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Blending West and East

January 28, 2009
by Punyamurtula S. Kishore, MD, MPH
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Treatment programs should not lose sight of powerful healing tools that complement today’s technology

On any given day, one can go through the daily newspaper or click on the television and find a story about a celebrity entering or leaving a rehabilitation center for drug or alcohol treatment. The public perceives these episodes in a relatively simplistic context: The rock star or the diva needs to take the cure by putting himself/herself in other people’s hands, and do his/her own part by staying sober or drug-free.

The public’s fascination with the dramas of the rich and famous is a phenomenon better left for a sociologist to explain. But examined in a far larger context, this “treatment-centric” approach sheds light on a gap that exists between Western and Eastern cultures in their respective approaches to medical treatment of all kinds.

Staying with another mainstream American reference, consider the human body as a computer system. We are blessed with an abundance of medical technology to treat the “hardware—the patient’s body. We have state-of-the-art hospitals, cutting-edge diagnostic tools, and an array of constantly evolving medications for most every malady. All these tools have something in common: They are reactive tools put into play after the medical problem has introduced itself.

What is lacking is the “software,” a way of thinking and living that Eastern cultures have followed for centuries and one that could have positive implications for Western medical systems if integrated more fully into their philosophies and practices.

Any practical discussion of this “East-West” dynamic should begin by first examining the very foundations of Eastern philosophy. Eastern medicine takes the position that humans are not perfect, and that we are powerless over many forces in nature. The idea is that life is a work in progress, inevitably subject to universal, natural forces. These tenets can apply to all individuals, of course, but they also can take the form of a blueprint for recovery in the context of addiction treatment. Consider the following “guide” for addiction treatment patients:

Recognize the natural rhythms of the body. Sleep, don’t work, when the body tires at night. Be active during the day, when your hormones are most active. Follow this logical routine daily, not in fits and starts.
Respect the notion of “we are what we eat.” Eat and drink in moderation, and ritualize your intake. For instance, drink tea at a specific time every day.
Keep the body limber and the mind at peace. Practice exercise, stretching, and yoga to get the body back to normal.

The implicit assumption in American and other Western medical systems is that we are inherently perfect and that when imperfections (i.e., illness and addiction) surface, various treatments and medications can get us back to our perfect state. We eat too much, so we take diet pills. We overstress ourselves, so we pop an anti-inflammatory medication or two, or a tranquilizer. We don’t get enough sleep, so we take a sleeping pill. We have no breakfast, and then have a heavy meal in the evening. We are out of sync. We give fish to our patients, rather than teach them how to fish.

All in the family

One of the greatest divides between East and West in the addiction recovery process lies in the role of the family. I once treated a 16-year-old patient who had been stopped in a car with marijuana three times. In such a case, the approach in this country is too often punitive, involving a trip to a treatment center or juvenile detention facility, often coming into contact with older individuals with substance use problems and being separated from the family. This attitude mirrors the historical American emphasis on independence and the individual—picture the lone cowboy in the Old West.

By contrast, the Eastern approach places special emphasis on the family. As an example, when my Haitian patients come in at my medical practice, their entire family accompanies them. The family ideal is a core component of the treatment process.

Of course, at the very heart of this dichotomy is the fact that medicine is big business, especially in this country. The United States spends roughly twice as much on healthcare as Canada does, for instance. A total of 16% of our gross domestic product is spent on healthcare, according to a 2007 report by the National Coalition on Health Care.

1 But healthcare also is compromised by other big business influences. Consider that while public health messages on television, in newspapers, and on cigarette packages warn of the dangers of smoking, tobacco companies are allowed to use habit-forming nicotine in cigarettes to ensure sales of their products—and lobbyists advance their interests. Giant drug companies profit via the pipeline of prescriptions that doctors write for patients.

These pressures make it extremely difficult to step back and examine our health system in the most fundamental way. We need to ask ourselves whether healthcare is being carried out in a fashion that recognizes the essence of how our bodies work, and what should be done to realize our well-being.

Best of both worlds
Although some Eastern medical practices have been used in North America since the first settlers arrived, the concept was not introduced into mainstream America in a big way until 1971. That was when James Reston of