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Passion, Compassion and Medical Practice by Dr. Ernesto Contreras, M.D. For many centuries the practice of medicine was aimed at taking care of the whole individual. It was characterized by compassion, sympathy, and love toward the sufferer. But in this century, that practice had gradually been transformed into an impersonal, cold, scientific discipline in which the patient has little voice, and is expected to submit unquestioningly to the doctor's authority. This unfortunate change has been the result of assigning too much importance to scientific knowledge and experimental methods which consider the human body purely as a complex machine that has been repaired by means of advanced technology. From the start of the century, science virtually declared war on the employment of medicine of spiritual laws and values. Left brain came to dominate right brain; cold knowledge pushed out compassion and love. When the brilliant French astronomer La Place, who published Celestial Mechanics in 1799, was asked by Napoleon why he did not dedicate a word to the creator of the heavens he had so elegantly described, the scientist answered: "Sire, my science is not based on hypothesis." The concept that science has nothing at all to do with God has done much to delay real progress in human knowledge. The moment a young student begins his studies in medical school, of textbooks and lectures begin the process of brain washing him into the supremacy of basic science over spiritual values in his future career. When he graduates as a doctor, he is full of the arrogant conviction that he knows a great deal. If he manages to become a specialist, he is molded into a proud, self-sufficient "professional" He is convinced that with science alone he is capable of solving all the problems of human suffering; that to treat a case of typhoid fever, meningitis or cancer he does not need God's assistance. Before the patient he must appear in unquestioning command. He believes it "unprofessional" to show emotion, which is equated with weakness. Even doctors who remain committed to spiritual values in their personal lives often start to behave as though they are agnostics the minute they step into the consulting room. The tender compassionate heart of the young healer is thus transformed into the cold and insensitive heart of the man of science. This is even more evident in the new generations of oncologists. They are impersonal and removed - even cruel - when the verdict of cancer, with its terrifying future, is handed down to the patient. They even dare to give dates when the patient is expected to die! This attitude has stricken the lives of countless cancer patients, and generally retarded progress in the treatment of cancer. Our experiences at Centro Medico and Hospital del Mar for the past 23 years lead me to believe that perhaps 25% of cancer patients who die prematurely because of aggressive cancers could live longer, happier lives simply by receiving more personal care, developing better communication with their doctors, and even, perhaps, learning how to love them. How fresh and timely sounds the voice of Ezekiel, the prophet of God, transmitting the gracious promise of his Sovereign Lord to His people: "I will give you a new heart and put a new spirit in you; I will remove from you your heart of stone and given you a heart of flesh." (1) Any doctor who applies for a full-time position in one of our institutions must be willing to experience this change in his or her heart: we feel the value of a sensitive, compassionate and loving physician cannot be overestimated. We consider it vital that our staff have a practical, living experience of two basic laws: 1- The Golden Rule: Do to your patient as you would do to yourself. 2 - The Second Commandment: love your patient as yourself. At our institutions we practice medicine with the mind and with the heart; science and art. We use all that science offers, but we know we must use our artistic abilities to make a good diagnosis, to establish the best treatment, and, of no less importance, to create good rapport with patients and inspire in them confidence, faith, hope and a positive attitude. To change the heart of stone to a heart of flesh also implies that we have to go back to the healers' underlying assumptions about the nature of the human being. Man is not just a highly evolved animal composed merely of a body and a limited mind. Man is of a different order of creation, with an enormous unexplored mental capacity and a spirit. He is an indivisible trinity, and whatever affects his body will necessarily disturb his mind and his spirit. For many years doctors,, especially in chronic diseases, have dedicated all their efforts to treating the physical aspect, artificially leaving aside the other areas. This has been a great mistake that has delayed progress, especially in cancer. Another negative result of the materialistic practice of medicine is the false concept that cancer is initially a local disease that only requires local treatments to be cured, such as surgery and radiation. Cancer, no matter how early it is detected, always will affect the mind and the spirit. In many instances, the real disease starts in those areas and later on will manifest as a physical illness. Thus, cancer should always be considered as a systemic problem in order to establish the proper therapies. The types of treatment prescribed have also been greatly influenced by the purely scientific and materialistic practice of medicine. In the case of cancer, the degree of aggressiveness the therapies have reached is almost unbelievable - in surgery, the hemicorporectomies and supermasectomies; in radiation therapy, the total body irradiation and massive short term programs; in chemotherapy, the protocols of four or five extremely toxic chemicals. Each of these can produce some good immediate results, but very frequently the price the patient pays as a human being is simply too high. Even in the best hands there is always a risk of death or permanent side effects (iatrongenia), that could result in a very miserable life. Another basic and long-standing mistake made in conventional treatments is that practically all the efforts of the doctor are directed toward destroying or eliminating the malignant cells - a disease-driven model of medicine. And as the aggressive procedures are not selective, they also destroy many healthy cells and damage the patient's immune system. So, when they cancer cells that have survived the initial attack get organized again and produce a relapse, the body is in a very poor condition to fight back. The programs we have developed, besides being substantially less aggressive, give major emphasis to rebuilding the immune system. This is accomplished by means of detoxification, diet, vitamins and other immunostimulants which must include spiritual therapy and psychotherapy. The more attention we give to the latter aspects, we have discovered, the better the chance of effective restoration of the immune system. This philosophy is not based on hypothetical or purely mystical ideas. It is a realistic approach that is proving to be extremely helpful. Our patients enjoy a much better quality of life than under conventional treatment routines, and, frequently, remarkably long survival periods. In a recent article a Canadian oncologist (2) expresses the thesis that serious, ethical doctors must exercise their profession based on the "biomedical model" which is considered by him to be the only one which scientifically explains the cause and natural history of cancer. The "common sense" model is for ignorant people of quacks. The facts, however, show that by sticking to this "biomedical model," oncologists have made little or no progress. This is the conclusion reached by two reputable professors at the Harvard School of Public Health. They reviewed thousands of charts from 1950 through 1982, and, according to that study, the current cancer treatments should be considered a "qualified failure." They conclude that "we are losing the war against cancer," and that more public funds should be devoted to prevention. (3) The
following three case histories are of very seriously and terminally
ill cancer patients who came to us for treatment. All are extremely
well documented according to orthodox criteria. In January 1981 there was evidence of more tumor growth in the abdomen causing blockage of the ureters Her condition was very critical. On March 25th a right nephrostomy had to be performed just to make her less uncomfortable. Chemotherapy was discontinued. In spite of her condition, the patient was willing to keep fighting and this encouraged us to continue with the metabolic therapy. By December of the same year she was doing remarkably well in spite of the fact that the tumor masses kept growing slowly. In June 1983 she started to show episodes of partial intestinal obstruction, which gradually got worse and in May 1984 a transverse colostomy had to be performed. Prognosis was again very poor, but once more she evidenced great courage. Since then, up to February 1987, when she last visited our hospital as an outpatient, she had been holding up in good condition, remaining very active, traveling frequently and seemed very well-adjusted to her ostomies. Her local oncologist can't explain how she is still living - and happily too! He encourages her to keep taking the program that has helped so much. He is convinced that her positive attitude and faith have been the main factors in her amazing survival. (4) Case 2 - White female, age 53. For several years she was exposed to severe emotional stress. During 1981 and 1982 she suffered frequent spells of diarrhea and cramps which were not helped by the usual remedies. In early October 1983 she developed acute abdominal pain and noticed that her urine had a fecal odor. She was hospitalized and complete studies showed she had a huge carcinoma of the sigmoid colon. Emergency surgery was performed on October 17 and the surgeon removed the tumor, but he also found involvement of a loop of the terminal ileum which was attached to the urinary bladder forming a fistula, so he removed the affected loop and repaired the bladder. Her postoperative course was complicated by pulmonary edema and myocardial infarction. Radiation therapy and chemotherapy were started in November, but had to be discontinued soon because of intolerance. On January 9, 1984, she was admitted to our institution in very poor condition and in a terrible state of depression. Given very little chance of survival, we put her on our full program of metabolic therapy, mild chemotherapy (5FU) and a strong program of psychotherapy and spiritual assistance. To our surprise, she developed a very positive attitude and started to improve in all aspects. Five weeks later she was discharged in good condition and went home very optimistic. By September of the same year she was doing so well that the mild chemotherapy was discontinued. A CAT scan showed no evidence of tumors in her abdomen. During 1985 and 1986 she enjoyed a very normal life. Her last visit with us was on March 4, 1987. She felt so well that she has asked us to close the colostomy that was done in her first emergency surgery. (5)
Case 3 - White male, age 53. In September, 1986 he began to suffer from indigestion, excess gas, alarming loss of weight and later, severe pain in his right hip. He was studied and found to have very large liver, a right pulmonary nodule, and a lesion in the lumbar spine. A liver biopsy disclosed a very aggressive metastatic adenocarcinoma and a bone scan detected metastasis in his fifth lumbar vertebra. The final diagnosis was primary carcinoma of the right lung with massive metastases to the liver and to the firth lumbar vertebra. He soon became bedridden with excruciating pain and started to deteriorate rapidly. Nothing was offered to him, being so terminally ill.
Scientifically
speaking, and applying the concept of the bio-medical model so
faithfully espoused by the "accepted" medical establishment,
none of these three cases should have survived long (add the other
two cases or simply their file data? ) None of the three received
miracle drugs to which we might attribute the stabilization or
remission of their condition. To ask for a change in the heart of the healer is not a purely hypothetical or mystical request. It is an urgent need if we really want to see more effectiveness in the treatment of chronic degenerative disease, especially cancer. Let us pray that in the near future more and more doctors may be willing to humble themselves, accept their limited knowledge, look for divine guidance, and permit their hearts of stone to be transformed into hearts of flesh. Only then may the title "Doctor" become synonymous with that of "Healer." Notes: 1 Ezekiel 36:26 2 M.L. Brigden, M.D. Postgraduate Medicine, January 1987, p. 271 - 280 3 Bailar III and Smith, New England Journal of Medicine, May 8, 1986, 1226 - 1232 4 Hospital del Mar, Chart CMM-79-17120 5 Hospital del Mar, Chart CMM - 81 - 20694. 6 Hospital del Mar, Chart CMM - 86 - 27579. Ernesto
Contreras R., M.D. is a graduate of University of Mexico (BS.
1932, M.D. 1939.) He is the founder, director and medical oncologist
of Dell mar Medical Center and Hospital in Tijuana, Mexico (founded
1963). He has been developing cancer prevention programs thorough
the use of metabolic therapy and non-toxic anti-tumor agents since
1965. He is a member of a number o medical associations and author
of numerous articles for medical publications. He has a wife,
Rita, 6 children and 15 grandchildren and is very active in the
Mexican Methodist Church. REFERENCES [1]
The Heart of the Healer With Prince Charles, Norman Cousins, Richard
Moss, Bernie Siegel & Others.
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