Integrative medicine is the application of the kind of thinking embodied in general systems theory to medicine. Integrative medicine has mostly to do with the approach one takes to understanding what has called an event, such as a symptom or the collection of symptoms, signs, and lab testS we call an illness. At present, medical thinking remains quite linear and simple. Doctors and patients alike are tempted by the idea that an illness has a single cause that can be treated with a single pill. Solving the patient's problem is too often limited to finding which pill or group of pills will work. This is largely done by experimentation trusting as much in luck as in skill.
General systems theory presents ideas about casualty in which a web of interactions produces a result that is not as easy to blame on a single factor. Health is sustained by a state of balance among countless strands of a web of genetic, physiologic, psychological, developmental, and environmental factors.
When something goes wrong, it makes sense to pay attention to all aspects of this web that can be addressed with reasonable cost and risk. The occasional reference to integrative medicine in this article is a shorthand for the application of the principles of general systems theory to medicine.
We will discuss two different meanings of the word "systems" here. The training given most doctors teaches about "systems" as a way of dividing the body and categorizing diseases that affect it. There are the cardiovascular, nervous, immune, reproductive, gastrointestinal, urinary, integumentary (skin), musculoskeletal, endocrine, reticuloendothelial, and hematologic systems. Most medical training, textbooks and courses are organized according to these divisions of the body. The same systems are the basis for classifying disease.
When a doctor graduates from medical school they are expected to pick a system and become a specialist in it.
Becoming a generalist and being devoted to understanding the workings of all systems and how each is a interconnected and vital part of the individual is discouraged.
There is another medical view of "systems" theory in which the notion of a system is quite different from the earlier discussed accepted medical way of dividing the body. This view of systems theory provides a unifying, as opposed to divisive, concept of how things work in nature and the individual patient. It allows a doctor to view biological systems as unified by the interaction of their many components and to make functional, as opposed to anatomical divisions, as the balance within the whole system is accessed.
The medical concept of systems and disease leads a doctor toward a narrow path. The student doctor learns to take pride in a parsimonious approach to finding the one explanation for the patient’s problem. The doctor gives the diagnosis, the name of the disease, as the explanation of the patient’s problem and is comfortable saying that the disease is the cause of the symptoms. “Your sadness is being caused by depression,” “Your high blood pressure is the result of hypertension,” “Your cramps and diarrhea are being caused by colitis,” “Your child can’t pay attention because he has attention deficit disorder.” Having made the diagnosis, the doctor may then apply the treatment that works best for that symptom: an antidepressant for depression, an antihypertensive for hypertension, a pill to suppress cramps and diarrhea, or Ritalin for the hyperactive child, a drug that would lead to the imprisonment of anyone found selling it near the playground.
Doctors who adhere to the newer emerging concepts of systems theory follow a broader path. Students of this approach take pride in a lavish approach that considers all the components of the patient’s system that might be out of balance. The doctor makes a functional assessment with the understanding that the diagnosis is the name, not the cause, of the patient’s symptoms. Having made the diagnosis, the doctor makes a functional assessment of the individual patient’s balance and prescribes the supplementation of needed elements and the removal of toxic elements that interfere with balance. The broad path is less costly in the long run because it is faithful to the realities of the interrelationships in biological systems.
A doctor who chooses to follow this systems concept should eventually reach the point where they can ask themselves "Have we done everything we can for this patient?”
This question takes on a different significance for a generalist and a systems analyst than it does for a specialist, a person focusing on one particular system.
It is not just a question of the generalist concentrating on a large territory and the specialist on a restricted one. It is the kind of question that goes with systems theory as applied to medicine versus the present model in medicine that views the disease, not the individual, as the target of treatment.
As a doctor, asking yourself this question makes all the difference in your approach to your patient’s problems. If you view the patient as a complex system interacting with the environment, then you must do everything reasonable to help establish balance in the system.
Balance means providing all the necessary elements to optimize the system and removing any interfering elements. Nutrients are necessary elements. Toxins are interfering elements. The difficulty is that each of us is unique, and the necessary and interfering elements differ, sometimes widely, from person to person. In systems analysis, in treating each person as a unique problem, what counts are the differences between that person and others. In traditional medicine, in treating each person as a disease, it is the similarities that count. As we are defining it, intergrative medicine means understanding health as an ever-shifting state in the complex web of interactions which, when working in harmony, yield a dynamic balance that we experience as feeling well.
Intergrative medicine in biology can be grasped, even by the beginner, in terms of such certain recurring generalized functions as perception, memory and language.
By the time they finish their training many doctors feel they can stamp out illness with their ballpoint pen and prescription pad, they are comfortable with the landmarks they have been given to find my way as a doctor. They have a detailed view of the real world inside the human body as well as an imaginary world populated by diseases whose attack they believe to be responsible for illness. A belief in that imaginary world works quite well in the management of the acute illness that one encounters in hospital wards where most medical training takes place, and the narrow path works quite well for treating trauma, acute infections or the intense phase of a psychosis. Belief in the same imaginary world does not work well for you when and if patients begin asking you questions that begin with the word could: “Could my cramps and diarrhea be caused, not by colitis, but by something I am eating?” “Could taking vitamins help my depression?” “Could my child’s hyperactivity be caused by allergies?” As you begin to struggle with the answers to those questions and ask yourself “Have I done everything I can for this patient?” you begin to leave the security of the narrow path, putting a tentative foot on the broad path of the systems approach to health.
This causes you to follow a much more navigable and realistic terrain than the imaginary one you learn in medical school in which illness is seen as the attack of a disease. The landscape of intergrative medicine* is revealed in a functional, as opposed to an anatomical, view of things. Of all the various functions in human biology there is one overriding function that connects to all the others. Understanding its chemistry and immunology can unify the physician’s approach to problems of any level of complexity. It is detoxification.
When we speak of detoxification, we do not mean a treatment for alcohol and drug abuse, although such treatments are tangentially related to the subject of this book. We mean the processes by which the body rids itself of unwanted materials. We do not mean what happens in the bathroom, whether that is bathing or emptying the bowels or bladder. We refer to the biochemistry of handling potentially harmful chemicals that appear within the system and which must be neutralized before they pass from the body. We are not referring exclusively to the harmful environmental chemicals we have all learned to fear: lead, mercury, other heavy metals, additives, dyes, hormones, pesticides, herbicides, fungicides and petrochemicals of all sorts or pollutants of the air, water and food supply that we ingest.
Detoxification is central to understanding functional assessment in medicine not so much because we live in a toxic environment but because detoxification is the biggest item in each individual’s biochemical budget. It handles waste not only from the environment, but from every process in all the organs and systems of the body. Nearly every molecule the body handles has to be gotten rid of when it has served its purpose. Doing so involves a deliberate process of rendering the molecule inactive. It is a synthetic activity, a creative enterprise in which small molecules—such as the ammonia left over from protein metabolism, hormones no longer needed by the endocrine system, used neurotransmitters from the nervous system, or the by-products of a well-functioning immune system—must be changed before they can be safely excreted from the body.
Illness and disease will affect the body’s detoxification chemistry, and if there is something wrong with the detoxification chemistry, any other problems will be aggravated. It is central to all systems. Detoxification chemistry provides the map and the vehicle for understanding the functional landscape of each human being. It offers a new way to defend the body’s health by establishing and maintaining a state of balance instead of waiting in fear for an expensive disease to strike. In fact, the conventional medical disease-oriented approach to health care is sinking the medical economy. We will not be able to save medical dollars until we change the way we think about illness.
You need not wait for public policy to recover from the collapse of the current health-care system to adopt practices based on a modern understanding of biologic systems. If you understand some basic principles, you can make choices that will reduce your risk of illness and enhance your health.
The chemistry and immunology of detoxification unifies our grasp on health problems more effectively than just giving problems a name and prescribing pills to suppress symptoms.
The concept of toxin embraces a wide variety of familiar substances that may pose problems for some peopie and not others. Individuality is the key. Taking charge of your own health depends on knowing how to assess your individual biochemical and immunologic quirks. This requires patience and taking plenty of time to to understand detoxification concepts and considering all the angles.
