On the NIH 5 year plan

This weekend I attended a continuing education meeting (CME) for conventional physicians, and while neither Reiki nor energy based healing were discussed, I could not help but reflect that the comnents of some of our speakers were, advertently or inadvertently, supporting the integration of complementary medicine into what we do in "evidence based medicine." The plain fact is, everyone wants access to the best of evidence based medicine when it works, but much of what we utilize every day is extremely expensive and has fairly high side effects.

I also cannot help but reflect upon the ill advised, poorly thought out, and regrettable decision by the NIH to focus research within its next 5 year plan of complementary medicine on pharmaceuticals rather than energy based medicine.

Here is what a highly prestigious speaker quoted to our conventional group of physicians this weekend" "Far too large a section of the treatment of disease is today controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudoscience."

Well - what is shocking is this quote was not from 2010, but rather from a contemporary of Usui Sensei, the quote is from Dr Osler, the founder of the Department of Medicine at Johns Hopkins and one of the father's of Modern Scientific Medicine.

And what does that mean in todays terms? The speaker went on to discuss the over usage of sedatives and antipsychotics in nursing homes today. In terms of sleep, scientific evidence was quoted that a major class of sleeping pills "decrease the time to onset of sleep, prolong the first two stages of sleep and shorten stages 3 and 4 (deep sleep) and REM sleep." (Medical Letter 1999)

Now deep sleep and REM sleep are what really "refresh" us, and the speaker went on to encourage us not to prescribe these medications adding, that for people having sleep induced by sleeping pills the report of daytime fatigue (next day) is "3.8 fold increase" compared to people not given a sleeping pill and continuing to report sleeplessness.

We were informed that in one recent case "the government charged that executives" (or a company which i will not name in the blog) "planned and executed schemes to illegally market (varying medications for pain and sedation). The fine in this case, "$2.3 billion amounts to less than 3 weeks" of the alleged companies sales.

These comments above, which I am reflecting on, are from a highly respected conventional teacher speaking at a very conservative and conventional physician meeting.

Conventional physicians are struggling to be "evidence based" - this is the best way for us to be, it is how we can best assist patients - but in the case of conventional medicine, we need more evidence about what complementary techniques can do and what they cannot do, especially - energy based and spiritual techniques.

The simple fact is that, complementary techniques like Reiki, Acupunture have very low costs and very low side effects.

I had a patient come in last month wishing a prescription for sleeping pills. I quoted the evidence to him, and tried to convince him that a medication was not a best option - it would take far less time to write a prescription! In the end, we agreed i would do a Reiki treatment on him, and not so surprisingly, he fell asleep. Now I have a conventional practice, not a Reiki practice, and except for terminally ill patients who I am treating in hospice, I am not day to day doing Reiki therapy - and so I offer options of colleagues who have Reiki practices.

In hospice we see cancer patients every day. And to make myself perfectly clear, if there is a chance that surgery and chemotherapy and radiation therapy will cure a patient, I am 100% supportive of educating to this option. "Cure" is a wonderful thing. Sadly - we do not yet have a cure for all cancers - and what happens when the conventional treatments are in fact not curative, and the patient is worsening in the face of such treatment? That is the dilemma. Can we "care" (or even as some say "heal") when we cannot cure?

This past week I was treating a patient whose oncologist had given up hope. Nonetheless, she wanted to continue aggressive treatment that would clearly not cure her and might well shorten her life. She came to hospice perhaps to die. We spent some time discussing the options, and she was very focused on what would happen after she died, what would her family do after she died, and in talking with her family we said to her, "please live the time you have. Please focus on the time you can share with your family now. Please don't give up the time you can live now."

She changed her focus - and went home. We do not know for how long. We only believe that each day someone can enjoy and share with loved ones is a precious day.

I can remember very early in my conventional practice, many years ago, having a very tough week. I had two patients with incureable brain tumors. I had long discussions with my neurosurgical colleague who did the biopsies, and he was clear that aggressive treatment would not succeed. In both cases, i had long discussions with the patient and with the family. One patient went to another surgeon, entered a hospital, had aggressive brain surgery and died that week in an intensive care unit. The other patient declined aggressive care, went on a vacation with her husband that they had always wanted to take together, and eventually, months later, died with hospice support and surrounded by her family at home.

It seems to me that a good physician is evidence based, and holistic - and isn't committed to forcing the use of one type of care or treatment. Medications can be lifesaving, i wouldn't want to have pneumonia and not take an antibiotic!

If conventional and complementary approaches can work together, and both be evidence tested, - care can be more sensible, and more holistic.

There was a recent article in the New York Times (10/2/10) quoted by our speaker this weekend, "For decades anitpsychotic drugs were a niche product. Today, they're the top selling class of pharmaceuticals in America, generating annual revenue of about $14.6 billion, and surpassing sales of even blockbusters like heart protecting statins."


The NIH should have had the wisdom to realize, the dollars spent on pharmacologic research is already extremely high, and the five year priority plan should have had the wisdom to be more balanced. More evidence based research on Complementary Medicine, especially energy based, should have been included. Osler. I think, would have understood that.