Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Tuesday, October 09, 2007

On Healing

I've been thinking a lot lately about words and how people use them; specifically about how we speak of what we do in medicine. I find myself wanting to articulate why I reject the term "Healer." Here is the essence:

"Healing" is neither a transitive verb nor a noun*.

My first clinical rotation of the third year of medical school was Surgery. One of the things we dutifully learned was things that interfere with wound healing: infection, foreign bodies, poor blood supply, and so on. It turns out that the best we could do was avoid those things to the greatest extent possible so the wound would heal. What that means is that there is a natural, maximum speed for wound healing that we can't increase, although there are plenty of things we can do to slow it down. Our job is to make sure conditions are optimal, and then wait.

Certainly there are occasions when things go seriously wrong with the body (and the soul.) Injuries; tumors; abuse; they happen, and frequently require skilled care in order for the body's innate healing mechanisms to fully do their thing. I believe that abuse, be it sexual, physical or emotional -- especially in childhood -- can cause cancer of the soul that, like cancer of the body, sometimes needs some pretty heavy duty "psychic surgery" to allow real healing to occur. Even though the surgeon or oncologist or psychotherapist has to take an active role in treatment (often inflicting significant suffering, knowing (hoping?) that greater health and wholeness will be the ultimate result) the intervention is not the "healing."

Disease can be treated; cared for; medicated; cured. Suffering can be eased; soothed; ministered to. Not "healed."

People don't heal other people, whether they are doctors, nurses, skilled psychotherapists, or even mothers. We can't make people heal; we can only let them heal. Wounds heal themselves. Healing and wholeness are the natural state of living things, and bodies strive for them at the cellular level. Like our heartbeat, breathing, digestion, gestation, growth and all those other wonderful functions our bodies take care of for us (that can go wrong but usually proceed apace quite nicely, thank you very much) healing happens.

*[Edit thanks to Lynn Price, my fellow word whore.]


At Wed Oct 10, 01:45:00 AM, Blogger jmb said...

This is a great post Dino.
However creating optimum conditions for the body to do its work takes a great deal of knowledge and skill. Also knowing when and what drugs to prescribe to aid the process or prop up the body's failure is vital.
Somehow the word healer has a negative connotation for me, associated with quackery or similar.

At Wed Oct 10, 04:30:00 AM, Blogger Randall Sexton said...

Healing is a journey, not an intervention. It's often about vision and spirit and it requires looking through the wrong end of the microscope. Healing transforms your life, and often, but not always, result in a cure.

At Wed Oct 10, 09:40:00 AM, Blogger rlbates said...

Nice post. We often (sometimes) said in residency (and stil) that the patient got better in spite of our care.

You are so right when you say we have to try to "optimize" conditions and remove the obstacles, so that THE patient can heal.

At Wed Oct 10, 09:46:00 AM, Anonymous Anonymous said...

Great post, Dr. Dino!

At Wed Oct 10, 10:17:00 AM, Anonymous Anonymous said...

When I saw your title, I said to myself "Now there's a word that's misused."

Strange timing because I've been thinking about writing a post on this very same topic. It amazes folks that there's no pill that will make that bone knit faster, no ointment that will make the skin close quicker, and no words that you can say that will assuage someone's pain. All you can do is optimize conditions and then wait.

It all happens inside regardless of whether it's a broken bone or a broken spirit. All you can do is set the pieces right so hopefully they grow the way they're supposed to as time marches on.

It isn't strange to me that we haven't figured out how to do more. I don't suspect we ever will.

At Wed Oct 10, 10:21:00 AM, Blogger Fran said...

Great post!


At Wed Oct 10, 12:58:00 PM, Blogger Lynn Price said...

As a word whore, I appreciate that "healing" isn't a transitive verb. And it's doubly interesting to see all the docs who agree with you. As a patient, I'm all too likely to bless my doc because, without their help, that healing more than likely wouldn't have taken place. So, in the long run, I'm very happy to say that my doc healed me. Odd coming from an integrative care practitioner, eh?

At Wed Oct 10, 09:47:00 PM, Anonymous Anonymous said...

"Healing Happens"
Bumper sticker?
Slogan for new bandage?
Slogan for hospital?
Slogan for practice?

Imagine deep voice:
...Dinosaur Family Medicine...where Healing Happens"

Sorry. couldn't help it - been working too hard today:-)

(p.s. I can do a logo!)

At Thu Oct 11, 11:29:00 AM, Anonymous Anonymous said...

Great post. If only more people understood this simple truth.


At Thu Oct 11, 05:40:00 PM, Blogger Dreaming again said...

Thank you. From the bottom of my heart.

Today, I've been feeling out of sorts ...physically and emotionally. My autoimmune system has declared all out war on my body. (shouldn't there be a way to reboot the body to let the immune system know we are on the SAME SIDE???) Oh! that's what those drugs are for ...they ain't workin ... ok, they are ... I'm alive ...if this was 50 years ago, I'd not be.

Emotionally, my Therapy team, is putting back together, doing as you say, the psychiatric surgery, to heal the wounds from the past ...

add these two together ... and it feels like there is chaos amuck.

I needed to hear this. "Healing and wholeness are the natural state of living things, and bodies strive for them at the cellular level."

It's ok ... the war is on ... the battle may be waging, but it's goal is to win the war.

ok, enough rambling.

At Thu Oct 11, 06:23:00 PM, Anonymous Anonymous said...

Dear Dr. Dinosaur:

Oddly enough, Merriam-Webster's dictionary claims "heal" to be a transitive verb. And isn't the English version of "Die Zeit heilt alle Wunden" simply "time heals all wounds", a clearly transitive usage?

Apologies for picking nits --

At Thu Oct 11, 06:51:00 PM, Blogger #1 Dinosaur said...

Felix: Interesting example of the "transitivity" of the verb "heal" in the context of my discussion.

I shall accept that nit only on the condition that it be agreed that time, indeed, is the only thing that truly "heals" anything.

At Sun Oct 21, 08:53:00 PM, Blogger The Tundra PA said...

Such well-written words, Dr. D, and so very true. As patients and as providers of care we can only open the way for healing to happen. I so enjoy your writing, and your voice. It makes a difference.

At Mon Oct 29, 11:19:00 AM, Anonymous Anonymous said...

A close relative suffers from depression. Healing may be a lifetime experience, which is a terrible burden. What's really important about your post is including how the circumstances in life can introduce illnesses that require much more than the accumulation of hard data. Personally, I think the human part of medicine is more important than the mechanical part. Humans are hardy and resiliant until they lose the hope to heal.

At Thu Nov 29, 12:27:00 PM, Blogger Chris said...

So well written. I've learned well that my patients mostly need me to get out of the way and let them heal. Be well, Chris


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