What a funny and complex question to think about. On a personal level my body remains a mystery. I am often surprised and sometimes confounded by my own biology. I created an art project once where I broke my body down into its various parts, drew pictures of each part--my foot, my leg, my ear, my nose, my belly, etc.-- and told the stories that belonged to each part. So many stories our bodies have to tell! The line between biology, culture, personal history, and societal beliefs begins to blur.
We have, as a human culture, many understandings of our biological selves and perhaps no understanding at all. As a graduate student in medical anthropology this very question was the leading question in all research related to the field. The answer to the question depends on who you talk to: a woman with "heart trouble" in Iran and a cardiologist in the United States will have very different explanations and treatment ideas for her symptoms. Arthur Kleinman, a medical anthropologist who wrote a groundbreaking book in 1980 called "Patients and Healers in the Context of Culture," provided the term "Explanatory Models" or EMs to describe this phenomenon. For Kleinman, it is vital to always ask a patient "what do you think is the cause of this problem?" And this question will lead to a greater understanding, for both patient and physician, of how to treat someone's symptoms, and of what the cause of the symptoms really is--especially when working with someone who comes from a different belief system.
In the West we might be led to believe that allopathic medicine possesses the REAL understanding of our biological selves. That the close scientific investigation of the body provides the correct answers. Yet really, surprisingly, through study of things like the placebo effect, alternative forms of healing, and turning an anthropological eye on Western medicine itself, we discover that this isn't exactly the case.
Cecil Helman, an anthropologist at the University of London, studied, among other things, culture and pharmacology. Helman writes: "In many cases, the effect of medication on human physiology and emotional state does not depend solely on its pharmacological properties. A number of other factors, such as personality, social or cultural backgrounds, can either enhance or reduce ths effect, and are responsible for the wide variability in people's response to medication." That statement is rather shocking for someone coming from a Western biomedical perspective. How can this be?
Helman reports that in study after study placebos have been shown to effectively "cure" practically any organ system in the body. He states:
"It is therefore the *belief* of those receiving (and/or administering) a placebo substance or procedure in the *efficacy* of that placebo which can have both psychological and physiological effects."
An important point here lies in the parenthetical phrase "and/or administering" -- it doesn't even have to be the patient that has the strong belief -- it can be only the physician's belief that impacts the efficacy of a treatment! A study was done on five treatments (specifically, in this case, five different drugs) for angina pectoris "all of which are now believed to have no specific physiologic efficacy, yet at one time all were found to be effective and were used extensively." How can it be true that at one time a drug cured on a number of people of angina pectoris and now the drug doesn't work? The only difference found between the time the drug worked and the time it did not is the collective belief of the physicians!
It is this study that comes to mind when people try to defend acupuncture as truly effective because it seems to work on non-human animals. What they are trying to say is that the effectiveness of acupuncture can not only be in the mind of patient because it works in animals who have no belief in acupuncture. What is missing here is the impact of the belief of the acupuncturist on the outcome.
Another case where this is true -- the impact of belief of a practioner on the biology of another being -- is with the effectiveness of prayer. Dr. Larry Dossey is a physician who reports on the effectiveness of prayer to heal in his book "Prayer is Good Medicine." Again, there are many scientific studies that validate his assertion.
In light of all these studies, a straightforward understanding of the physical parts of the human body (and the effect of chemical substances on the body to treat sickness) begins to hold a little less weight in offering a true understanding of biology. We are not machines. Nothing can be explained in simple biological terms...unless maybe that is your belief system.
The short way to answer this question then, do we really understand our biological selves, is no. What a fantasic mystery we are!
There is perhaps another way to speak about our "biology" our "life" that includes more than just looking at our internal organs...
2. Impressions on the links on evolution:
There's a lot of information in those links! I guess I never knew that the topic of evolution could span so far and wide. I looked into "Deep Time" which really provides some perspective on our own little lives. It's amazing to me that life as we know it took so long to evolve, and that we are capable of destroying a lot of it in the blink of an eye. I also looked at PBS's mate selection quiz which made me wonder if my lips were puffy enough and my chin small enough...never thought a site on evolution could make me feel so evolutionarily inadequate! And finally, I tend to believe that life forms can sort of "will into being" certain traits. Even with all that time for change involved, it still seems a little too weird that moths could develop spots that look like owl eyes. My world view would throw some consciousness into the mix there. I still stand by the belief that we are not machines!
1 comment:
I love the section referring to the belief mechanism by both the healer and the treated, highlighting to me the fact that a physician can affect positive change by believing in the treatment at hand.
That could be one reason that traditional western medicine is disappointing many of us these days. Perhaps doctors that have been trained to follow appropriate “modern practices” to treat their ailing patients are becoming disillusioned with the outcome. Perhaps seeing that the best drugs and most powerful medical machines cannot heal their patients, many doctors may have lost faith in the same treatments that they ask us to believe in.
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