Thursday, May 10, 2012

Wanted: Physicians Who Speak

Written by Bill Benda, MD
2011 Naturopathic Champion
Each time I am asked to write for this blog I find myself a bit taken aback, given the discrepancy between my particular choice of topics and those of the other thought leaders of your profession. As many of you likely know, I am not an ND, and after a decade or so working with the AANP and various medical schools I no longer sit on any naturopathic committee, or council, or board (OK, I am still on the board of Natural Doctors International, out of love and respect for Tabatha Parker). But I still write for this blog, even though I have become more cantankerous and curmudgeonly with time, regaling you dear readers not with tidings of comfort and joy but with rhetoric more akin to Cormac McCarthy. And as I sit at my computer seeking yet another offering for Physicians Who Listen, I find myself asking my same self, “Why?” Why do I continue to poke and prod rather than pacify and protect? It certainly isn’t adding to my circle of naturopathic friends.

Well, I’ve come up with an answer. Two, actually. The first being that it fits my particular personality (oh, well). But the second is the more cogent reason: Because nobody else seems to want to. Poke and prod, that is. In a world, and a health care system, so ripe with dilemmas and disparities, we in the healing arts tend to remain quiet on the most controversial issues of the day. I am not talking about topics such as affordability, access, third party vs. universal coverage, or legislative inroads – I have attended enough DC FLIs and state and national conferences to hold extraordinary respect for the battles that have been and are being fought by your leadership. I am instead referring to less tangible, but perhaps far more socially consequential, issues of the day: abortion, war, gun control, the media, our political process, recent Supreme Court rulings. Catholic nuns, for God’s sake.

Of course I am fully aware of the futility of thinking any of us can influence the historical aftermath of such intrinsically impossible issues. But this is not about aftermath – it’s about the internal effect, both personally and professionally, that such discussions can have on the future of naturopathic medicine. As each of our professions, whether allopathic or naturopathic or homeopathic or traditional Chinese medicine, mature within the structure of our social and political systems, we must pay attention to the need to mature from within as well.

A couple of weeks ago I wrote a piece for the online Wellness Times, Karolyn Gazella’s quite popular natural medicine offering to the lay public, entitled “Till Death Do Us Part.” It was a treatise on the death of my mother a month or so ago, although the gist of the article had more to do with the concept of physician-assisted end of life than with my own personal/familial experience. Here is an excerpt:

“I am talking about South Florida here, home of the elderly, and perhaps the epicenter of nursing homes—not a realm where I have spent much of my professional career. Each time I visited her during her last two weeks, I walked through hallways filled with wheelchairs containing men, and even more women, talking to no one and often crying for help. Some were holding stuffed animals as comfort—these especially broke my heart. Really, seriously, broke my heart.

They broke my heart because for the first time I realized that I had helped put so many like them in this purgatory of lingering between life and death. We in healthcare tend to remember those we save, and repair, and then release to return to a full life among their families and loved ones. But sometimes we go too far, and our unprecedented longevity, courtesy of our pharmaceuticals and surgical procedures, often brings with it incalculable suffering. I clearly recall the doctor-as-god mentality of the ’70s and ’80s, with white-coated knights heroically battling death by whatever means available, unaware of and unchallenged by the wishes of the afflicted patient. The physician dictated, the patient followed—to the last breath. This mindset has not disappeared from the medical professional ethic, as doctors feel compelled to combat the incurable cancer, tube-feed the severely compromised preemie who will never recover, or pump the ancient heart trying so desperately to stop beating. I believe we doctors need to stop.

With us baby boomers heading over the hill like lemmings in the next few decades, and Alzheimer’s predicted to be epidemic by the year 2020, I believe we who call ourselves healers must reconsider our role in the facilitation of a good death as the appropriate ending to a good life. I contend that we serve each patient best by respecting their authority over what is to be their final earthly possession—their physical body. Of course the topic is fraught with legal, political and moral jeopardy. But I am certain that this is a conversation whose time has come. It’s time to seriously discuss the issue of physician-assisted death.”*

Controversial? Yes. Risky? Yes. More important than the entire agenda of August’s upcoming conference?

Mom says yes.

So speak up, people! Spread out a bit from commenting on who the new executive director is going to be or whether your particular state organization is getting enough attention from the national – and toss around a topic that seems inconsequential to the future of naturopathic medicine. What about the upcoming election cycle? What about Syria? What about Trayvon Martin?

What about those nuns?


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