I just gave Grand Rounds at One Medical in San Francisco. For those of you not familiar with Grand Rounds, it’s a lecture where all the doctors gather in the hospital to learn about the latest research. The lectures tend to be dry—lots of data, lots of slides, lots of science—and it’s not a format that lends itself to debate or discussion afterwards.
I’ve been speaking all over the country on my book tour for Mind Over Medicine, and most of the audiences are a mix of empowered patients, conscious doctors, alternative health care providers, and hospital staff. I’m also training very open-minded doctors in the Whole Health Medicine Institute, so I have some experience speaking to doctors.
But giving Grand Rounds is a whole different ball game. Frankly, I was terrified.
My talk was titled “How The Doctor Can Be The Medicine,” about how rather than simply prescribing drugs, as doctors, our presence can be a force for healing. I loaded these doctors up with scientific data from our most respected journal, The New England Journal of Medicine, to support my point, sharing the data that demonstrates that the doctor can be either the placebo or its evil twin opposite, the nocebo, depending on whether, as doctors, we are kind, compassionate, and optimistic versus rude, rushed, and pessimistic.
I taught them 15 Ways The Doctor Can Be The Medicine:
- Open your heart.
- Make eye contact.
- Take your hand off the doorknob and sit down.
- Be present.
- Offer healing touch.
- Invite your patient to be your partner.
- Avoid judgment.
- Educate, but don’t dictate.
- Choose your words with care and remain optimistic.
- Trust your patient’s intuition.
- Be respectful of other practitioners who are treating your patient.
- Reassure your patients they are not alone.
- Encourage stress relief and let your presence relieve stress.
- Offer hope, because no matter how grim the prognosis, spontaneous remission is always possible.
How The Doctor Can Be The Placebo
To add credibility to my discussion, I shared with them a quote from Harvard researcher Ted Kaptchuk, who runs the Program for Placebo Studies at Harvard. During an NPR interview, Kaptchuk said, “A sugar pill doesn’t do anything. What does something is the context of healing. It’s the rituals of healing. It’s being in a healing relationship ... But the placebo pill is a wonderful tool, or a saline injection is a wonderful tool, to isolate what is usually in the background, take it away from the medications and procedures that medicine does, and actually just study the act of caring. That’s, I think, what we’re measuring when we study placebo effects.”
A Good Way To Deliver Bad News
I told these doctors that, when they’re giving a patient bad news, they have a choice. When they offer up grim statistics about the patient’s prognosis and use words like incurable, chronic, or terminal, they activate stress responses in the patient’s body that deactivate the body’s natural self-healing mechanisms.
The doctor has the choice, instead, to offer hope and nurturing care, withhold negative prognostic data unless the patient asks, and say things like “I’ve had patients just like you who have been cured. It doesn’t happen often, but I want you to know it’s possible.” When the patient is treated with hope and love, the stress response flips off, the relaxation response is activated, and the body’s self-healing mechanisms can get to work.
The whole lecture was based on science. We talked about the placebo and nocebo effect. We discussed the hypothalamic-pituitary-adrenal axis, as well as the sympathetic and parasympathetic nervous system and how they affect the body’s natural self-repair mechanisms. There was nothing “woo woo” in this Grand Rounds.
What Makes This “Alternative?”
Here’s what concerns me. Afterwards, a few hesitant doctors came up and said, “It’s great that they’re bringing some CAM speakers here.” In doctor lingo, CAM equals “Complementary and Alternative Medicine.” I had just spent the whole hour spouting data from The New England Journal of Medicine. There is nothing “alternative” about data from this journal. It’s as mainstream medicine as it goes. How did I suddenly get dismissed by the medical establishment as “CAM?” Since when is it “alternative” to talk about how doctors who are kind and optimistic with patients can improve the patient’s outcome?
Amazon did the same thing to Mind Over Medicine. This is a book about pure science. Every statement I make about how the body is equipped to heal itself is backed up with annotations straight from the medical literature. I didn’t make a single claim I couldn’t prove from a peer-reviewed journal. Yet, check out the categories into which Amazon lumped this book about science:
I also got a bee in my bonnet recently when I heard that TED organizers would label a lecture like this as “red flagged” because I discussed the placebo effect. (Read my thoughts on Why TED is not dead here.)
You Can’t Affect Change If You’re Angry
I was tempted to get my feathers ruffled. I tried so hard to give a lecture that was unquestionably scientific, based purely on the truth as I understand it. And yet, what I’m teaching isn’t yet considered mainstream. I know from experience that you can’t change a system if you make it wrong, so I took a few deep breaths, and nodded to the doctors who expressed appreciation that a “CAM speaker” had been brought in to enlighten them. Yes, I said. I was grateful to have the opportunity to serve.
As the room cleared, a few stray doctors stayed behind to confess, now that their peers were gone, that they believed what I said, that they had read Mind Over Medicine, followed my blog, read my Facebook posts, or seen me on PBS, and that they were inspired to be the medicine with their patients.
One guy said, “You changed me today. I’m not going to just dump negative prognostic data on my patients anymore. Instead, I’m going to ask them whether they want to know, but I’ll preface it by saying ‘There’s scientific evidence that it’s not good for you to know these numbers, but if you want to know them, I’ll tell you.’”
My heart leapt with joy. Baby steps, baby ...
I came away from Grand Rounds literally skipping. Maybe the scowling doctor in the front row will never be ready to hear what I’m teaching. But if I opened the hearts and minds of just a handful of doctors in that room, and if they help just a handful of patients, Mission Accomplished.
I have to remember that every revolutionary scientist was first dismissed by the mainstream as “cuckoo.” Then, when enough people came to realize that the revolutionary idea was simply truth, others came on board, and ideas like “the world is round” became mainstream. Note to self: Lissa, these things take time. Patience, grasshopper.
In the moments when I get discouraged because people are dismissing the truth as “alternative,” I have to remind myself of Margaret Mead’s comforting words. “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.
This small group is already forming, and it warms my heart and gives me courage. If you’re an empowered patient or conscious health care provider who are part of this small group ready to revolutionize health care, raise your hand and join the HealHealthCareNow.com forum!
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