Doctors should be healers first

Medical marvels employ new ways of looking inside your head.


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Just as the invention of the flashlight was a quantum leap for doctors who wanted to look in your ear, the new scopes mean we don't have to wait for the autopsy to see what is percolating in your brain in real time.

These expensive gadgets - with challenging abbreviations such as MRI, PET, and CT - are a mixed blessing, though, because it makes it seem like getting well is just a matter of higher technology - which it isn't. What these brain scans can do, however, is measure changes in blood flow to the brain, or how oxygen and glucose are used in brain tissue.

Why would anybody, besides Dr. House's crack team, want to know this? Because research with these new tools demonstrate definitively how the doctors' psychological approach to patients is vitally important to the process of healing. Now we know, for instance, when the doctor conveys diagnostic and treatment information to you in a warm and caring fashion, parts of your brain are "lighting up" (on the scope) like a Christmas tree. Endorphins and other brain-produced chemicals are flowing to help you overcome fear and pain.

Contained in this "placebo effect" (one of my favorite subjects) floats a key element for helping sick people get better. What used to be the nuisance factor in medical research has now become the darling of healing modes of communication. Understanding the placebo effect sharpens our understanding of social and psychological factors for positively promoting the body's own brain chemistry.

Physicians, therapists and regular people who care for an ailing family member can learn from this. A mother's instinctive stroking the brow of her pain-stricken child turns out to be exactly the right soothing to turn on natural anti-pain and anti-fear reducing juices in the amygdala brain. In the same way, patients holding the hand of a loved one, experience real (not just psychological) comfort.

Should it be any surprise that loving concern, warmth and caring bring about measurable improvement both for psychological and physical conditions?

What I used to call "The Doc Woodford Effect" now has verifiability. Doc Woodford was the wise and caring family physician in a small town in upstate New York where I lived and worked for several years. He was professionally low tech, and for years he practiced general medicine without the benefit of the modern medical developments of the past half-century.

What he did have were long-term professional relationships with the layered generations of that town, who respected him and placed their confidence in him. I have always maintained that it was his positive attitude and positive regard for everyone, rather than the "sugar pills" he gave out, which improved people's condition. In retrospect, it was probably the combination of both that did the job.

It is that quality of professional practice that has been lost in much of today's time-limited visit to your physician. The average doctor has gradually become more of a technician than a healer. Is it the health insurance industry or too much reliance on "science" that steals from the essence of "The Doc Woodford Effect" on today's ill patients?

These potential good effects of having the time for communicating warmth and caring attention have seemed to move out of the MD's office and into the offices of psychotherapists.