he Limitations of Medical MaterialismLarry Malerba D.O.

The following is excerpted from Green Medicine: Challenging the Assumptions of Conventional Health Care, available from North Atlantic Books.

Normal Science

Perhaps the most disappointing and disturbing realization that I came to after five years of medical school and residency training was that almost no one was interested in discussing the nature of health and illness, disease and cure, or the cutting edge of new developments in the quest to heal the sick. There was virtually no interest, no innovation -- an intellectual vacuum. There was little desire to examine novel ideas, and sometimes even contempt for anything other than the latest state-of-the-art technological advancements within the confines of mainstream medicine.

Not a moment was spent discussing medical history or the history of scientific innovations, for that matter. It was as if to say that all that had come before was essentially irrelevant to the practice of medicine, or was only of value to the academician or the intellectually curious. Imagine if you took all photos of departed loved ones, threw them away, and resolved never to talk about them with your family and friends ever again, because it was believed to be of no practical value to the present or future. Likewise and equally disturbing was the fact that not a moment of class time was spent on the philosophical underpinnings of medical practice, or the philosophy of scientific ideas or methodologies; there was no seeking to understand what it was that we were doing or why we were doing it. Much to my dismay, even within the halls of the psychiatry department there was a remarkable lack of interest in these pertinent and essential topics.

I suppose I was nave to expect that medical scientists would be naturally curious about the historical and philosophical origins of their profession. And yes, you can study the history of science, the history of medicine, or the philosophy of science in the rarified halls of academia, but do not be fooled into believing that these fields of knowledge inform the average doctor pumped out by the assembly line of conventional medical education. Like many successful industries, the end product is guaranteed to be of the highest quality, pre-packaged with white coats and stethoscopes, standardized and homogenized, ready to meet the needs of the demanding consumer. Independent thought is not permitted to gum up the works. And by extension, these cookie-cutter doctors are designed to serve mainstream consumers and their cookie-cutter maladies. But there is one serious glitch in the educational program. People and their ailments rarely conform to the size or shape of the cookie-cutters that medical graduates acquire by virtue of their long years of medical training.

In my initial enthusiasm as a newly enrolled medical student, I initiated the formation of an alternative medicine club. I went through the proper channels and obtained permission from the administration to use classroom space for meetings. The wheels were set in motion and flyers were made up to advertise the first meeting. But my excitement was quickly dashed when I was called to the dean's office at the last moment. I was informed that persons involved in accrediting the university would soon be visiting the campus, and that the club posed too great a potential threat to the status of the school. I remained undaunted and was given permission, ironically, by the Unitarian church directly adjacent to the university campus to hold meetings in their basement conference room. Our club was ultimately a success, and many young minds were corrupted with ideas of medical heresy that year. In fairness, that was almost twenty years ago, and I do know firsthand that the average medical student nowadays is significantly more receptive to green medical practices. However, the glacial speed with which modern medical institutions are inclined to change remains a significant impediment to progress.

Thomas Kuhn, the influential historian and philosopher of science, would have said that my frustration revolves around the nature and activities of "normal science." Normal science entails the everyday activities of scientists who are engaged in research and practicing within the framework of assumptions of the prevailing scientific paradigm. Kuhn also popularized the term "paradigm" in relation to scientific pursuits to mean the worldview, underlying assumptions, or set of rules regarding how a particular branch of science is viewed, structured, and practiced. This means that persons engaged in the activities of normal science within a given scientific paradigm are busy studying and testing phenomena that fall within the parameters of that branch of science. What they are not busy doing is questioning or challenging the underlying assumptions of the consensus of the scientific community and its cultural milieu.

Kuhn's most significant contribution to the field is his book The Structure of Scientific Revolutions, which is a staple of almost every Philosophy of Science 101 course. Some excerpts from this important work will help develop my theme:

Scientists work from models acquired through education and through subsequent exposure to the literature often without quite knowing or needing to know what characteristics have given these models the status of community paradigms.23

They do not need to know because they are occupied with working within, and not disputing, the set of rules they have assimilated from their education and cultural environment. If an experimental outcome does not conform to preconceived expectation, then the result is commonly believed to be due to ineffective technique on the part of the investigator and not to erroneous assumptions made by the paradigm the research is conducted in. Kuhn also speaks of the peculiar colorblindness of the scientific enterprise:

Closely examined, whether historically or in the contemporary laboratory, that enterprise seems an attempt to force nature into the preformed and relatively inflexible box that the paradigm supplies. No part of the aim of normal science is to call forth new sorts of phenomena; indeed those that will not fit the box are often not seen at all. Nor do scientists normally aim to invent new theories, and they are often intolerant of those invented by others. Instead, normal-scientific research is directed to the articulation of those phenomena and theories that the paradigm already supplies.24

Resistance to new ideas and forcing the natural world to conform to a predetermined framework is particularly egregious in the field of orthodox medicine. Take, for example, the historical reluctance to acknowledge the existence of an illness like chronic fatigue syndrome (CFS). The rationale has been that, since CFS cannot be proven through examination or testing, it can not exist. As we shall see later [in Green Medicine], the existence of all diagnostic entities can be called into question because they are artificial, predetermined constructs of modern medicine, but for now, I will frame the discussion in conventional terms. In those terms, then, once all possibilities of "real" and "legitimate" physical maladies that might account for the fatigue of the CFS sufferer, such as anemia or hypothyroidism, are ruled out, it is, by default, assumed to be a psychiatric condition. This demeaning assessment carries with it the implication that the problem is "all in the head" of the complainant.

Science as Myth

Popular culture tends to equate science with truth or objective fact, failing to understand that conventional science does not have a corner on the market of potential lenses for viewing the natural world. Each new pronouncement made by the scientific community is assumed to be true and tends to be accepted by the mainstream with minimal, if any, critical analysis. To recognize the extent of this wholesale yielding to scientific authority one needs only to observe how popular news programs and newspapers dutifully report the results of the latest scientific studies. Predictably, for example, each new nutritional "fact" supported by the research can trigger a cascade of food products making various health claims, which is followed by a stampede of consumers all too willing to fall for each dietary quick fix-even while the next "fact" indicated by the latest data may well contradict the previous.

A levelheaded review of these trends in medical science should make one wonder about the "scientific" nature of the science that it claims to be. Scientific flip-flopping is commonly characterized by research authorities as the price we pay for medical progress as our knowledge grows through a process of trial and error. I would propose, however, that it more closely resembles chaos, and the truth regarding its ultimate value in terms of human health is a much more difficult thing to discern. A full perspective required to make an accurate judgment is not accessible to us through truncated studies that examine only pieces of a story and parts of the human body.

There is something seriously askew in the fickle way with which the scientific community makes its authoritative claims, and the corresponding willingness of the gullible public to uncritically accept whatever they are spoon-fed. This is the very same dynamic that causes some hungering souls to accept in blind faith whatever their spiritual leaders decree as truth. Dr. Edward Whitmont, in The Alchemy of Healing, his powerful examination of the nature of health and illness, boldly draws little distinction between modern science and myth:

We rarely stop to consider that any truth is multifaceted and that the postulated validity and claims of absolute truth of the current scientific ideas rest on a priori metaphysical assumptions . . . these modes of belief, in their sweeping claims, have become culturally dominant modes of thinking. As a priori ideas, they are mere mythologems, the mythologems of the post Renaissance/Enlightenment period. As mythologems, albeit contemporary ones, they have no more claim to absolute truth than any other myths.25

Myth here does not mean untrue, but rather denotes the stories produced by the human psyche that serve to impart meaning to humankind's existence. In this sense, the myth of the tree of knowledge in the Garden of Eden is a powerful metaphor for a psychic reality, but it is no more or less true than the story of the rise of modern technological society, whose abilities to travel to the moon and to unravel the secrets of DNA contain within them the promise of someday solving humanity's problems. Just as in the myth of Atlantis, where an advanced civilization was ultimately destroyed by greater cosmic forces because its advanced state of high technology had come at the expense of nature and soul, so too, twenty-first century technological society flirts with self-destruction when it arrogantly presumes to be able to master and control the forces of nature. According to some, the consequences of ignoring the higher laws of the universe ultimately led to the downfall of Atlantis through a karmic correction in the form of volcanic eruptions, earthquakes, and tidal waves.

Modern humans are just now becoming aware of how their quest for control over nature may be contributing to the phenomenon of global warming. Will we heed the warning or will we plunge ahead in reckless disregard? Medical science may be able to synthesize a drug that reliably lowers a fever, but the assumption that it is desirable to lower a fever is a highly debatable question whose answer has far-reaching consequences and depends upon each individual situation. Shall we forge ahead and lower that fever anyway, simply because pharmaceutical technology makes it possible? Our lack of understanding and failure to heed the messages of nature have resulted in an unprecedented degradation of the environment and a corresponding desecration of the body-heart-mind-soul. Education of professional and layperson alike regarding green medical philosophy and its holistic/ecological worldview will be essential if we are ever to reverse this recent and rapid decline.

These materialistic and metaphysical assumptions about the nature of a universe that science aims to study are no less arbitrary than the assumptions that underpin disciplines that are not considered "scientific" by scientists, such as parapsychology, numerology, alchemy, or the study of the psycho-spiritual archetypes of Carl Jung's collective unconscious. Because scientific endeavor is usually not concerned with reflecting upon its own underlying assumptions, the vast majority of its energy is directed toward deepening what it already does know rather than expanding the breadth of knowledge into what it does not know.

This disposition toward increasing the depth of knowledge within each specialized field is often accompanied by science's tendency to overstep its bounds by making hypocritical judgments regarding areas of human endeavor over which it has no authority. It will not deign to allot scientific resources to the study of, say, astrology, which it dismisses as pseudoscience, but it nevertheless reserves the right to pass judgment upon it. The stereotype of the scientist as an egg-headed know-it-all provides a suitable image to consider here-it's akin to Star Trek's Mr. Spock expounding upon the irrationality and lack of utility of human emotion. Similarly, in Planet Medicine, Richard Grossinger points out the way in which medicine fails to recognize its own limitations:

We can summarily say that the thing which is wrong with orthodox medicine is not the system itself, but the way in which it presents itself as the only or most effective way to treat sickness . . . Sometimes orthodox medicine is shockingly provincial. In order to save its reputation, it gives people the illusion it is handling more than it is and that the other methods for getting things done are either primitive, untested, exotic, unscientific, or un-American.26

The point of this philosophical exploration is to make clear that the conventional medical paradigm is grounded in an underlying set of assumptions that prejudice one into believing that all health problems are based in the physical body and therefore ultimately solvable through material means. Quite to the contrary, truly effective green healing will not be achievable until the left-brain of science welcomes the right-brain of emotion, intuition, the subjective, and the intangibles of human nature back into the equation of human health care. Good science knows its boundaries and acknowledges what it does not know and cannot know due to the limitations of its methodology.

Notes

23. Thomas S. Kuhn, The Structure of Scientific Revolutions, The University of Chicago Press, Chicago, second edition, enlarged, 1970, p. 46.

24. Thomas S. Kuhn, The Structure of Scientific Revolutions, p. 24.

25. Edward C.Whitmont, MD, The Alchemy of Healing: Psyche and Soma, North Atlantic Books, Berkeley, California, 1993, p. 39.

26. Richard Grossinger, Planet Medicine (revised edition currently published by North Atlantic Books, Berkeley, California), Shambhala Publications, Inc., Boulder, Colorado, 1980, pp. 23-24.

Copyright 2010 by Larry Malerba. Reprinted by permission of publisher