On pins and needles
al.ter/na.tive: (adj.) nontraditional or unconventional, as in ideas or methods
When one attempts to understand the meaning of "alternative," the Webster's Dictionary definition does not provide a satisfying impression. Instead, images of 1960s hippies dancing barefoot at a Grateful Dead concert or visions of 1980s punk rockers with blue hair may spring to mind. The 1990s, however, provide society with a new version of "alternative"-an alternative that no longer defines only the music or entertainment industry. As the medical establishment enters the new millennium, "unconventional"-or as many people label them, "alternative"-medicines are becoming a popular and oftentimes controversial form of healing.
Homeopathy. Naturopathy. Midwifery. Acupuncture. Therapeutic touch. Nutrition. The list of holistic healing methods is endless. "I think the word 'alternative' suggests that we can either use conventional (allopathic) medicine or the many other approaches to health and healing," said Trinity senior Lisa Pohl, co-developer and leader of a house course based on alternative medicine.
This house course, developed by Pohl and Trinity senior Paul Choi, is divided into two semesters. The spring semester course, titled, "The Art of Healing: Integrating Spirit, Mind and Body in Medicine," explores the meaning of health and healing in students' lives. Choi and Pohl developed the course, in part, because of their own interests in examining the mind-body connection. "If there is any passion in my life it is for exploring the real essence of healing," Choi said.
Other students in the course echoed Choi's enthusiasm for alternative medicine. "Treating the whole person [is important]. If something works for you personally, there's nothing wrong with it not being 'conventional,'" Trinity junior Dorothy Kozlowski said. "[Alternative medicine] definitely should be integrated."
But some are a bit more skeptical about whether "alternative" medicine can be taken to the limits of exploration and integration. Dr. Edward Halperin, chairman of Duke Medical Center's department of radiation oncology, argued in a recent issue of The Journal, a publication of the North Carolina Medical Society, that the Office of Alternative Medicine within the National Institutes of Health should be abolished.
"Do not be trapped by words," he cautioned. "'Alternative' medicine is an alternative to medicine and is unproven treatment, not another form of medicine."
Although Halperin acknowledged that some people feel better from a variety of treatments-such as vapors, massages and the like-he is hesitant to condone extensive research into "alternative" healing. For example, he noted, "Studies to investigate force fields emanating [from people's hands], in my opinion, is nonsensical."
But for those who believe strongly in the benefits of alternative medicine, Halperin's reluctance points to a serious barrier to its further development. "History shows us that this level of skepticism in medicine has caused serious problems," said Choi, whose parents are both doctors of conventional medicine but practice acupuncture. "It is important for us to expend our resources in the most vital places."
Choi notes that St. John's wort, an herb that helps treat depression, is a facet of "alternative" medicine that is effective and is being taken seriously. In fact, the NIH is sponsoring a $4 million study of the "happy herb" at the University. "It is dangerous not to heed the possibilities that [the herb] may give us," Choi explained.
Dr. Larry Burk, an associate professor of radiology at the Medical Center and the faculty sponsor for the house course, is also an advocate of "alternative" medicine.
"There is a deep need for research," said Burk, a columnist for The Chronicle who uses medicinal strategies such as hypnosis and imagery to help patients. "I respect Halperin's argument in that he is skeptical of the quality of the research that is done, but I feel that as an academic institution, we have an obligation to test these things."
Halperin does agree that some studies may be useful-but only to an extent. "Studies of potentially useful botanicals is not unreasonable, but the majority of the material is laughable and should not be funded," he said.
But the controversy sometimes created by "alternative" medicine has not slowed its growing popularity.
"Many of the changes that are occurring in our present health care system reflect a current dissatisfaction with a medical establishment that does not focus on attaining harmony of mind, body and spirit," Pohl said.
One physician taking on this integration of treatment is Dr. James Dykes, a board certified family physician and 1980 Duke medical school graduate, who has practiced in Durham since 1987 at Integrative Health Care. Dykes' practice combines both conventional and "alternative" forms of medicine to provide the patient the optimal experience in healing.
"I use western medicine judiciously and will combine that, if a patient is interested, with stress reduction strategies that can range from biofeedback to massage to acupuncture to nutritional or botanical supplements," he said.
Although Dykes' profession emphasizes the importance of traditional medicinal practices, he explained, "If I learned anything at my years at Duke Medical School, [I learned that] healing is a mystery. We have to be both skeptical and open-minded about what tools may be useful for individuals."
But while some doctors are also beginning to use "alternative" treatments to treat patients, not all see the practicality of researching these forms. Dr. Roy Mathew, a Duke psychologist, is currently conducting a study on how spirituality can help treat drug addiction-a study he considers to be part of conventional medicine.
"Spirituality is a very difficult thing to study-like studying [a reaction to] the beauty of a sunset-but a recovery from alcoholism seems to be facilitated with an increase in spirituality," he explained.
And despite the fact that Mathew sees merit in using "alternative" tactics in teaching and medicine, he agrees with Halperin that some forms of alternative medicine are difficult to study.
"It is hard to say, for example, that you have to have a data-based study about prayer for helping patients... my children or my wife," he said. "That is a given."
Perhaps part of the reason that "alternative" medicine is such a nebulous topic is because of the broadness of the category.
"I really don't like the term 'alternative medicine,'" Choi said. "It implies it is inferior. Alternative medicine is anything non-western." In addition to such recognizable treatments as herbs, homeopathy, midwifery, meditation and massage, other forms of healing are included as well: The importance of touch, traditional Chinese medicine, therapeutic touch, stress management, nutrition and even dance and movement therapy, are considered alternative forms.
Confusing? The complexity of the debate stems from the question of, "How far is too far?" Although Halperin and others believe NIH should abolish its separate branch of alternative medicine research, others believe that research is the only way to facilitate development and interest in this new and developing field.
"Whatever technique you use in medicine, the most important thing for us is to facilitate the true healing and go beyond healing the body and go further towards healing the mind and spirit," Choi said.