In the past week, the New York Times published two articles related to the subject of healing. One was written by Doctor Bernard Lown, a noted cardiologist in Boston. Doctor Lown lamented that there is such a focus on the technology in medicine that doctors have lost their focus on supporting healing. A second article was written about the Lucille Packard Children’s Hospital at Stanford. It described how the hospital was designed to help children heal, with murals of animals and birds, soft colors and objects to divert children’s attention from the technology that they must endure.
We hear the term healing, as distinguished from curing, all of the time. What do the terms mean? Are they the same or are they different? As the terms are commonly used, curing implies an outside agent, like the doctor gave the patient a cure. Healing, on the other hand, suggests that getting better is at least in part an inside process, something that the body does itself. I don’t know if everyone would agree with that separation, but as used I think this is usually the distinction that is made.
We lament the focus of modern medicine on “curing,” finding a diagnosis and giving a curative agent, leaving out the supportive processes that bring about “healing.”. Physicians and hospitals are, I think rightly, criticized for being too technology focused and not supporting the patients’ processes of healing. The degree to which I support this view is expressed by my belief that there is no curing without healing. What are the bases of that viewpoint?
We commonly exhort patients to “fight” the disease, or we talk about a will to live.” These are our expressions of recognition that the sick person has a significant role in recovering from an illness or injury. A surgeon fixes a broken bone by immobilizing the broken part and allows the patient to heal. Doctors give patients antibiotics to cure bacterial infections, but if the patient’s body is too old or too sick to participate in their recovery, the person will succumb to the illness anyway. The opposite is also true. We recognize the placebo effect when the patient’s belief that they have been given a cure leads to the resolution of symptoms. This is not just “in their head”; the problem disappears.
What is this “healing” process? We have some ideas about that. In healing infectious diseases, it is well known that healthy immune systems are crucial to ridding the body of infections. Antibiotics help, but if the immune system is not functioning, the person may not get better. The same is true for cancer. Infusing poisons to kill cancer cells rarely gets rid all of them, but recently we have found that strengthening the immune process can bring about cures of some cancers. Fear and stress suppress immune function. They also reduce circulation to some parts of the body making it more difficult for immune cells to reach the affected parts and to maintain healthy tissue.
So, what are the ways in which healthcare providers can use the healing processes, which they are accused of ignoring. Being sick is a very lonely experience. No one else can feel what we feel and often we feel helpless and anxious about what the future holds. Being in the hospital multiplies the sense of displacement and helplessness that many feel. While technology is wonderful, it is very cold and indifferent. We crave the presence of human contact. Doctors and nurses have magical powers. Understanding, compassion and reassurance from them has a much greater power. When a doctor takes the time to truly listen to a sick person and to connect with their fears and anxieties, it makes an enormous difference. It doesn’t need to take a lot of time. Experienced doctors know the power of human touch, the laying on of hands. My cardiologist always listens to my heart even though I’m sure he knows that it is highly unlikely that he will hear anything new, and I am always reassured.
Healing also means healing the psychologic changes that accompany illness. A serious illness is a significant psychological challenge. One emerges from a physical illness weakened, often with less self-esteem and less confidence. It takes time to heal the psyche. An attentive physician can provide reassurance and encouragement and can refer the patient to others who can help the return of function, rehabilitation experts like physical therapists, occupational therapists and the like.
So often physicians are focused on their computer and test results these days. I’m not anti-technology. The new technology is amazing, and it has brought about treatments and new diagnostic methods that are more efficient and less invasive. But the blessings of technology come with a price, namely that we forget to provide the human support that is part of the cure. Actually, there is a tradition of healing in medicine that goes back millennia, which has been displaced by a focus on hard results and forgets the softer side of caring. Dr. Francis Peabody, a well-known medical clinician, said in 1929, “The secret to caring for the patient is to care for the patient”. With modern medicine, there is a danger that the focus on technology will displace physicians‘ attention to and role in the process of healing and we will be poorer for it.