Anatomy of an Illness as Perceived by the Patient (11 page)

The letters reflected the view that one of the main functions of the doctor is to engage to the fullest the patient's own ability to mobilize the forces of mind and body in turning back disease. There was general agreement in the letters that modern medication is becoming increasingly dangerous and that, to the fullest extent, the careful physician should attempt to educate the patient away from reliance on exotic drugs. The new trend favors an understanding of the powerful recuperative and regenerative forces possessed by the human body under conditions of proper nourishment and reasonable freedom from stress.

Not all the communications came from doctors. One episode involving a layman underlines many of the key points raised by the physicians. A New York lawyer telephoned to say that his four-year-old daughter was in a coma and in critical condition in Lenox Hill Hospital. She was stricken with viral encephalitis, against which antibiotics have no record of success. It was difficult for him to accept the fact that nothing more could be done than was being done. The lawyer wanted to know whether, in the light of my own recovery from a severe collagen disease after taking large doses of ascorbic acid, the same treatment might be useful for his daughter.

I told the lawyer that it would be highly irresponsible for me, a layman like himself, to attempt to give medical advice. Moreover, there was no way of determining what part of my recovery was due to the intravenous infusion of ascorbate and what part to a full mobilization of the salutary emotions, not excluding laughter or a robust will to live. I suggested that the lawyer consult his daughter's physician about the possible use of ascorbic acid.

The lawyer said he feared the child's doctor would be scornful of anything as unsophisticated and over-popularized as vitamin C. I then told him of the large number of medical tracts I had received from doctors, in response to my article, supporting the use of ascorbate in a wide range of disorders beyond the reach of antibiotics or other medication.

In particular, I spoke of the work of Irwin Stone, a biochemist in San Jose, who is among the country's leading authorities on the efficacy of ascorbic acid in the treatment of serious disease. I offered to send the lawyer reprints of articles from medical journals about the work of Stone and others on the functions of ascorbate in body chemistry. What seemed especially impressive to me about these papers was the data on the ability of ascorbate to activate and enhance the body's own healing mechanism. I suggested that the lawyer might wish to review this material with the child's doctor in the event he had not already seen it.

The next day I left for a new round of the Dartmouth conferences in Latvia, U.S.S.R.—fourteen years after the Dartmouth meeting described in the opening chapter. While abroad, I made inquiries at various medical centers and learned that intravenous infusions of ascorbic acid had been effectively used in a number of cases of viral encephalitis.

On my return to New York, I telephoned the lawyer to ask about his daughter. He said he had spoken with Irwin Stone, who told him about recent experiences in which serious cases of viral encephalitis had been reversed through large doses of ascorbate. Armed with this information and with reprints from medical journals I had sent him, the lawyer had spoken to the child's specialist, only to be rebuffed. When he had offered the materials from the professional journals, the doctor had said he didn't need to be instructed by a layman in medical matters.

The lawyer then decided on a plan of action. Several days later he asked the specialist whether the next time his child came out of the coma he might offer her some ice cream. The specialist encouraged the lawyer to do so. The lawyer bought a pound of sodium ascorbate, which is more soluble and less bitter than the ascorbic acid form. He mixed at least 10 grams of the powder into the ice cream, which he put in a thermos jug. He took the jug with him to the hospital, where he stationed himself full time. When his little girl came out of the coma, he asked whether she would like some ice cream. The reply was an enthusiastic yes. He was elated when she gobbled up most of the pint.

The next day the lawyer again gave his daughter a large portion of ice cream, enriched this time with an even stronger dose of sodium ascorbate than before. He continued the process day after day, and each day, the child would be able to spend longer periods of time out of the oxygen tent. The improvement continued steadily in the following days, during which the lawyer gave his daughter an average of 25 grams of sodium ascorbate daily. After two weeks the child was taken out of the oxygen tent altogether.

The lawyer's voice vibrated with excitement over the telephone as he told me of the child's complete recovery and the prospect of having her home again. I asked if he had informed the specialist what he had done.

“Certainly not,” he replied. “Why should I make trouble for myself?”

Obviously, it is poor—and dangerous—policy for any layman to act behind a doctor's back. Yet there may be something about the specialist's attitude that warrants scrutiny. Was there a hardening of the categories that caused him to shut himself off from a serious consideration of alternatives? Was he overreacting to what he regarded as an intrusion? One of the most striking features that emerged from the letters I received from doctors is the evidence of a new respect for the ideas of nonprofessionals. “Nothing is more out of date than the notion that doctors can't learn from their patients,” wrote Dr. Gerald Looney, of the Medical College of the University of Southern California. “People today are far better educated in medical matters than they were only a quarter century ago. The entire field of nutrition, for example, is one in which many patients can hold their own, to say the least, with their doctors. Maybe the new spirit of consumerism has at last reached medicine. I teach my students to listen very carefully to their patients and to concerned and informed laymen. Good medical practice begins with good listening.”

One of the attractive characteristics of ascorbate is that, properly administered,
*
it does no harm even if it may do little good. Under these circumstances, was there any justification for the total refusal of the child's specialist to give serious consideration to the lawyer's request? Is the obligation of the doctor confined only to the patient? What about the legitimate emotional needs of those very close to the patient? The specialist's relationship with the child was limited in chronology and circumstance; the father had a lifetime commitment.

Another example of a problem arising from a doctor's dealings with a relative of a patient concerns the wife of a man dying from cancer in Boston. She telephoned to say her husband had been through the standard treatment—radiation, surgery, and chemotherapy—and she was despairing about the future. She had read that Linus Pauling, the Nobel Prize–winning chemist, had said that vitamin C is a cure for cancer. Her hopes had been raised by this prospect, and she wanted to know if, on the basis of my own experience with a supposedly irreversible illness, I thought ascorbic acid ought to be tried.

As in the case of my conversation with the lawyer, I told the woman that it would be highly improper for me to attempt to give advice. I did, however, call her attention to the fact that Dr. Pauling's conclusions were based largely on the research of Dr. Ewan Cameron, of the Vale of Leven Hospital in Loch Lomondside, Scotland. Dr. Cameron was careful not to claim that ascorbic acid was a cure for cancer. His work indicated that ascorbic acid would
prolong
the survival time of cancer victims but would not
reverse
cancer. His studies involved one hundred patients suffering from advanced malignancies who were given large doses of sodium ascorbate over a period of many weeks. The results were compared with the experiences of a thousand cancer patients of similar condition who were given no ascorbate. The average survival time of the patients in the first group was substantially longer than that of the second group. (It is important to note that “substantially” means a matter of weeks or months, and not years. While Dr. Cameron sees no evidence that ascorbic acid can expunge cancer, he believes that his work is significant in that it clearly indicates that ascorbate has cancer-retardant qualities.)

Cancer cells, Dr. Cameron says, release hyaluronidase, an enzyme that attacks intercellular cement. “Proliferation will continue as long as hyaluronidase is released; proliferation will stop when the release of hyaluronidase stops.” Ascorbic acid, according to Dr. Cameron, strengthens tissue-grounding and therefore counteracts hyaluronidase activity.

Such, at least, was the gist of the material that I offered to send to the woman in Boston whose husband was dying of cancer. I emphasized that ascorbic acid could not be regarded as a proven cure for cancer or other advanced diseases. She asked whether I would be willing to discuss these matters with her husband's doctor. I told her I thought this would be inappropriate but suggested that her doctor might like to talk to my own physician, Dr. William Hitzig, who had provided full support for my decision to discontinue aspirin, butazolidin, colchicine, and sleeping pills—all of which were toxic in varying degrees—and to seek to reverse my condition through a comprehensive regimen, only one part of which was regular intravenous doses of ascorbate.

The woman telephoned two days later to say she had attempted to discuss the possible efficacy of ascorbate for her husband, only to have the doctor cut her short by chanting “quack, quack” and then describing the whole process as “b. s.”

The woman and her husband decided to discontinue the doctor's services, although he had been a longtime family friend. They also decided to leave the hospital and to return home, where the atmosphere made for a less stressful environment and where a local doctor was glad to administer the sodium ascorbate.

Their course of action produced results similar to the findings reported by Dr. Cameron. The husband gained some ground. His appetite improved; so did his will to live. He succumbed to cancer after six months—four or five months later than the original prognosis. Most important, perhaps, was that he was able to spend his remaining time in congenial surroundings in the company of his wife.

Death is not the ultimate tragedy of life. The ultimate tragedy is depersonalization—dying in an alien and sterile area, separated from the spiritual nourishment that comes from being able to reach out to a loving hand, separated from a desire to experience the things that make life worth living, separated from hope.

The trend in modern medicine is to move away from the notion that it is always mandatory to hospitalize seriously ill patients. The great technological advances in electronic equipment, typified by the hospital intensive-care unit, are not without their built-in penalties. A patient in an intensive-care unit is provided with everything diagnostically necessary in an emergency—everything, that is, except the sense of security and ease that the body needs even more than pinpointed and clicking surveillance. It creates a tendency to panic, itself one of the most dangerous multipliers of disease. Many doctors are increasingly aware of the circular paradox of the intensive-care unit. It provides better electronic aids than ever before for dealing with emergencies that are often intensified because they communicate a sense of imminent disaster to the patient. It dramatizes the absence of warm contact between physician and patient.

Dr. Jerome D. Frank, of the Johns Hopkins University School of Medicine, told students at the university's graduating exercises in 1975 that any treatment of an illness that does not also minister to the human spirit is grossly deficient. He cited a 1974 British study showing that the survival rate of patients with heart disease being treated in an intensive-care unit was no higher than the survival rate of similar patients being treated at home. His interpretation was that the emotional strain of being surrounded by emergency electronic gadgets in an atmosphere of crisis offsets any theoretical technological gain.

In that same commencement talk, Dr. Frank referred to a study of 176 cases of cancer that remitted without surgery, X-rays, or chemotherapy. The question raised by these episodes was whether a powerful factor in those remissions may have been the deep belief by the patients that they were going to recover and their equally deep conviction that their doctors also believed they were going to recover.

One of the most succinct statements I have read anywhere bearing on the need of the patient to have faith in the physician was written by Dr. Robert R. Rynearson in the
Journal of Clinical Psychiatry
, June 1978. “Illness,” wrote Dr. Rynearson, “particularly chronic illness, may force the sufferer into a dependent relationship with the person who offers to heal him. If trust does not become an important part of this relationship, it is unlikely that healing will occur. Physicians who ignore the importance of the relationship with the sufferer are often those who possess a simpleminded philosophy about illness—that is, that illness is the enemy which he assaults with all the skill and technology at his command. And, technology being what it is today, the sufferer may succumb to the treatment.

“Physicians need to be in actual touch with patients. Increasing technology in medicine is pushing the physician away from the patient. If the physician allows machinery to be interposed between him and the patient, he will be in danger of forfeiting powerful healing influences. A thorough physical examination fosters trust—there is a laying on of hands and a listening attitude. The sufferer is being touched and understood. The physician is then allowed to collaborate with the patient in altering the delicate balance between illness and health.

“Physicians must resist the idea that technology will some day abolish disease. As long as humans feel threatened and helpless, they will seek the sanctuary that illness provides. The distinguished scientist and humanitarian, Jacob Bronowski, cautioned us in this regard: ‘We have to cure ourselves of the itch for absolute knowledge and power. We have to close the distance between the push-button order and the human act. We have to touch people.'”