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Rustum Roy

By Erin Murray,2014-09-30 04:31
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Rustum Roy

    Science and Whole Person Medicine: Enormous Potential in a New Relationship

    Rustum Roy

    Evan Pugh Professor Emeritus and Founding Director, The Pennsylvania State University

    Visiting Professor of Medicine, The University of Arizona

    102 Materials Research Laboratory, University Park, PA 16802

    Abstract

    During the 1990‘s a silent revolution occurred in the most highly industrialized countries including, for example, the U.S. and Europe. This was the utilization and acceptance of various healing practices (which for convenience has often been labeled as ―alternative medicine‖) by an enormous fraction of the population. Moreover, this population cohort is much wealthier and better educated than the average citizen.

    At the same time the phenomenon of the globalization of the economy has become a reality for large numbers. Globalization involves two-way interaction. This globalization is accompanied by broadband interactionsfood,

    language, clothing, travel, education, religionamong world citizens drawn from different traditions. This

    interaction is a major unstoppable force behind the inevitable globalization of healing practices. Obviously as the struggles for power, wealth and recognition proceed, it will no longer be possible for this generation in the Western world to ignore or denigrate the medicine and healing practices used by hundreds of millions in other cultures. Nor will it be easy to assertwhen international data refute itthe superiority of the most expensive western systems,

    especially at the very time when some of these systems are in disarray.

    Table I, taken from Eisenberg‘s data (1998) collected at Harvard over a long period of time, show the incredible utilization of ―alternatives‖ by U.S. citizens. They prove the unavoidability for the (western) science community

    and western policy makers to come to terms with a very different future system of healing in their countries. It is

    inconceivable that choice-loving U.S. (and other western) citizens will reverse the trend in these data, and go back to acceptance of the monopoly of western medicine and its claims as being uniquely ―science-based‖. The opposite is

    almost certainly true, further opposition to legitimated claims, and the personal experience of a hundred million western citizens will ultimately lead to further disenchantment with the dogmatism in mainstream medicine and science, and erode support for both of them. What is obviously needed is a retreat from the innate skeptical reaction of much of the stance of western medicine, the development of a mutual respect for other cultures and their achievements, and a genuinely open, scientific and wholistic approach to the issues, especially in this context, to other practices of healing. Fortunately such changes are already started, especially among the younger physicians and among students in medical colleges.

Major Opportunity for Western Science

    In the following, I will develop the theme that in a kind of unchosen association, the traditional elements of the medical community have biased all of modern science in their own negative

    reaction to a vast range of scientific observations made in the area of medicine and healing.

With the radical change in situation between ―alternative‖ and ―high-tech medicine‖ detailed

    below, the time has come for the chemistry, biology and physics communities to start to look at the data being presented by the alternative or whole person healing researchers with an open mind. Why? In the opinion of a few dozen very senior distinguished colleagues in physics, chemistry and biology, none with the slightest financial or professional vested interest, indeed at considerable risk to their reputations, there are two major reasons for this new look. First, of course, it is inadmissible science to reject new results or concepts without examining the data. But the obverse is the most compelling reason why scientists should pay close attention. This area, roughly included in the phrase the science of living-living and living-non-living matter interactions, appears to those senior scientists who have studied the literature, to contain the seeds of the next real breakthrough in science. These are not idle armchair speculations, but swarms of separate data, obtained completely independently, in all parts of the world. This could be the sign of a revolutionary discovery of the kind that quantum mechanics was.

    There is also a much more mundane or crass reason for showing interest. The funding for this field is certain to skyrocket within the decade. I recall, for the record, that in a similar situation in 1981-82 science education of the non-scientists including K-12 was held in such low esteem that the science community let its budget be cut to zero without a murmur. It was the public, through

    their Congressional representatives, that lifted one research agency‘s (NSF) science education

    budget to approach the billion dollar level. Hence imaginative scientists could enter what is sure to become a well-funded field, and a one with revolutionary science potential.

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The “unscientific” stance of some in western science

    Since Western medicine has changed its approach and its practice from a wholistic family physician style, (relying on science and the ‗art‘ of personal knowledge and interaction) to its reductionist, impersonal reliance on ―conventional science,‖ we start by examining the status of this parent, science.

    The cultural change in the status of science after WW II was rapid and powerful. The aftermath of the atom bomb and distortion of the reason for the U.S. success in acquiring it started it. And the post-war emergence of technological prowess as chief driver for the U.S. economic hegemony gave birth to the ―linear‖ model of science policy: science applied science

    technology prosperity. This erroneous theory shaped 3 decades of United States policy. Yet it was only the decisive and unanimous actions by U.S. and world industry to shut down 100% of

    their untargeted basic research and still prosper, which was able to write ‗finis‘ to this ahistorical concept. The connections between science and useful value are much more chaotic, and expert opinion by historians strongly favor exactly the opposite view: that science is mostly applied technology. But that policy error shaped the ―weltanschauung‖ of the science generation now in

    powerand even more so of the non-science trained leaders in politics, journalism, the social sciences, etc. Their misguided cultural view was defined for them by the society in which they grew up. In a similar context Robert Bartley, Editor of the Wall Street Journal, recently quoted Walter Lippmann‘s Public Opinion (Lippmann 1922) thus:

    “For the most part we do not first see, and then define, we define first and then see.

     In the great blooming, buzzing confusion of the outer world we pick out what our

     culture has already defined for us, and we tend to perceive that which we have

     picked out in the form stereotyped for us by our culture.”

Worse was to come. In the post World War II era, the world‘s dominant western culture vaguely

    defined this also newly crowned progenitor of prosperity, ―science,‖ as the only road to truth.

    No scientists, and few others, objected. This stereotype and egregious error has been the source of many problems in Western societies, and remains a major barrier to a true globalization of knowledge.

    During the post WW II half century, exactly the period during which this author has been very active as a physical chemist-materials scientist in world science circles, there has occurred a notable transmutation in the scientific establishment and its practice of ―science‖. From being the champion of discovery and innovation and newness, science as practiced today has become the main religious establishment of the West. I have developed this thesis in detail elsewhere (Roy 1981, Roy 1995). From a deep curiosity about new facts, establishment science has become a ―defender of the faith‖, a conserver of today’s theories. No one denies that that is the purpose

    of one key element of the system: peer-review. This key procedure can only check new results

    by the single test of conformity to the true faith, i.e. current theory. Indeed peer-review is most accurately characterized as the paradigm-police.

In its alleged other task to keep out ―bad‖ science, peer-review has failed dismally, since all the

    major so-called ―pathological science‖ events (poly-water, cold fusion, etc.) were entirely the

    product of peer-reviewed journals. On the other hand, the obverse of the system‘s attempt at keeping out bad science, has succeeded beyond measure. Dozens of the greatest advances by Nobel laureates and others had been initially rejected by the peer-review system. Defenders of the science establishment, by their amazing total silence on these two charges, have obviously

    entered a plea of ―nolo contendere‖.

    Reclaiming the true heritage of science: Innovative, iconoclastic, fact-based

    Dogma (theories dressed up with power) ill befits science. Rightly have scientists held up Galileo Galilei‘s challenge to dogma with facts, as the quintessence of our trade. The cardinals

    who refused to look into the telescope because dogma had it that the moon‘s surface had to be perfect are, appropriately, scorned as unscientific. But that behavior is now most commonplace in only two communities: the rightwing religious fundamentalists and the conventional science-establishment.

    Let me be very clear that this opinion is not some idiosyncratic view of one insider. It is widely shared by vast numbers of scientists and engineers throughout industry. Moreover it is hardly an

    invention or discovery of the author. The most thoughtful authorities in the philosophy of

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    science spotted this trend just as it was starting, immediately after WW II. Here is what Alfred North Whitehead, a towering figure of philosophy and mathematics wrote (1948):

    “The universe is vast. Nothing is more curious than the self-satisfied dogmatism with

    which mankind at each period of its history cherishes the delusion of the finality of its

    existing modes of knowledge. Sceptics and believers are all alike. At this moment

    scientists and sceptics are the leading dogmatists. Advance in detail is admitted:

    fundamental novelty is barred. This dogmatic common sense is the death of

    philosophical adventure. The Universe is vast.”

    No more precise description of the real world of the science establishment, as I and leading materials scientists encounter it daily, could be penned than: “…Advance in detail is admitted;

    fundamental novelty is barred.” Peer review is the process which enforces this status.

    But let us retrace our steps further: fifty years earlier, another pre-eminent philosopher of culture, William James, commented along the same lines as follows:

    “If there is anything [that] human history demonstrates, it is the extreme slowness with

    which the academic and critical mind acknowledges facts to exist [that] present

    themselves as wild facts, with no staff or pigeon-hole, or as facts [that] threaten to break

    up the accepted system.”

    But the bedrock of science, alike in China, and the west, was laid some 2500 years ago. And both Aristotle and Lao-tze emphasize the essential precondition for good science in the absolute adherence to the primacy of facts not of theories about the facts.

     “A good scientist has freed himself of concepts and keeps his mind open to what is.”

    (Lao-tze in Tao te Ching, s.27, Stephen Mitchell translation)

    “Nor again must we in all matters alike demand an explanation of the reason why things

    are what they are; in some cases it is enough if the fact that they are so is satisfactorily

    established. This is the case with first principles; and the fact is the primary thingit is

    a first principle. And principles are studiessome by induction, others by perception, d; so we must endeavor to others by some form of habituation, and also others otherwise

    arrive at the principles of each kind in their natural manner, and must also be careful to

    define them correctly. (Aristotle in Nicomachean Ethics), I . (vii) 17-22

    Quite apart from the field of medicine I can attest, from a 50-year career, to the virtually unbelievable state (reviewing papers, proposals, providing public funds) of the modern science establishment in the area of my current very active research in materials science. Examples can be drawn from even the last two or three years during which period I have been involved in two

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    major materials processing discoveries in materials science. One is in the use of microwave radiation, and the other utilizing simultaneous, multiple frequency pulsed lasers, both for processing ceramics, semi-conductors, and metals. Our experience has been described exactly by Whitehead. ―Advance in detail is permitted fundamental novelty is banned.” I describe them

    for emphasis on the gradual changing of ―science‖ into an institution guarding its established

    sacred dogmas.

    In both technical discoveries, one by us and one by a small company in Detroit, after the publication in the leading journals, after issuing of several U.S. and world patents, the ―establishment‖ through its arcane review processes has turned down 100% of a dozen proposals for public research support over three years. These decisions backed by the agency heads, set an imprimatur on disbelief, uniformly expressed in reviews: ―it can‘t be true, it doesn‘t fit our

    theory.‖ What , the reader may well ask, is the evidence for the recognition that these discoveries are indeedtrue and fundamentally novel. In both discoveries a dozen separate

    major industrial research laboratories, from all over the world, have sought out the inventors, made repeated visits, and funded research to the tune of hundreds of thousands of dollars, and paid literally millions of dollars for the license to the patents. (Mistry 1996, Mathis 1995, Fang 1996). Lately because such responsible individuals‘ judgements, backed by corporate funds have become known the science establishments (after (5 years) have slowly started to accept the

    reality of these discoveries.

    I have provided this current example to justify my generalizations of the critique of establishment science from others far beyond the world of medicine. In case after case, the reviewers or critics in exact analogy with Galileo‘s bishops and cardinals, simply refuse ―to look down the telescope‖ because the claims of these fundamental novelties are not explainable by their ―self-satisfied dogmatism.‖ If science is to regain its position we must all agree to abide by the canons explicitly laid out by sages from Aristotle to Walter Lippmannthe facts are the first

    principles of science.

Western medicine in an historical and global context

    Every human culture developed its own system to respond to disease, pain and death. Of these perhaps Ayurveda of India with its different yogas, is the most ancient and highly-developed

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version. In China the ―Qi-gong for healing,‖ and ―Qi-gong for society‖ (exercise, martial arts,

    etc.) is perhaps an analogy. Each of these large systems has a specialized brand of herbal medicines, exercise and spiritual components. In the theory behind each there is an absolute integration of body, mind and spirit. In the place of death in life there is also a very different element compared to Western medicine.

    th century, western medicine was the Judeo-Christian cultural parallel to Till the dawn of the 20

    these systemsalbeit less than a few hundred years old. The enormous difference was that this single model was the medical system of the militarily and economically dominant (for the last 500 years) culture and it naturally assumed it too was ―superior‖ to the medical systems of other

    cultures.

    In fact it was the ―alternatives‖ within western medicine which have proved to be its most effective contribution to health. Prevention as the key to improved health is without any question still the greatest contribution of the West to global health. From Pasteur and vaccination, to Lister in Glasgow (rejected by the high-tech medical community of his day) with his carbolic acid and washing, to the engineering technologies for providing pure water and air, and refrigeration to preserve food, the impact of western medicine has indeed been profound. The emergence of some very effective pharmaceutical agents from aspirin and quinine to

    penicillin to the myriad of specialized drugs and of the truly miraculous engineering of

    diagnostic tools and surgical procedures has been the magnet which has captured the minds and wallets of the west. Much of this western medicineup to WW IIwas embedded in the

    Judeo-Christian body-mind-spirit, person-centered worldview of life and death, In addition, a tradition of selfless service on the part of the doctors and nurses was a key element in the system.

    Today, 50 years later what is called contemporary western medicine has changed its character dramatically:

    a. It has attached its rationale and philosophy to the western ―enlightenment‖ view and

    specifically to the classical physical sciences.

    b. Following that model, it is radically more reductionist, treating the body alone (or, in

    part, the mind alone)

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    c. It has made death which is absolute and inevitablean enemy, thereby sealing its

    long term limited relevance.

    d. It has relied increasingly on the skills of others: chemists and physicists and engineers,

    in creating vast stores of new pills and diagnosis and treatment technologies making

    the accurate transmission of such knowledge to the patient through one or two (or

    more) intermediaries increasingly difficult and uncertain.

    e. The healer-patient personally-knowledgeable relationship (of the kind found in the

    country or family doctor) has all but vanished.

    f. The service orientation of the profession has been dramatically weakened as in many

    other sectors of society, in favor of a monetized value system, and here with possibly

    more fundamental consequences.

    g. The disarray of the entire healthcare system is not a topic here except in so far as it

    impacts items (d) and (e) above, but obviously affects all points.

    Yet the spectacular and much publicized successes of western medicine deserve to be given special attention because of many of the results achieved and its efficacy across many cultures. The world‘s suddenly increased fascination with, and allegiance to western scientific medicine was triggered in a way by the discovery of the original antibiotics like penicillin with its near miraculous, utterly reliable effects in so many cases. In the succeeding five decades there has been an explosion of public and private interest and huge, lopsided investments in the further development of this western ―scientific‖ approach. This approach quite incidentally and

    unconsciously made an unremarked break from healing systems of all other cultures. Western ―scientific‖ medicine taking its cue from the adjective ―scientific,‖ opted for a reductionist approach to healing. Present science is quintessentially reductionist. Healing was reduced to ― curing‖; all disease was the common adversary; medicine became the means to cure; death the absolutely common part of life became the enemy. Most importantly the whole personbody,

    mind and spiritto be healed was reduced to the body only.

    Medicine sought therefore to relieve pain, cure (and to a lesser extent prevent) disease. The ―medicine‖ which has received the most attention has been a succession of drugs. This approach with its roots in every ancient civilization and their use of various plants (and inorganic

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    substances) and its early brilliant successes such as quinine, aspirin and salvarsan, moved after penicillin‘s discovery into high gear with the tools of modern organic chemistry which were,

    literally, growing explosively after WW II. The antibiotics were a special subset which chemists loved and which deservedly earned the appellation ―miracle drugs.‖ Not only in the effort to synthesize both naturally occurring winners, but also with totally new synthetic drugs, a solid track record of success however cost ineffective - was built. Yet as in any mature field of technologyand from a research viewpoint pharmacological medical research is a very, very mature field it is now vastly overgrazed by hordes of scientists. The opportunities are limited because they are formed by the same human needs present since the dawn of history and addressed by very well-funded chemists and biochemists for 40+ years; i.e., there are no major new problems and the old ones have been addressed by very clever people. AIDS was a lucky godsend for researchers a major new disease. Innovation and research productivity per dollar in medical research is clearly on a very flat plateau.

    It is not relevant here to discuss the nature of the motivating factors and the resulting constraints, in the enormous research effort poured into this field. The private pharmaceutical companies of course are motivated by their normal profit needs. But here the special, if not unique, nature of the case of medicine as an industrial product plays a role. If a particular pill did some good, there is no industrial vector to push for finding the efficient or minimum use of the pills. If a

    little is good, should more be better? The ―market forces,‖ focused on maximizing profits,

    obviously cannot ever produce optimum medicineand thereby hangs a major system weakness.

    Market forces ineluctably push for maximizing use: health never requires that either in number

    1 or time.

    Hence, the advance of modern pharmaceuticals by the private or public-private combination sectors has resulted in an ambivalent result within the very complex system of patient-doctor-third party payershospitalslawyersinsurance companiesFederal and State

    Governmentsuniversity medical researchers media, and free enterprise rhetoric, which

     1 On May 30, 2002, ABC Television and Peter Jennings presented a one-hour special titled, ―Bitter Pills,‖ the first

    exposè of the major practices of the pharmaceutical industry. It is clearly the opening salvo in a long-overdue action against the industry.

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constitute the western healing system. On the one hand there has been an outpouringalbeit

    hardly claimed to be cost-effectiveof new drugs, a few of them very significant. Likewise by

    linking surgeons to the advances of modern electrical engineering, physics and chemistry there has been a truly phenomenal advance in diagnostic capabilities of all kinds from routine ppb chemical analyses to fMRI and CAT scans. Yet, overuse of these invaluable tools also, not only increases costs dramatically, it also underestimates the power of the personal, detailed intake interview, and use of ―hands-on,‖ diagnostic procedures. Hippocrates‘ dictum: ―It is more

    important to know the person who has the disease, than to know the disease the person has‖ is ignored by high-tech, low-talk, and low-touch medicine. A remarkable datum is the pharmaceutical companies switch of such a large fraction of their drug synthesis work to major searches for new medicine by using the ancient empirical scientific data base of finding the most

    effective plants, accumulated over some millennia by native healers all over the world.

    Surgery is not, strictly speaking, a part of medicine. Surgeons are descended from a different, lower social status, guild. Modern surgery draws heavily on modern materials, and electrical and mechanical engineering for its many miracles. At the leading edges of the field the overall achievements of contemporary surgery are very significant, but because of costs, hard to get to most patients. In the case of medicine in general, such advances are also mainly incremental improvements on existing technology.

    For all major sudden hurt or insults to the human system (accident, trauma, or massive infections), modern surgery accompanied by modern medicine has produced a truly remarkable responsive life-saving and extending system. For chronic or systemic or slower-developing insults or disorders, and especially for end-of-life situations, this same modus operandi of ―scientific medicine‖ has proved to be much less successful and some would say, now forms part of the problem.

The track-record of “scientific medicine” in the U.S.

    In the following I will examine the record from the viewpoint of various outcomes. i. International comparisons

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