October 17, 2010

Mark Foster, DO
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Bob–

A couple of very positive patient encounters yesterday:

• First, I saw a fit, vibrant 45 year old woman who presented for the first time complaining of knee pain. She probably has a meniscal tear of the knee. In the course of taking her history, I noted that she was not on any medications or supplements, and also, that she had checked the box for “depression” on her past medical history. She did not appear depressed at all. In fact, she appeared to be the epitome of a healthy, happy Colorado outdoorswoman. So I asked her about her history of depression. (Keep in mind that this was prior to me divulging any information about my new bias against psychotropics.) She said, “Well, that was a long time ago, when there was a lot of negativity in my life. I think I was depressed. I tried about three different medications for a short time, and the only one that seemed to work was Paxil. I took that for three months at the most, and my depression improved, but I felt like a zombie, and I said, ‘No, this isn’t me,’ and so I stopped taking it and stopped going to that doctor. I picked up a book at a health food store about treating depression naturally. I remember it had a rainbow on the cover. Well, I didn’t even read it, but it made me start thinking about my lifestyle. I wasn’t exercising, I had a lot of unnecessary stresses, and mostly, my diet was terrible. I was eating fast food and junk food all the time. The most important thing I did was to start eating healthily. It didn’t take long before my mood started improving, and I felt like myself again. That was 18 years ago at least, and I’ve had some ups and downs, but now I know what I have to do to pull myself out of it.” At this point, I gave her a high five and told her that we were going to get along just fine. She continued, unprompted, “You know? I just believe that our bodies don’t need all of this medication to get better. It seems like we’re designed to heal if we just take care of ourselves like we should.” Another high five. We philosophized together for a good while, and I recommended your book as well as Andrew Weil’s to help reinforce her healthy, holistic paradigm of mental and physical health care. Then I ordered an MRI and referred her to an orthopedic surgeon for her knee.

This brings up an interesting point: orthopedics is a medical specialty where modern technology often provides a life-changing miracle for patients. People who otherwise would have been crippled by knee arthritis or a rotator cuff tear at age 50 can now get a new lease on life for another 20 or 30 years.. And there are so many other fields where technology can save and enhance lives: lifesaving trauma care, antibiotics, cardiac interventions, cancer treatments. Problem is, I think, that as a society, we’ve become blinded by these dazzling miracle cures that always show up in movies and on TV shows, things that get top billing on magazine’s “Best Advances in Medicine” lists. We have translated those medical successes into an almost blind faith in all technological interventions. If it’s new, expensive, cutting-edge, and has a fancy medical-sounding name, then it must be great. Both doctors and patients are susceptible to this type of thinking. As your book delineates so clearly, that blind faith in the powers of science to cure all human suffering certainly helped foster the fatally flawed paradigm of mental health we’re dealing with now, which sadly has created a new type of suffering all its own.

But it’s great to see the subset of patients who have rejected the magic bullet delusion and are living demonstrably healthier lives because of it. I’ll try and share the other case later today . . .

Mark

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Mark Foster, DO
Letters from the Front Lines: A family physician, after having read Anatomy of an Epidemic, writes of his struggles to prescribe psychiatric medications in a thoughtful way . . . and help some patients wean from the medications.