, public health and other medical
experts in various fields together with nurses, support lab scientists and
technicians will try take as many types of measurements as possible and combine
our data to make an assessment.
Even that may not be complete. What about
their economic, social and spiritual well-being even if we cover as much as
possible from their demography
Then comes the most difficult
part of the question pertaining to the definition assessment of optimal health!
How do we measure or know an individual
is in optimal healthy? This was also question we were asked when we were just
students in London University.
Can we answer it as someone
with the longest, stress-free and disease-free longevity? Frankly, I do not
know the answer. I leave this to someone who has the answer on optimal health.
Jesus Heals, not Cure, Treat or
Manage a Disease:
Nowhere in the Bible did it
mention Jesus was a doctor who treats and manage a disease using medicines and
drugs like we do. Jesus clearly was a Healer, not a doctor or a physician as we
know it. The only physician
among 70 disciples and 12 apostles appointed by Jesus was Luke who may have
been a Gentile. But we have no clue how Luke treats the sick
The Bible always uses the
word “heal” performed by Jesus. It never use the word “treat” or “manage” a
disease given by Jesus.
He heals the blind, deaf and
the mute, the paralyzed, those possessed by demons, maybe of unsound mind, healing
of a man with dropsy, a woman with a bleeding disorder, the mother of
Peter's wife lying in bed with a high fever, the healing of the man with a
withered hand, and the lepers, a boy possessed by a demon, all those who merely touch the edge of
his cloak were all healed of their various illnesses, What was even more awesome He even raised the dead.
Nowhere in the Bible does it say
Jesus treats or manage the sick, blind, the mute or paralyzed. Neither does the
Bible says Jesus uses medicines, drugs and the knife to “manage” the sick Clearly Jesus was
a Healer extraordinary.
He was not a doctor or a
clinician. Jesus was far, far more than
doctor or a clinician. He did not use drugs,
medicine of all kinds, radiotherapy, surgery and vaccines for treatment or
prevention of diseases like we do.
His words and other miracles
alone were as awesome as His healing powers.
Healer or Doctor:
So what is the difference
between a healer and a doctor? If we have someone who is able to heal our
physical body, the mind, our social well-being and our spirit completely, and a
doctor with those “fantastic” qualifications like MD, FRCP, PhD who only treats
the physical part of the body that is diseased, but ignores our entire
well-being as officially defined by the World Health Organization in its
Constitution, whom then would we chose or prefer?
Integrated Medicine:
In the 1960’s till mid-1990’s
I was working as a nutritionist and medical researcher at the Institute for
Medical Researcher. Among the multitask jobs I was involved in were sitting in
numerous expert technical committees, one of which was sitting in a Joint World
Health Organization – Ministry of Health and Institute for Medical Research (WHO-MOH-IMR)
Technical Committee on Traditional and Complementary Medicine in the country,
and how we can incorporate them into the mainstream health-care system
I sat in that committee for
about 5 – 6 years till my retirement, after which many others committees and sub-committees
took over.
In that committee we
discussed how best to implement traditional and complementary medicines into
the conventional allopathic system at the recommendation of the World Health
Organization (WHO).
It was very problematic. We
needed to look into the administrative, logistics, training and qualifications
of the practitioners, the efficacy and safety and the legal aspects, their
acceptance culturally, socially, economically, and even the elements of
religion, taboos, ethnicities, among many
needed to be looked into. It was a very tough job and decision to make. It took
us countless meetings over the years.
Finally long after my
retirement, some 20 years later traditional, complementary and integrative
medicine was official recognized as a registered practice by an Act of
Parliament.
Initially only 3 government
hospitals were involved as a pilot project offering Traditional Chinese
Medicine (TCM).
The years that followed due
its very high demand, acceptance, safety and efficacy especially for chronic
conditions, today there are 15 Ministry of Health hospitals in the country offering
TCM and 2 other Traditional Indian Medicine. A few private hospitals,
especially for TCM have also joined in.
The Body is Not a Machine:
The living body is not some kind of a machine with moving
parts that needs to be oiled with drugs when some parts are not working well. A
patient is a person with a physical body, mind and soul. He is living not dead
or some kind of a biochemical machine that requires some “oiling”, or to block
out a chemical pathology.
As a physician, clinician or a doctor or even a medical
researcher, whatever we wish to call ourselves, we will merely be controlling
the symptoms and signs of the disease using drugs and pharmaceuticals to
inhibit pathology.
That’s not even a cure. The patient will be asked to come back for the
same in the next appointment, maybe 3 months later. We are not healing him
either. We are just treat a case, not a
person.
We would only be looking at the biological, chemical and
physical aspect of his problem, not heal a person physically, emotionally,
mentally, socially, let alone spiritually
Treatment and Management:
In the practice of medicine
we often use the terms “treating and managing” or “treatment and management” of
a disease. What is the difference?
Clinicians normally would
prefer to use the term management than treatment, while patients normally would
prefer to call it treatment.
Both terms are normally interchangeable and are often
confused both by the clinician and the patient.
But to my mind, there is a difference. In my understanding,
the management of a disease is more holistic than merely treating a person
physically with drugs, medicines and surgery.
Personally I feel it is far more important to provide a
patient with wholesome health care, than just physically “curing” a disorder. I
feel it more important to provide a patient the much needed mental and
emotional help, or even spiritual care given collectively then merely prescribe
some medicine, and ask him to come back for follow-up for the same condition.
It would be back to square one for him with unending
medication merely to suppress or control a disease. He never gets “cured” let
alone healed completely and wholesomely.
We would be denying a patient of a wholesome healing and
complete health and well-being as defined by the World Health Organization
But above all, whatever systems of health care or medical
practice we accept or practice, we all have one first and most important
cardinal principal to be followed and that is in Latin:
“primum non
nocere” to mean “first do no harm” as part
of the Hippocratic Oath all doctors and healers need to swear by
Lim ju boo
