Sunday, December 26, 2004

First, Do No Harm

A few years ago, at a Shabbat dinner, the topic of non-Western medicine came up. I said with great conviction that I did not believe in any form of non-Western medicine. I thought that Eastern medicine and the holistic approach was a load of crap, and that the practitioners of this "art" were shamans and charlatans.

After the dinner, one of the other guests called to suggest a friend of hers for a blind date. The man was a doctor of Eastern medicine, and practiced acupunture and Chinese healing. Needless to say I laughed, and said I couldn't date someone if I didn't respect their job/beliefs. In the end I agreed to go on the date, and was quite shocked. I was expecting some long-haired hippie-type man, in a flowing caftan with a crystal around his neck. Instead, the Caucasian version of Mr. T. met me at a coffee shop. This huge, muscular, clean-cut, Republican, conservative guy was the Doctor of Eastern Medicine.

Obviously, over the years, my position on non-Western medicine has changed. And will probably continue to change over the course of my nursing studies. I now believe very firmly in the holistic approach to medicine, believe that a combination of western and non-western medicine and healing is required in all situations. I think the specific patient and the situation will determine what combination of East adn West I use on my patients.

Today, for my "Theory of Nursing" class I had to watch a film called "First, Do No Harm", starring Meryl Streep.

It is the haunting story of a little boy named Robbie, who develops epilepsy, and his mother's struggle with the medical establishment to help her son. The movie opens with the discovery of Robbie's epilepsy; as it progresses Robbie goes from being an active, happy child to a lethargic almost mildly retarded little boy, thanks to the side effects of Dilantin and Tegretol, seizure medications that often do quite a bit of harm.

While Robbie's medical condition spirals downwards, the rest ofhis family's life is thrown into flux, both from social perspective, as they grapple with the decision to tell their friends and neighbors, and from a financial perspective, as Robbie's mounting medical costs force the family into serious debt, leading to the foreclosure of their home, the sale of their posessions, and poverty.

Meanwhile Robbie is not getting better, the medications are slowly turning him into a vegetable, and the all-knowing neurologist suggests a very expensive and risky brain surgery that may or may not work, and could kill Robbie.

His mother, Meryl Streep, finally decides to regain some of the power, and research epilepsy at the public library. She eventually discovers that doctors at Johns Hopkins University have invented this diet, the Ketogenic Diet, which alleviates the effects of epilepsy. In 1/3 of the patients it eradicates their sezures completely, in 1/3 it reduces the amount of sezures dramatically, and in 1/3 it does nothing, but certainly causes no harm. The Ketogenic Diet is more or less a strict form of the Atkins' Diet.

To make a long story short (see the film yourselves!!) Meryl Streep must battle the medical establishment in order to be allowed to put her son on this diet, despite the fact that even if it doens't work, there are no adverse effects. Meanwhile, her son's doctor's want to dope him up with medicine and perform a risky brain surgery, rather than give her the chance to save her so using a non-scientific method, as no one can explain why this diet helps epileptic patients. They try to take away her parental rights and force Robbie to undergo this risky surgery and harmful drugs, because their belief in themselves and in Western medicine is so great.

The phrase, "First, do no harm," is usually attributed to The Oath of Hippocrates, the oath newly minted physicians take while being "hooded", as they graduate from medical school.

As I've just discovered, this is a fallacy. The phrase "First, do no harm" appears nowhere in the Hippocratic Oath, not in the original version written by Hippocrates in his native Greek in 400 BCE, nor in the modern version, written by Louis Lasagna in 1964.

And yet, this steadfast belief held by many physicians that Western medicine is the only true medicine is harmful. What is it about Western medicine that makes us put such faith in it? What does everyone else believe? What would you do in this situation?

As often happens, the most chilling part of the movie was the credits. The film was 100% true. Many of the bit parts in the movie were played by epileptics who had been cured using he Ketogenic diet. Google it and you'll see what I mean. I cried and cried at the end, and vowed that this film would shape what kind of nurse I become.

I was easily the most powerful film I have seen in years. Go rent it.


Anonymous Anonymous said...

I enjoyed reading your comments on "...First Do No Harm". Last year my 3 year old son started having seizures, up to 30 a day. Medicine could not stop the seizures, but the Ketogenic diet did.

9:35 PM  

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