This is the transcript of a forum I facilitated with Isabelle Soule, nursing professor at the Oregon Health Science University nursing school. The names of the forum participants have been changed for reasons of confidentiality. The forum was held on June 14, 2013 at the Process Wok Institute in Portland, OR.
Pierre: Let me explain and give you a context for the forum. I taught this afternoon a class which was called: Health-in-Sickness and Sickness-in-Health. This is related to the forum topic, a topic I have been involved in for many years. I have a background in medicine and psychology and am very much interested in both the individual aspects of medicine and psychology and how to bridge medicine and psychology, also how to relate the individual aspects of medicine and psychology with more collective aspects of medicine—and how that affects our individual work and experience of anything that comes under this umbrella of medicine, health care or wellness. With the topic of medicine—when does it heal and when not?—and with the idea of health-in-sickness and sickness-in-health I want to point at aspects of health and the health system and at concepts or cultural ideas about health that actually make people sick. They contribute to people’s feeling of being different and sick and marginalized. On the other hand, there are aspects of sickness that are actually healthy. We will explore this kind of polarity between health and sickness. Tonight, the idea is to explore as a group what are the themes and the concerns that we as a group and as individuals have around whatever we think medicine is.
Medicine is an umbrella that can include a lot of different modalities, a lot of different philosophies, techniques and skills that are present in a culture and in this field that we live in. Health and healing is also an umbrella that can include a lot of different things. Just by mentioning health means that there is something that we want to achieve that is an opposite to another experience that is called sickness or illness or disease. Who defines what is healthy? Who says what is sick? Who has the power to diagnose people? Who has the expertise to help people? These are all questions that are rarely discussed in a community setting. That is what I wanted to give the opportunity for tonight. We will see what comes up because I don’t know. It depends on us as a group.
The way I would suggest we do this: I suggested at the end of the class that maybe some of us who were in the class might start speaking from one point of view or another. And then Isabelle and I will help facilitate the group discussion and we will see where it goes. I was thinking that maybe after about 45 minutes or so we might interrupt the discussion and break up in smaller groups so that everybody can have a chance to speak. For some people, a larger group is more intimidating. It doesn’t have to be but it can be. So breaking up in a smaller group for 15 minutes helps. Then we come back and see where the discussion goes. Does that sound like a good way to go?
Michael: I love it.
Pierre: You love it. Good. Not everybody has to love it. So who wants to start? I am leaving it open. I noticed that a few people in their introduction of themselves have already started mentioning some topics or concerns.
Amy: Can we take a position or any other criteria?
Pierre: Sharing a personal experience, taking a position, we will see.
Adam: I have an idea that comes into my mind, which is that in a large sense health comes from connection and a sense of well-being, a sense of abundance and connection; and ill-health comes from fear and contraction and stress.
Pierre: What was that last part?
Adam: Ill-health—illness—comes from fear, contraction and stress.
Michael: So I think this leads right to the question: if that is how we define health and that is how we define sickness, then what is medicine?
Adam: Fear mongering! Ha ha ha (others react).
Pierre: Fear mongering?
Adam: Yes, I think that modern medicine is about fear, getting fear, addressing fear, and so it actually exists in the realm of illness rather than the realm of health and it perpetuates the realm of illness rather than develop health.
Connie: Except, not always.
Adam: Not always.
Connie: I mean, sometimes, Western medicine addresses health most effectively.
Adam: Yes, absolutely.
Michael: So, if that is fear mongering on the other side of the line, what is health promoting?
Connie: That is a good question.
Adam: Connection, good food, community, getting your hands in the dirt, riding your bike…
Nancy: Do you express these points of view outside of forums like this one?
Adam: Yes.
Nancy: Who listens?
Adam: I am talking with people in the Permaculture community.
Michael: The connection piece seems to really relate to one thing we talked about in the class, which was about the connection, the relationships between the doctor and his client or patient, or provider and patient and client, whatever term we want to use—but how important that relationship is and how sometimes it is there and how sometimes it is not, and what we can do to strengthen it, enhance it.
Adam: It seems that modern medicine is about urgent care, like when things really go wrong, when a bone is broken or whatever. I don’t know that I would see them as part of the realm of health. It is more about how we respond to those things and not about how we heal from them, and that doesn’t connect us.
Isabelle: I am curious to go back. So I heard fear from you and also heard about fear, about going to the hospital. So I am curious about a connection that might be in that thinking. I want to learn more about fear of going into care.
Pierre: If we talk about, fear there is also someone who creates fear.
Amy: Just creates fear and not experiences fear?
Pierre: If we experience fear there is something on the other side that creates that experience, something or some role or person that is intimidating.
Daniel: I wanted to throw that in there early on. I personally have not had many good experiences going to the hospital. I usually go into the hospital because my head is bleeding or there is a stone in my kidney or something bad and traumatic is happening. So it’s partially through association that I don’t like them. I have a general mistrust of hospitals, while I respect much of medicine. I mean I totally value it as an amazing group of knowledge and learning, even though it doesn’t feel right for me. I am more interested in prevention than intervention, which was what we were talking about. I am more interested in really eating well and exercising—not living in fear of having to go to these places. I don’t want to be part of the health care system. I don’t want to put my health in some expert’s hands. I’d rather continue to research and go with my experience.
Ellen: Well, medicine: we can have a lot of negative association with it because medicine is almost necessarily about pain and suffering and dysfunction. Even when we go to the positive side we are talking about the prevention of pain and suffering. There is such a thing as health promotion, but medicine rarely does it. So the association of medicine is already… well, there is no positive medicine; there is positive psychology, which is a great innovation and revolution, but I can’t think of instances or institutions of positive medicine.
Daniel: Food is. Let your food be your medicine and your medicine be your food—Hippocrates. I think that is positive medicine.
Ingrid: I am really fascinated by that. I think there is kind of a loop, you know, where people who are into traditional medicine care about people’s health. Traditional medicine sees us as individuals and they tell us we need to take care of this. But I think they get tired of telling people “be well”. Other things in my life were huge stressors. Anyway, they end up happening and taking over the process.
Nancy: Before I lose my train of thought I am noticing the roles that are coming up. One of them is sort of like a role of a more traditional medicine that says: I have the power of doing this versus one that is more about affirmation and self-healing.
Ingrid: Yes, that is fine and I also think there is another role, which is: You need to make this better and I don’t want to change, so you in your white coat, you fix this and I don’t want to know how you do it; and so the health promotion medicine doesn’t work at all because maybe people seem not receptive and on the other hand that is really what people need.
Pierre: So in a way there are a lot of voices that have been touched upon, some of which express a criticism against a certain way of medicine. There is a criticism or fear or mistrust of certain aspects of the medical field or medicine. And then some voices are starting to defend that side, also saying: Well, it is needed because we are here to fix things when things are not going well, and that is part of what we do; another side that says we want to support the individual responsibility to take care of themselves and health promotion. That is really important. Maybe there might be more views…just trying to frame.
Michael: I want to chime in. There is a lot of criticism against Western medicine that exists these days especially in communities like this. I work in mental health and I work with many individuals who swear by the pills. They are on a lot of pills but they thank the Lord every day that they have those pills because those pills are what lets them get by. I come from a very self-empowerment perspective and mind freedom that is pro-choice with drugs and a lot of advocacy for non-drug intervention. And what I keep seeing is that sure there are these stories and times of people getting over the symptoms without medication. But the fact is we live in and so much of our society is sculpted around this idea that we will get better through the use of medication. And so a lot of the house we live in doesn’t permit or make it easy for us to follow the other self-empowered visions of recovery.
Pierre: Strong statements.
Ellen: I want to speak up for a lot of doctors who acknowledge that they don’t heal people; they just do what they can to help the body heal itself.
Michael: That is a good point. So much of it is the perspective; the actual technique or what’s done can be the same, but the way one looks at it, the way one interprets it, can make a huge difference.
Daniel: That agency of where healing happens is an interesting point. I think when you go to the doctor, saying, “heal me” there is a certain expectation like my life is broken from some accident and go to the hospital and say heal me, putting that agency in a person. And there is another role, which is like with affirmation, food or walking or Earth, healing myself. Where is the healing power? Is it in the drug, in the doctor, in the individual?
Nancy: Previously, we were invoking Hippocrates, which is the originator of the Western medical oath: first do no harm. But in the case of my relative who was put on some medication and then put into rehab for taking it—which completely gave her this bizarre sense of self of a drop out and screw up—talk about the identified patient. I am just trying to say something is up with that. First of all, her diagnosis happened to be ADHD. How do you tell a kid has ADHD and give them drug? That is what happened. She wanted to be sent to rehab. She had the self image of someone who had to be on medicine to correct something. It was said she had a learning problem. Now she is in jail; she has gotten into criminal behavior. But when I knew my cousin, she was a happy-go-lucky person. We watched sitcoms together. We watched Seinfeld, Friends. We had a good time. She wasn’t an extreme person; she wasn’t unlawful, she wasn’t belligerent, she wanted to belong like a typical adolescent.
Daniel: (Siding with Nancy and representing Nancy’s position as a role) There is a ghost of a victim of the medical system, which was what I was coming from before. I went to the hospital and it made me worse. I am just joining you as a role—your cousin is getting to be an intense ghost in my head. You made me sick and now I don’t want to go to them anymore. Is that okay to join you?
Nancy: Sure, but then I would say I don’t have anyone to go to other than you. You are the one: I don’t know where else to go. I don’t have anyone else besides you.
Pierre: (Siding with Nancy) But then you are making me sick, putting your labels on me and putting me in the hospital and blaming it on me if I get dependent on the medication. You are making me sick.
(Crossing to the other side of the room) So there must be another side here, which is probably hard to represent, which might say: Well, we do actually know what is good for you. We have been in school for many years. We learned a lot and we know what is really good for you. We learned and studied and we are the experts. We know what is wrong with you and what is good for you. And you are asking for us.
Nancy: As a family member of a person who has gone through this drama . . . and if I think of mindfreedom and Portland Hearing Voices, which is a group of people who have been given psychiatric diagnoses and were put on medication and had in some cases about 100 medication changes in the course of their years, I am part of that support group community because I don’t believe you. I don’t believe you!
Pierre: Too bad. Too bad.
Nancy: Calm down.
Pierre: Too bad. Well, I am exaggerating this role here … help me out here. But, too bad. Here we do know. We have the DSM behind us and all the science, which says this is the best for you.
Joe: (Joining Nancy) Well, can’t you listen to me, or at least listen to my ideas? I am a unique person; each one of us is different. I know more about me. I would like you to listen to me and hear some of my ideas. Maybe what you are doing isn’t the best thing for me. Maybe some of it would be, or less of it, or some different medication or combination. I want you to treat me like a human being, not just being notes in the chart. I don’t know what you are writing in there.
Robert: (Joining Pierre’s side) I am so busy. I acknowledge you are coming to me. But this is also a business here and there are so many employed. There are so many people we can take. And yes, we cannot treat everybody as an individual. We studied it for so long and we know the medication works. You come to us, right? You ask us for help, so we are trying to provide.
Pierre: I know you work in the field. Are you speaking as a role?
Robert: Yes, it is a role.
Nancy: Yes, it is a big business. I don’t want to be seen as a bar code.
Isabelle: I am in the role of a health care provider, and you come in and I feel limited by my training. This is what I know how to do, and I think about it like this. And I want you to help me to help you. I don’t know how to do that, because I don’t know what you are talking about. I don’t know what “mind freedom” is. I have been trained in a different way.
Nancy: You know what? I am sick of giving information to you (expletive) up the hill at OHSU. I am (expletive) sick of it. I am not going to give you any more information about me or my family or my friends, so (expletive).
Isabelle: Hmm.
Pierre: There are a lot of feelings on that side. (Joining Nancy) I am assuming here there is something that says: Here it is too painful. Not only am I in pain and suffering but then I am being asked to help you help me. It is too much to ask, there is too much pain. You have no idea what it means to be on this side and to suffer and have on top of it to be exposed to the kind of abuse that is happening. It is not just you, but it is the system. And then being asked to educate you. It is just too much. That is why we get so angry, (expletive), because you have no idea what it means to be here.
Joe: Plus, we are hurting.
Miriam: I am sorry if you look at the statistics. We do what we do and we give our drugs to a lot of people and we keep the streets much safer than they were before. A few people slip under the cracks. That is just a fact of life.
Pierre: Wow, that is going to escalate the other side. Just saying, okay.
Ken: (Addressing both sides) There are two different things happening. Because I am talking on this side as an individual and you are talking on that side as a system. Why don’t you talk as an individual? Why do you always go back to your system? As your reason, your statistics, your wanting more information from me. On this side, I am a human being. Why are you not a human being with me with my pain?
Miriam: Because we are representatives of the system, first and foremost.
Nancy: That sounds good and powerful (joins the other side). I want to stand by you now (laughter).
Pierre: That is interesting. You don’t want to be only on one side.
Robert: (Talking from a role as a provider) I am employed here and I have a contract and I have so many patients assigned to me. It’s true I don’t really have the time. There are lots of things that bind me in that system. I say yes to that system, but there are limits.
Pierre: (To Robert) Do you want to try to listen to us?
Isabelle: (Taking Nancy’s side) I am sick of hearing about your problems. This is not about you. You are up there on Mount Zion in your little office. Come to my world. Come to the community and see how we live. You tell me to ride a bike for exercise. My streets are so unsafe I could be slaughtered if I ride my bike. You have no idea.
Francine: (Joining the role of the providers) That’s why . . . it’s so… talk about pain. Actually, that is why I stay on mount Zion—so I don’t have to feel the pain, my own pain of not being able to provide what I would like to. And I am scared of finding out even more of what I don’t know and can’t provide. I don’t know in the moment how to change and realize that it is not up to you to change me or to help me. I just want to say that in the moment I am feeling my limitations, and I am feeling how I do wall myself off.
Isabelle: I will not trust you until you are as willing to come into my world as I am forced to come into your world everyday.
Amy: Hmm.
Nancy: Part of me loves hospitals. You kind of know who is the boss. It’s like, clear. First of all, there is a lot of hygiene. Hospitals are clean. I love hygiene; it is very sanitized. And there is always somebody who is in charge. There is something reassuring about that, that I love.
Michael: Actually, there are a lot of superbugs that are kind of scary.
Pierre: It is also relieving to have some structure and to be able to let go.
Nancy: It is better than church.
Robert: We are here. You can come to us.
Michael: What ways do you see for us to come to you?
Joe: (Speaking from the patient side) Well, I need you. Obviously I need some help. I want us to work together. I want you to look at some of this research that I did, some information I found about these medications. I want you to look at some of these vitamins and herbs I found. I want to get your opinion on them because I probably am going to take them anyway. But it would be better if we would work together. And if you have stuff for me to read, I will read it—but we can’t go on this way.
Michael: I think money interests are stifling the whole system. Pharmaceuticals have too much power. I think doctors have a lot of power and rank, and I wish they had more and were doing something more. I mean, they are doing things to make things better. The system seems stifled by money interests in a lot of ways. We talk about drugs, again and again. It’s a slightly different direction. But it is a really frustrating part of everything, seeing family members…
Nancy: Aren’t doctors . . . aren’t they on top of the food chain?
Linda: (Talking from the patient side) In a way, but in a different way not at all. I don’t think we need you as much as you need us over there.
Pierre: Say more.
Linda: Well, I mean, look at your lives. What is it all about? What’s so exciting about getting up in the morning, starting your computer? You are running around with all your task lists. You are not following your experiences over there. You are more interested in running down task lists and speeding up. You’re not really breathing. You don’t live, you don’t look around, you don’t love. You are disconnected from these inner experiences. You want to give us pills to slow us down. You want to normalize us in a way so we do the same thing. And I think you feel depressed over there, often. We do, too, maybe but there is also a lot of …experiences.
Michael: Our happiness, buddy, looks like the happiness you see on the big screens and on the TV.
Ben: Why does the average doctor make $260,000 a year? Does the average doctor actually provide $260,000 a year of social good?
Nancy: That’s hard to quantify, right? I don’t know. It’s a good question.
Linda: (Shifting to the provider’s side) Oh, yeah. I mean, yes (laughter), $260,000 stabilized the system here.
Ben: I can get all the information that you provide off the web. For free.
Linda: You think so? I better read the web. (laughter)
Isabelle: You know, I am sick of hearing about physicians because as a nurse and nurse practitioner we are the largest number of health care providers in the nation, by far, and we are invisible and our pay is rolled into the room charge of the hospital and we become invisible when we have the most intimate contact with clients. And how come doctors get all the (expletive) attention?
Nancy: Somebody write that up on the board: Nurses.
Joe: Say more about becoming invisible. I am interested in that.
Isabelle: Well, when we are looking at health care transformation, right here in Oregon, we are leading the nation on this. And who’s on the panel? It’s physicians. And there is a tokenism once in a while. We do the bulk of the care. We know clients. We do health promotion and we are mostly female, and we get undervalued for the work that we do.
Ellen: Nurse practitioners and physician assistants provide 80 percent of what the doctors provide. They can prescribe schedule 3 drugs and can walk home with a paycheck of a quarter less than doctors.
Isabelle: We do not work for doctors. Doctors have no influence over my license.
Michael: But then I am pretty sure we pay a whole hell of a lot more to go to school than you did. (laughter)
Alice: Well, that was a dumb decision, wasn’t it? (laughter) $200,000 a year difference.
Pierre: We struggled through it. We deserve to have the big money. We are the experts. Without us you couldn’t do it. I know that nurse practitioners and nurses are okay and they are doing good work, but when it really comes to it . . . (laughter) there must be a side . . . well, there is a side that says: still the expertise and knowledge remains with us and at the end it’s us, that will do the neurosurgery.
Linda: Yes.
Robert: I want to say something about that. Yes, I can hear what you are saying. But where I come from in New Zealand, you pay a lot of money to become a nurse. And a nurse is doing the bulk of the work. I have to over there (moves to other side of the room to stay opposite the doctor role). I had a huge loan and the amount of money is about as much as you earn in a year.
Pierre: Someone says, “Yeah, I have to pay my golf fees.”
Linda: I am not a physician but from what I hear, life is really hard here. Like we have to study so much. We have to work shifts. We are burning out. We work 70-hour weeks. It is really tough to be a physician. So I should earn a lot of money, actually, over here.
Pierre: Liability.
Isabelle: Money aside, you saved my father’s life. And I am so grateful, and that is worth more money than ever exists. And I trust you. Thank you.
Pierre: Wow. The moment someone speaks and acknowledges one side. First time I feel somehow seen. And even though it is hard, I can also open up to the other side if you can see me. That sometimes I do a little bit of good. And I am sure that’s not the only experience here, because there’s a lot of other experience over there, too.
Robert: I found the most incredible doctor that does work with me and does look at my vitamins and herbs and supports me and gives me stuff to read so that I am not making bad decisions and have the full picture. But he is also willing to support me and the outcome has been really, really good.
Linda: Me too. I have a great physician.
Pierre: Wow, the atmosphere has shifted. I don’t want to minimize the other side also that is still in pain and that has been suffering from that side, but there is another side, too.
Nancy: I think the role of medicine needs to be re-evaluated. I think doctors could serve as priests or something. I mean, taking out a lipoma or taking out a tumor is one important thing that a doctor must do to save lives and reduce suffering. But they also have this thing that is more spiritual, is connection to a healing spirit. I feel in America in medicine, right now in medicine, there is not a lot of healing spirit, actually.
Isabelle: That is pretty fluffy. It is about the Krebs cycle. What is the Krebs cycle? What is your kidney filtration? You know if I’m just purple swirling over you that is not going to make the difference. I gotta do what I was trained to do. How can I really explain to you after 35 years of practice what I know? Can you really be an equal participant in your healing?
Nancy: Right. Actually, maybe you can’t explain things because maybe some things are not (expletive) measurable. Somethings are just not measurable. What is it with you people and your obsession with measuring stuff?
Pierre: Without measurement we wouldn’t know. We need measurement so we can identify when to intervene and what to do. And on the other side I must say, I want to speak personally because I was in this role. I want to give it back to you. What I experienced here is that it is also you who help create the system. You are part of the system; you are part of making me into that role. It is not only coming from me. It is not right if you just blame me for that system and don’t take some of the responsibility for the system. You can blame me, but then you are very happy to use me when you really need me. It’s also upsetting to not be seen and be one-sidedly blamed for the ills of the system. I am actually with you, and I suffered about the system. I am in favor of changing the systems. And I want all of us to work together. To the other side I say: it is not good enough. It is not good enough just to blame it on me.
Amy: I accept your challenge. I see a naturopath, Chinese medicine doctors, and get nutrition advice. I take tinctures and teas instead of drugs. I am looking at a fuller spectrum of what medicinal care can be. I am taking your challenge by not just visiting a doctor. Visiting a doctor when that is what is needed, when I have a broken bone, when it requires that level of medicine.
Pierre: It relieves me when I hear that someone is accountable on that side, too. It’s relieving.
Ken: (To Pierre) It would relieve us on this side if you would say to us, “Why don’t you go and see a naturopath?” “Why don’t you go and see an acupuncturist?” “Why don’t you change your diet?”
Michael: Sometimes it gets a little monotonous seeing people come in and the insurance is paying. Sometimes they have such minor illnesses that they can take care of themselves. They could go to a naturopath, acupuncturist or even a drug store. Get some Tylenol. We are here and we got all this training to do big things, work with big injuries. Sometimes a lot of little things come in.
Amy: (Taking the doctors’ side) You tell me about your stomach troubles and then I find out you are drinking 2 gallons of Mountain Dew a day.
Linda: There are also a lot of class issues that allow or hinder some of us to go to a naturopath and acupuncturist. Some of us don’t have an education. Some of us don’t have that.
Gene: I think more than that is so many people don’t have insurance coverage that will allow them to see alternative practitioners. This dichotomy feels so extreme and actually not necessarily where things are at for people of a certain class but for people of a poorer class this is where the dichotomy still is.
Nancy: I think bringing up insurance is so helpful to this conversation.
Ben: This was the ghost role, the ghost monster.
Gene: Yes, because there is a middle ground that now exists: a lot of progressive doctors, the doctors that he mentioned (referring to Joe), but they can’t afford them.
Isabelle: You talk about class. I gotta tell you, I don’t know about you, but when I go out to a social setting, I don’t want people to know I am a doctor. They put me up on a pedestal that I am not comfortable with and I see them get all weird and quiet when they find out that I’m a neurosurgeon. I pee in a toilet like everybody else. I am human. And you talk about your naturopath and acupuncture and I don’t know what Chi means, what this is. I don’t know anything about what you know.
Gene: I think that is completely untrue. I have seen so many doctors that go to naturopaths, that go to homeopaths. You know you are not fully being who you are.
Pierre: Some might, and some might not.
Gene: A lot, at this point. A lot.
Francine: Do you think that is true outside of the northwest as well?
Gene: I think we are talking about a really educated class of people and that within an educated class there is a lot of awareness and a lot of interest. But there is also not that much economic support, not that much institutional support.
Francine: I used to work up at OHSU. Several people come to mind and they are all people who went through med school a few decades ago and who are really skeptical about this woo woo stuff.
Gene: Yeah, that’s true.
Pierre: It’s about 8 o’clock. Is this a point where we can halt the discussion and break up into small groups? Would that be okay? Then we come back and see if we can deepen the discussion. How about doing it for 15-20 minutes so everybody can talk and maybe go a little deeper? How about spreading out, just four small groups?
Participants discuss in small groups and later gather as a large group again.
Pierre: Let’s have another few minutes and see where it goes. I went around and listened to the small group discussion and I tried to catch some of the themes that came up. I did hear about rank, power. I heard something about money and the business side, which is making a lot of money out of medicine. I heard about peers, collaboration, community, social medicine. Also about quick fix versus self responsibility, teamwork versus experts and specialists. That is what I heard walking around. Maybe you can share what some of you discussed, what you learned or where to go from here. Also, one other thing: so far we have been mostly talking about the issue in an impersonal way. I heard from some that there is a need for more personal stories and personal experiences so that we can ground it in some of our individual experiences.
Michael: Well, I think the big role that is hard to get around is insurance. We talked about that it doesn’t even matter what choices some people want to make, or how. Things are really limited by what insurance will cover and what they won’t. If we have insurance and if we don’t have insurance, it’s pretty limited, too.
Hellene: I was saying that I felt a bit outside the conversation, as I am Canadian. I don’t think the issues are exactly the same. That isn’t an issue for instance.
Ellen: Lucky you. I’d take your health care system over ours. I will, anyway.
Hellene: Yeah, I will, too. We still have the same things going on. We talked about how relationship is at the center of care. Because I run into the same things, you know, in Canada. Going to see my family doctor, a completely dehumanizing experience. Then I have switched and I’ve gone to see a nurse practitioner. Not that it is always like that. But anyway, I have gone and seen someone that is great. I really feel listened to and cared about. It feels more whole.
Michael: So can I ask you what is the prevalence of acupuncture and naturopaths in Canada? If it is much more of an option because it’s not insurance based?
Hellene: Right. So, I don’t know what it is like here. There is a lot of that but it’s generally not covered by insurance.
Michael: So that is privately paid, as well.
Ellen: The guild has kept the other guilds out.
Michael: Therein lies the same issue.
Ingrid: We talked about teams in our small group, how Western medicine is often faulted at looking primarily at the illness and not the resources and how our talk was very centered on what the problem is and not as much on examples of solutions and possibilities.
Ellen: It was a two-point question up there: when does it heal and when not? So not really what defines “heal” and what defines “medicine.” But when does it heal and when not? I have the sense of when the good side of medicine ends. Basically, I am really glad for the existence of antibiotics when I get pneumonia. Maybe I can avoid it, but maybe I can’t.
Pierre: (Referring to Ingrid) This is often an important point in the discussion. At one point there is a need for more practical solutions that comes up in a group. Now what? What can we do? I just want to frame that. That is often being marginalized. I want to support that. There is a need . . . one side that thinks, “Okay, now we know the problems. Now what?” This is maybe the next step for this group. I would suggest that we close the discussion in the large group and network amongst ourselves and maybe some subgroups will form that want to look at solutions and practical next steps.
Thank you all for a lively discussion.