samedi 29 septembre 2012

AN ARGUMENT FOR JEWISH DOCTORS WITH BUDDHIST TENDENCIES, FOR BETTER HEALTH CARE


A JEWISH DOCTOR INCLINED TOWARDS BUDDHISM WITH ANTHROPOLOGICAL TRAINING MAY BE YOUR BEST BET IN HEALTH CARE


The four noble truths contain the essence of the Buddha's teachings. It was these four principles that the Buddha came to understand during his meditation under the Bodhi tree.
• The truth of suffering (Dukkha)
• The truth of the origin of suffering (Samudāya)
• The truth of the cessation of suffering (Nirodha)
• The truth of the path to the cessation of suffering (Magga)
The Buddha is often compared to a physician. In the first two noble truths he diagnosed the problem (suffering) and identified its cause. The third Noble Truth is the realization that there is a cure.
The fourth noble truth, in which the Buddha set out the Eightfold Path, is the prescription, the way to achieve a release from suffering.


Cecil Helman, an anthropologist, suggested that a patient with a problem comes to the doctor seeking answers to six questions:
1) What has happened happened? This includes organizing the symptoms and signs into a recognizable pattern, and giving it a name or identity.
2) Why has it happened? This explains the aetiology or cause of the condition.
3) Why has it happened to me? This tries to relate the illness to aspects of the patient, such as behaviour, diet, body-build, personality or heredity.
4) Why now? This concern the timing of the illness and its mode of onset (sudden or slow)
5) What would happen to me if nothing were done about it? This considers its likely course, outcome, prognosis and dangers.
6) What are its likely effects on other people (family, friends, employers, and workmates) if nothing were done about it? This includes loss of income or of employment, or a strain on family relationships.
7) What should I do about it – or to whom should I turn for further help? Strategies for treating the condition, including self-medication, consultation with friends or family, or going to see a doctor.


A prominent UCL GP Professor had written: about Cecil Helman
He stimulated me to ask those frequently important questions such as ‘what do you think is wrong with you?’ ‘Why do you think it happened?’ ‘What caused the illness?’ and ‘what do you think will help you to get better?’ etc.  It was his ground-breaking book, ‘Culture, health and illness’, which opened the eyes of many practitioners like me to the richness of a patient’s experience, concepts of illness and relationships with health professionals, when so much of the trajectory of modern medicine leads us towards ever greater specialisation, fragmentation and the molecularisation of healthcare.  Cecil’s perspective was a counterbalance to the domination of medicine by the physical and biological sciences and helped many health professionals to make sense of their day-to-day interactions with patients.

In contrast, look at the so called Scientific approach to the Western Disease Care model which the Asians are eager to copy
Subjective
Tell me what is wrong with you?
Also don't take too long telling me, don't tell me anything not related to why you came to see me
Preferably in a language I can understand
In a study it was found that American Doctors interrupt a patient just after 13 seconds. For the first of many times.
Objective
Let me find out what is wrong by examining you. More and more of the physicians are relegating this responsibility to others and the machine and “blood tests”
Assessment
This is what I think is wrong with you.
I want the machines and laboratory to help me be sure.
Plan
This is what I think you should do.
And then the advice is: Exercise More and Eat Less

Everything is self-cantered on the Doctor with very little input from the patient. Most of the pronouncements are quantitative and nothing qualitative, nothing about the suffering of the patient.
As you can see, it is as if the patient has left his personality mind and thinking when he changes into the hospital gown and just becomes a body over which man and machine would contemplate on a diagnosis, not a good contemplation since most of the chronic diseases are poorly taken care of in the richer countries, not to mention the copy cat Asian countries’ Doctors.
Even the American Diabetes Association admits that the majority of its members are not capable of giving good advice regarding nutritional management for their patients.

So you decide, who would you rather have, if you are unfortunate to have a chronic condition?
A western oriented doctor, European or Asian, who spends his allotted time with you and orders tests and prescribes medications for you
(In America, they would advertise Board Certified, which has no meaning whatsoever regarding the quality of the doctor, all who take the Board Examination pass it)
(also beware of doctors and more and more other auxiliary professionals who now sport many initials after their name, Beware, I say, they are trying to hide something! It is incongruous and out of order to put MBA after your name, a degree that is highly suspect if you are a health care provider)
Or
A Jewish doctor who is inclined to Buddhist values, with training in Anthropology who asks about your family before he begins to questions you on your symptoms?