MY ODYSSEY TO INTEGRATIVE MEDICINE
Constance A. Catellani, MD, Medical Director of The Miro Center for Integrative Medicine in Evanston, Illinois and Professional Advisory Board Member, NOHA.
My career in Medicine started out as a very conventional one. Other than the fact that I was female at a time when most science majors and, certainly most medical students, were male, I considered myself a very mainstream student and physician. I had been a Biology major and Chemistry minor as an undergrad, did very well in the "hard" sciences like Physics and Math, and took Art and Literature courses for fun. I studiously avoided History, Psychology, Philosophy, Social and Political Sciences. I really felt that anything worthwhile could be scientifically proven or studied in a purely logical way.
Medical school and a residency program in Internal Medicine were grueling and demoralizing in a way that I had not anticipated, but I attributed my discontent to the inherent sexism and "hazing" mentality that was even more prevalent then. I never questioned the "dogma" of mainstream, pharmacologically- and surgically-oriented Medicine:
Needless to say, I felt like a great weight had been thrust upon me when I graduated from medical school. The responsibility of operating in such a paradigm was demoralizing. My chosen field of Internal Medicine was especially plagued by the fallacies of the dogma. My residency clinic patients all seemed to be well past their warranties, with long medication lists that only got longer as "side effects" accumulated, leading to the addition of laxatives, antacids, antidepressants, etc., etc. When the original medication no longer worked, stronger doses or more potent drugs were used, which accelerated the need for medication for the side effects of medication. And many of these scenarios did not end with longer medication lists. Some patients needed surgery for the medication-induced GI bleeding, dialysis for the medication-induced kidney failure, long-term nursing for the medication-induced stroke. This dreary progression, while not inevitable, seemed far too frequent and predictable for me to preside over it with any degree of comfort. I constantly questioned my decision to go to medical school. I was accepted into an excellent fellowship in Rheumatology and then declined it after realizing how large an abyss there was between the science and the clinical practice of Rheumatology in mainstream medicine.
I resolved my dilemma in a fashion befitting the very non-introspective 25-year-old that I was. I took a job in an Emergency Department in a major teaching hospital and became completely enamored with the emerging specialty of Emergency Medicine. I enjoyed the excitement, the acuity, the frequency of "cures" (very infrequent in Internal Medicine) and the separation from the chronic care of chronic disease. Naturally I still treated many people with acute exacerbations of chronic disease but they were sent back to their Internists for "definitive care" (translation: long-term symptom suppression in many if not most cases).
After sixteen years of Emergency Medicine, I realized that this is what mainstream medicine does do bestóbut the vast majority of patient encounters are not for acute, short-lived problems but for chronic, long-lasting issues that become more and more bothersome if the underlying causes are not addressed. At that point in my life, I was no longer able to stay up all night and/or work 12-14 hours on my feet without feeling the effects. I was looking for another way to practice but knew I could not go back to my original field of Internal Medicine. If anything, those medication lists looked longer than ever, and at least half of the pills seemed to be there solely to undo the adverse effects of the other half.
Fortunately, the Universe started sending signals to me that the way I was practicing was not necessarily the only way. One day, in my yard, I bent down to pick up a toy and couldnít straighten up due to severe back pain radiating down one leg. I did all the usual first-line treatments that I would have told anyone who presented to the ER (Emergency Room) with the same complaints and got no relief. I suffered for a month while contemplating and rejecting all the second- and third-line treatments. Finally, in desperation but with extreme trepidation, I visited a chiropractor who efficiently diagnosed my condition, explained it to me in believable terms, and sent me home pain-free for the first time in a month.
I was stunned! My experience with this chiropractor put a huge crack in the wall of my belief system. I had entered the "enemy camp" and had been treated efficiently, professionally, and far more economically than if I had gone "the mainstream route." Even more astonishing, my insurance reimbursed my chiropractic care at a better rate than my outpatient Gyne (gynecology) visits, which were my only source of comparison. I repeatedly asked myself "What do they (the insurance companies) know that I donít?" "Why are they reimbursing chiropractic care when Iíve always been told that it was ineffective at best and dangerous at worst?" Every time I saw a person with back pain in the ER, I debated whether or not to refer them to a chiropractor. But most importantly, I could no longer accept all Iíd been taught at face value. The window was open, and I had no desire to close itóI wanted to see what would happen when I opened a few more.
Of course, the next lesson arrived in the form of my second son. As an infant, he had asthma requiring a minimum of two nebulizer treatments daily for maintenance, and every few hours when he was ill, which was frequently. He had ear infections that persisted for weeks and months, and was on antibiotics nearly continuously. At the age of 18 months, he responded to only a few very potent antibiotics ("Plutonium" as I called them) and was being evaluated for ear tubes and steroids. When three friends who didnít know each other advised that I consult a homeopath, I reluctantly did so. (For many years, I had sincerely thought "homeopathic" was a synonym for "ineffective" .) Again I was astonished at his response to this "unproven" method. Homeopathy, combined with IgG4 (Immunoglobulin G4) food sensitivity testing and elimination, gradually but unmistakably improved his heath. When I could no longer remember when he had used his nebulizer machine, I moved it to the closet and eventually to the attic. His antibiotic use declined steadily and stopped approximately one year after starting homeopathics. His health is now robust with only minor illness that is easily treated with natural approaches.
The most profound lesson came from my mother. Years before my encounter with the chiropractor she had been diagnosed with metastatic breast cancer. Always a rugged individualist, she selectively followed or ignored her oncologistís advice, and began exploring alternative approaches, including macrobiotics, shark cartilage therapy, Gersonís diet, coffee enema therapy, and others. She joined a support group, Bosum Buddies, and started attending healing services in the area. At first I tried to convince her to follow more conventional strategies but eventually abandoned the effort and supported her in her new attempts. As the months turned into years, she enjoyed a remarkable quality of life and was never again hospitalized until the final few days of her life. After her death, when reading Bernie Siegelís work (Love, Medicine, and Miracles and Peace, Love, and Healing, among many others), I realized that she was truly an Exceptional Cancer Patient by his definition. A practitioner experienced in Mind-Body principles would not have been as surprised as I was by her seven years of high quality life post diagnosis. That major healing of her relationships with her children and other friends and family members was a part of that seven-year process also would come as no surprise to that experienced practitioner, but was an unexpected blessing to me and my siblings.
Two months after she died, I started to work part-time in a holistic/integrative medical center. I found myself on the very steep slope of the "unlearning curve"ó discovering that many other disciplines existed that had much better success with the dreary/dreaded conditions commonly palliated by internists. Patients with chronic migraines, intractable asthma, rheumatoid arthritis, irritable or inflammatory bowel disease, eczema, recurrent infections, and chronic pain of all shapes and sizes improved or became symptom-free. Best of all, in the process, their general health improved, their sense of control or empowerment became stronger, and there was no trade-off of "adverse effects" of treatment in exchange for symptomatic improvement.
Seven years have passed since I first began working in an integrative practice, the last five of which have been full-time at the Miro Center. Iím still on the steep part of the learning curve, Iím still astonished by the transformations in well-being that my patients manifest on a regular basis. Appropriate lessons and teachers keep showing up in my home and office, sometimes much to my chagrin, but always to my eventual benefit.
To conclude this story, I offer my revised version of the "dogma" presented at the beginningómaybe the "un-dogma" of Integrative Medicine:
I feel very fortunate to have been given so many un-ignorable lessons in my twenty years since finishing my residency in Internal Medicine. I no longer regret going to medical school and I am very glad that I was so clueless about all the challenges ahead so that I was not dissuaded from continuing. I suspect that the next twenty years will be equally exciting and challenging and Iím delighted to be a participant.
Article from NOHA NEWS, Vol. XXV, No. 4, Fall 2000, pages 3-5.