A Talk at a Medical School
The Benefits and Limits of Medical Expertise
A Major Study on Chemotherapy
Relationship to the Body
A Talk at a Medical School
I recall in the 1990s receiving a request to give a talk at Harvard Medical School, Cambridge, near Boston, Massachusetts, USA. The student, Jordan, who had sat annual retreats with me at the Insight Meditation Society (IMS) in Barre, Massachusetts, had received the agreement of his professors to invite me.
He rang me on the Monday to let me know he put posters on the noticeboards of the university and made announcements but he said there was little interest from students to attend the talk on the Friday afternoon.
I asked him the title for the talk on the posters. He said: “Mindfulness and Medicine.” (This was years before the mindfulness industry took off). I said I could not think of a more boring title. He asked me for a fresh title for the posters.
I told him to make the title: “Am I mad to want to be a doctor?”
Students and professors subsequently filled the auditorium.
I asked the students about their motivations to want to be a doctor – to cure the sick and injured or due to personal or family experience of suffering. There may be the motivation to serve others, to earn a significant salary, especially as a surgeon and to gain respect in the local community. Others become doctors to please mummy and daddy or to have extra letters (Dr.) before their name and after their name (PhD) or various combinations of those motives. Motives may change in time.
I told the students that if they responded to my questions, they had to be completely truthful. It was a spicy session. Motivation matters. A wise and compassionate motivation supports others. A motivation tied to self-interest inflates ego, corrupts the mind and distorts perceptions.
In those years, students spent a total of one afternoon – in four intense years of medical training – examining the relationship to diet, of what goes into our mouth and its impact on our health. Little has changed in subsequent years.
Mouths of patients might consume alcohol, tobacco, medication, drugs, prescribed and unprescribed, junk food, processed food, GM food, excessive sugar, salt and fat. Patients eat animals that have endured frequent anti-biotics and sea and river fish in polluted waters. They also consume various dairy products, milk, butter, cheese as well as in food items. More and more people become resistant to anti-biotics due to their diet.
Of course, there are a variety of causes and conditions for cancer – poor diet, genetic disposition, chemicals, stress, environmental pollution, smoking, alcohol, air pollution, excessive exposure to sunlight and living to excess. Most cancers are preventable while recognising that people still get cancer, who live mindfully with regard to diet, lifestyle and outlook on life.
Excess of consumption makes people sick to the point they suffer from cancer, heart disease and eventually the intake kills them. There is a widespread obesity epidemic that feeds despair, self-hate and compulsive eating. Yet Harvard Medical School, the top medical school in the USA, offered then only a single lecture and discussion on nutrition for medical students to inform then for a doctor’s entire career.
The pharmaceutical industry controls medical training. Medical schools in the West have changed little since then in the way of training in nutrition with classes on nutrition in medical schools ranging from zero to 70 hours over four years or more. Doctors often lack the knowledge and skills with a patient to find out precisely what dietary changes are needed and how patients will report these changes to the doctor.
Statistics for the USA generate alarm with the highest percentage of obese and very obese adults and children of any country. Other wealthy countries such have immense problems as well. Governments keep their mouths shut than rather challenge the food business. Two out of every three US adults are considered overweight or obese. The number of overweight or obese US citizens is expected to be three in every four by 2020. One in 20 adults are extremely obese. One in three US children are considered overweight or obese.
There is an epidemic of cancer as excessive consumption alongside process food injected with chemicals and farm animals subjected to intensive anti-biotics enter in the vulnerable molecules of humans, who were not made for such abuse of their bodies. People are digging their grave with a knife and fork.
Hippocrates said, “Let food be thy medicine, and medicine be thy food.” Doctors have mostly ignored this instruction despite taking the Hippocratic Oath.
Sadly, Jordan, a beautiful human being, died some years later from a brain tumour in his 30’s. He died a few years after he qualified. He had his first operation on his brain in his late teens. At times, Jordan endured blinding head pains. He told me that he found his mindfulness and meditation practice enabled him to keep calm presence of mind while living in the full challenge of the unknown and enduring severe pain at times.
I recall we had some wonderful exchanges in our enquiry sessions in the Dharma hall in front of the 100 participants and staff at IMS. His words, kindness and humility brought tears to the eyes of many who listened.
The Benefits and Limits of Medical Expertise
Doctors have the task and responsibility to offer their skills and prescriptions for the diseases and pain of the body. We have to bear in mind that doctors do not receive a training to treat the whole person. Doctors have little practical knowledge of the relationship of the psyche to physicality, mind to matter, mind to body. Apart from a few exceptions, doctors often do not have the subtle skills to show patients the way to dramatic changes in their way of living. Such changes accelerate the healing process through guidance in the quality of life, which can lengthen life expectancy by years. Success in medicine constitutes living longer regardless of the manner of living. The quality of life matters as much as the quantity of life in terms of years.
To put it rather crudely, the pharmaceutical industry employ doctors to dispense their products and use their equipment to make an impact on the body that will enable a person to live longer. The strategy often gets summarised as attack or poison (medication), burn (radiation) and cut out (surgery). Surgery has saved many lives through the cutting out of a tumour or cancer.
Doctors do not receive a training to look at the variety of causes, inner and outer with cancer as the effect/result/consequence of those causes and conditions. The pharmaceutical industry only wants doctors to look at effects and in the first instance prescribe chemicals to address any kind of biological or psychological disturbance. The hidden pressure and not so hidden pressure upon the doctors to prescribe medication makes it unthinkable that a doctor would resist offering medication, even if he or she knew that the person needed to make major changes in their diet and lifestyle to get well in mind and body.
Doctors find it difficult to decline to prescribe chemotherapy for a patient with cancer or even offer a massive reduction in the intensity of chemotherapy – even if they felt sure the patient would live longer on a smaller dose, say 20% of the current recommended course of chemotherapy. Other doctors will warn against offering a low dosage of chemotherapy while others claim that a large dosage may become life threatening. Oncologists know that the administration of chemotherapy is never a precise science with risks involved for the patient.
Doctors employ chemotherapy to stop the cancer from spreading. Chemotherapy does not cure a person from cancer but can extend the patient’s life. There are doctors who claim chemotherapy generally causes an improvement in the physical health of the patient, other doctors state that there is little or no improvement in health and there are doctors who claim chemotherapy could shorten the life of the patient suffering from certain cancers.
There is a growing awareness that recognises the conventional treatment and complementary treatment must work together for the deepest welfare of patients. There are only a few hospitals dedicated to the integration of medicine, forms of healing, practices, meditations and mindfulness, such as a progressive hospital in Essen, Germany. Doctors of conventional medicine and naturopathy work together.
To take a small example of support for patients: I have seen a group of of around 20 cancer patients in the grounds of the hospital engaged in walking and standing meditation together under the guidance of a mindfulness/meditation teacher working full time in the hospital. Such practices contribute to peace of mind and clarity for patients that reduces significantly the inner stress and fears that impact on the body.
A Major Study on Chemotherapy
Researchers at the Department of Radiation Oncology at the Northern Sydney Cancer Centre studied the 5-year survival rates of chemotherapy on 22 types of cancers in the US and Australia involving 154, 971 Americans and Australians with cancer.
Only 3,306 had survival that could be credited to chemotherapy.
In December 2004, this Australian study “The Contribution of Cytotoxic Chemotherapy to 5-year Survival in Adult Malignancies showed:
“The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1 % in The USA”
The study concluded: “As the 5-year survival rate in Australia is now over 60%, it is clear that cytotoxic chemotherapy only makes a minor contribution to cancer survival…. a rigorous evaluation of the cost-effectiveness and impact on quality of life is urgently required.”
According to this research, the best results from chemotherapy range from 41.8% effective, for certain cancer down to zero.
Chemotherapy can cause long term damage to the body, trigger secondary cancers due to highly toxic carcinogen and virtually destroy the immune system, vital for improvement in health.
Chemotherapy cannot distinguish between cancerous cells and healthy cells. Intensive chemotherapy and radiation may extend the life of the body or kill the body slowly, gradually and in a systematic way.
http://www.chrisbeatcancer.com/wp-content/uploads/2011/12/contribution-of-chemotherapy-to-5-year-survival.pdf (see Table 2 for effects of chemotherapy on particular cancers)
The harsh truth is that chemotherapy simply does not work well on various kinds of cancer. There is widespread treatment with chemotherapy of patients yet research shows few actually benefit from such treatment. Until doctors have the capacity to target the cancer, namely uncontrolled disorder of molecules, the consequences of chemotherapy for many may outweigh the benefits. The treatment of cancer through chemotherapy carries with it many unknown factors that neither drug companies nor the medical profession or patients can measure.
It would be naïve to make claims that alternative approaches to treatment of cancer through radical changes in diet, intensive breathing exercises, a fundamentally different lifestyle is the answer to cancer – before or after any necessary surgery. It would be equally naïve to think that such alternative approaches would have a lower chance of success than current studies of chemotherapy.
Mindfulness and meditation make a significant contribution to inner peace and clarity of mind that takes mental pressure off the body. The twin approach of mindfulness and mindfulness cultivates equanimity, minimises concerns about the future and enables the application of appropriate judgements in addressing a major health issue. With the mind at peace, there is less pressure on the body so that the healthy cells of the body and the strengthening of the immune system can work to reduce the impact of the cancer. The key is the treatment of the whole person. This includes consideration of the patient’s environment, indoors and outdoors.
There are patients who feel very grateful for having undergone chemotherapy. It is not easy for doctors to determine the correct dosage of treatment and the correct use of drugs suitable to attack the cancer cells. Others can recover from chemotherapy and radiation in spite of such treatment rather than because of it. The extremely high degrees of toxicity in chemotherapy contribute to the doubts in the minds of some oncologists about such treatment, which can feed anxiety, transform their appearance, destroy their appetite with a loss of love for life, even if they live longer than the initial prediction before chemotherapy.
Relationship to the Body
The capacity to relax in the face of sickness, pain and disease contributes to the maximisation of energy working to heal the body rather than burning up energy in excessive thinking, anxiety and movements of mind swinging to and fro between hope and fear.
The relationship to the body matters as much as the condition of the body. The construct of the self easily grasps onto the body though identification of the “I” with the body or the use of “my” shown as making a possession of the body.
The body functions as an object of mindfulness. There is the seeing of the body. There is contact with the body. There is knowledge of the condition of the body. There is the experience of the body. The body is an object of interest. An object cannot be the subject.
You are not the body.
The form of the body confirms as elements, DNA, cells, molecules, sensations, form, size, weight and the collection of organs confirm the body. The body emerges in the becoming/evolutionary process as an expression of nature.
The body comes from nature belongs to nature. The body is not your identity. It is not who you are. It is not a possession. You are mindful of the process of the physical. You respect it. You take care of it and get to know its strengths and vulnerabilities.
If you practise seeing body as body, not as I or my, then you will have glimpses of what it means to not to taste death.
May all beings see body as elements
May all beings see body as belonging to nature
May all beings be free from deceptions
End of Part One of Two