Where Is The Love?
Photo credit: Painting by Peter Triantos (http://petertriantos.com/)
“Love is the magic bullet of healing”, according to the later founder of my chiropractic alma mater Dr. James W. Parker. (1)
In fact, he spoke often of his “love concept” in health and healing during his weekly mandatory assemblies to both staff and students. As twenty-somethings, we would for the most part, snicker at this commentary. The cantankerous nature of his delivery, his slipping faculties -further hid the wisdom of his teachings from the ignorance of our youth.
Besides, we were up to our proverbial eyeballs in anatomy, microbiology, biochemistry, pathology and the like. Who had time to discuss the merits of Dr. Parker’s “loving service” and “healing intention” ramblings?
Neither professors, nor state board examiners were ever to ask us about these.
I was right, they never did.
So, how relevant is ‘love’ in healthcare delivery?
This morning, I read a lovely article, written by Nirmala Ranga on the Chopra Center website titled, “Love Is the Key to Healing”. (2)
The title asserts, much like Dr. Parker did that “love is the key to healing”. But, is it?
Is it even relevant in today’s modern, uber-scientific, healthcare industry?
Does it matter if your healthcare provider has healing intention?
Does love improve health outcomes in cancer patients, or in back pain patients, or in cases of colds and flu? Does it impact health outcomes?
Let’s try to break this down.
I think it’s reasonable to assert that the ultimate goal in healthcare... is to improve health.
Health defined as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. (3)
While healing, is the process of restoring health, of becoming well again.
Here’s where it gets very interesting.
I decided to search MEDLINE (an electronic online database containing more than 30 million health and biomedical science articles) using a MeSH (Medical Subject Headings) search for the term “healing” and found...wait for it...nothing.
A further search of “Love and Healing”, in that same 30 million plus database found 6 measly, and debatably relevant articles.
How is this possible? I thought.
“Medicine is traditionally considered a healing profession, but it has neither an operational definition of healing nor an explanation of its mechanisms,” author Thomas Egnew writes in the Annals of Family Medicine. He goes on to further state, “that medicine has no accepted definition of holistic healing is a curiosity. If healing is a core function of medicine, then exploration of its symbolic meaning compels organized research of healing phenomena, and an operational definition of healing in a holistic sense is warranted.” (4)
So, think about this for a second.
In terms of the scientific landscape of healthcare, healing isn’t even on the radar.
So where does that leave love?
This is where the discussion becomes even more complicated. Partially, because the word “love”, in English, is according to Alexander Moseley in the Internet Encyclopedia of Philosophy, “broadly defined and hence imprecise, which generates first order problems of definition and meaning.” (5)
Moseley goes on to argue that some of the challenges with defining love, may be partially resolved by applying more nuanced definitions of the various types of love, as described by philosophers of ancient Greece.
The Greeks in fact described eight different types of love, the most referenced of which include: eros (erotic love), philia (love without physical attraction i.e., the deep, platonic love shared between friends), and agape (unconditional love i.e., the love for one’s children).
So what would the delivery of love in terms of healthcare, look like?
Entering my 21st year in practice, here’s my best take.
I suppose the theoretical ideal would be to provide care completely selflessly, altruistically and unconditionally -the agape love.
While unrealistic as a continuous course, I do believe that opportunities of true selflessness do exist, which can be transcendent for both the patient and the doctor.
More realistically, I think that love is delivered by first appreciating the patient, their values and their beliefs (consistent with the evidence-based medicine triad of healthcare decision making).
An authentic relationship is then cultivated, through a spirit of equality (phila or brotherly love). Caring and empathy naturally emerges through this egalitarian bond of mutual respect and understanding.
Like all winning relationships, this is a bilateral exercise. Patients that view this relationship as a vendor-consumer relationship (i.e., doctor gives, patient takes) are robbed of its intrinsic intimacy and potential value.
The question is, can this type of loving service be measured? Is it reproducible?
I believe it is.
Imagine a checklist for doctors and clinics as follows:
Are we grateful for this patient? Yes or no?
Do we acknowledge and appreciate this patient? Yes or no?
Do we understand what it is that they value? Yes or no?
Have we made an attempt to incorporate their values and beliefs into their treatment? Yes or no?
Have we attempted to understand this patient’s pain or suffering? Yes or no?
Have we attempted to communicate clearly and authentically with this patient? Yes or no?
Do we fundamentally view this patient as an equal in this relationship? Yes or no?
I might even argue that if a checklist like this was coupled to a well-controlled study, the outcome of love could be measured.
As the chronic disease crises continues to loom large in the primary care landscape, the need to rethink the nature of the doctor-patient relationship is in order.
Can healing occur in the context of a robotic and emotionally disconnected environment? Probably.
Was Dr. Parker right in asserting that “love was the magic bullet of healing?”
Twenty-one years in practice, I’m not actually sure if he was right, but I’m almost positive, he wasn’t wrong.
To quote The BlackEyed Peas, “Where is the Love?” Hopefully, it's closer than we think:)