A Positive Future for Medicine

42coverAn interview with Alicia Landman-Reiner, M.D.
Issue: Winter 2005, Winter of the Soul; Issue #42

Alicia Landman-Reiner, M.D. is a physician and board member of the Physicians’ Association for Anthroposophical Medicine (PAAM). She is also the course director for the PAAM-sponsored training course for doctors. The training is comprised of six four-day intensive workshops over two years, taught by anthroposophic physicians and therapists from North America and abroad. It is held in several locations around the U.S. where anthroposophic medicine is being practiced, including the Fellowship Community, Camphill Beaver Run, and others. LILIPOH publisher Claus Sproll interviewed Dr. Landman-Reiner about the PAAM training program at the August 2005 Artemisia conference, a meeting of anthroposophic therapists.

LILIPOH: Why would anyone do the PAAM training?

Dr. Landman-Reiner: To become enthusiastic about medicine again. It will not be news if I say that our medical system is currently broken in many respects. A great combination of problems is to blame – political forces, economic inequalities, uncritical use of technology … but, while we agree heartily that these are problems, we in anthroposophic medicine uniquely focus on: how can we see our patient as an integrated being of body, soul, and spirit; and what therapies can evoke healing – a return to wholeness – and why. The whole way medicine is conceived and taught in universities today is based on the idea that the body is an elaborately complex machine – and our methods of investigation and of treatment and healing – are no more nor less than an extension of this idea. We are taught to reduce everything to its biochemical, molecular level if possible. We are taught to quantify everything, and to mistrust the qualitative. And we are deeply reinforced in our habit of dualism – which is the idea that the body has a purely external, objective reality, independent of how we observe it and conceptualize it – i.e., that as scientific observers we have no effect on what we study. These ideas – besides actually being based on physics that was surpassed with relativity theory and beyond – are contradicted by every wisdom tradition throughout human history. That is to say, if we look deeply into wisdom traditions we find more complex and nuanced views of the body. Yet these assumptions are not recognized as controversies by our scientific training today. We are dealing with what Rupert Sheldrake calls “institutionalized science.” We are taught these assumptions, unquestioned, at the highest educational levels. Andrew Weil, the M.D. and botanist, comments that modern scientific medicine is the only healing tradition in the world which claims to have no underlying principles. Well, every healing approach has principles. The reductionism and dualism I just described – these are our principles. But in our institutions, our universities, these underlying assumptions are unexamined. This makes it hard for doctors, who may have a deep personal intuition that the human body is not merely a machine, to hold onto their conviction that healing has a spiritual component, and to find a language to express this conviction. And that is very painful for these doctors and medical students. They become disillusioned, and later they can burn out. Medicine today has nearly completely lost the concept of intuition. In anthroposophic medicine we work towards developing our intuition. In practice this is not even remotely a fuzzy, vague, dreamy capacity. It is a kind of knowing. It just happens to be a kind of knowing we don’t understand very well, today. Doctors are often highly intuitive people. Rachel Naomi Remen, M.D., who has written inspiringly about doctors and patients (Kitchen Table Wisdom) teaches doctors to consider using their intuition, in a situation where it could clearly do no harm. This is wonderful. Anthroposophic medicine works to develop, in a thoroughly conscious, systematic and sober way, our capacities in the direction of intuition. As doctors, if we are to develop the medicine of the future, we need to change. To go beyond the reductionist model of the human being in illness and health, we need to develop our capacities. We cannot develop a new model with merely our old ways of thinking and seeing. This is what you might call, “holistic basic research.” This is something which Anthroposophy has been working with – soberly, methodically, scientifically – for 80 years. We in the profession can become enthusiastic about medicine again, when we see that our dream of a medicine which is scientific, but which goes beyond scientism, can be realized. The other reason to take this medical training is to learn better ways of helping our patients. The anthroposophic remedies are effective in many situations where conventional medicine offers nothing, or only symptomatic care via medicines with undesirable side effects. The remedies and our therapies – such as movement work, art therapy, massage, bath therapy – help with acute and chronic illnesses. We all know that standard medicine can have pathetically little to offer in many chronic illnesses (arthritis, back problems, headache, menstrual problems, digestive problems, recurrent infections, learning difficulties). So it is a true joy to discover that if we work with homeopathic remedies, with botanicals (plant remedies) and with therapies – there is much healing possible. For acute illnesses – colds, flus and ear infections – a recently published international study, by Harald Hamre and colleagues, directly compared anthroposophic treatment versus conventional treatment, and showed that the anthroposophic approach resulted in quicker healing, far fewer drugs (antibiotics, pain relievers, decongestants), and fewer complications. My own experience as a family doctor bore this out, very much so. It is vastly more satisfying to practice medicine this way. In our training, we are not only teaching theory. We try to be as practical and direct as we can, giving our participant medical doctors tools they can use “on Monday” after the workshop.

LILIPOH: Is there a future for that kind of medicine? Can you make a living with it?

ALR: Yes. Yes. The future: One study of arthritis treatments showed anthroposophic treatment to be more effective than standard treatment, and was cost-effective. The future of medicine lies in relying less on drugs, and more on approaches that engage the patient in the healing process. Initially it is more demanding for patients to, say, become engaged in movement therapy (called eurythmy in anthroposophic medicine) than to just be given aspirin or ibuprofen for arthritis. But in the long run, wherever the patient is engaged body, soul and spirit, the real possibility of healing arises. Patients are longing for this. A patient of mine came back from the oncologist – whom I know to be a very competent conventional doctor – saying, “I asked her how I can participate in my healing. She told me, ‘there is no way. Just take your chemotherapy’.” The patient was outraged. She knew there had to be a way she could participate in her treatment. And it has been demonstrated by research, that women live longer with advanced cancer by having the support of a peer group; and that people with heart disease – with blocked coronary arteries – can unblock them through diet, exercise, and by strengthening their relationships with other human beings; that’s the study by the cardiologist Dean Ornish, M.D. So, the future of medicine lies in engaging the patient in therapy – the whole loving, hoping, sometimes confused, sometimes astoundingly clear, upright, creative human being. And that’s what anthroposophic medicine has been engaged with for over 80 years. An anthroposophic doctor must go through standard medical training, and is therefore fully licensed (as an M.D. or D.O.). An anthroposophic doctor meets the usual standards and surpasses them. This is not “complementary” treatment, but a larger view of medicine which encompasses standard treatment. Many insurances cover this kind of medical care, because it is offered by an M.D. in the context of the usual medical standards. Anthroposophic medicine is incorporated into many models of health care delivery. It is integrated into several normal community hospitals in Germany. It is integrated into intentional-community settings in the United States and elsewhere. The McMullens, two doctors in Ann Arbor, Michigan, offer anthroposophic medicine in a cooperative setting, in which the patient group supports the practice, like the “CSA” (community supported agriculture) initiatives readers may be familiar with. You could easily incorporate anthroposophic medicine into an HMO setting; you could offer classes in home care, remedies for acute illnesses, chronic disease programs – it’s completely possible.

LILIPOH: What makes you get up in the morning? What drives you?

ALR: What makes one get up in the morning is not a logical thing. The front page news is frequently tragic. In talking to patients for 25 years, it seems to me that no one gets away without rather a lot of suffering. But it is also a very beautiful world. I hope to be in it for my full 100-year quota. People’s capacity to love each other, to laugh – what an amazing thing. If, when I do die and cross into the spiritual world, there is no humor there, I’m going to be very upset. Being a doctor is a huge privilege, in that people come to my office, vulnerable. That’s the nature of going to the doctor. I know it myself when I go in and have to say, “I have this pain …” I feel so exposed. Like maybe something is actually wrong with me, not just “my back ...” But see what that means: I get to see my patients at their most beautiful. Because, really, when we are vulnerable, we also reveal our best selves – the part we try so hard to cover up all the time! Children come into the office and are just themselves. They don’t need any coaching. They come right in, and ask, “do you give shots?” Because that is really what they are worried about. After the first visit, they remember just which toys, sit right down, and start to play. No coverup. Adults – we cover up our true selves. But when we are faced with illness, it gets peeled back, and we are just there, just ourselves. And that is an extremely precious thing to be part of: to have the privilege of dealing with people who are reacting to difficult diagnoses, to successes and failures of therapy, to the wearing march of chronic illness – and over and over they do it with such courage, such good will, humor, and imagination. So, to have the privilege of helping them along this journey, is very wonderful.
Look forward to Part 2 of Dr. Landman-Reiner’s interview in the next issue of LILIPOH.