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A Holistic Approach to the Doctor/Patient Relationship.

Achieving Ideal Patient Care Through Personal, Social, and Physical Wholeness. By Abe Kurien, MD

Achieving Ideal Patient Care Through Personal, Social, and Physical Wholeness. By Abe Kurien, MD

The concept of health as applied to a human being implies wholeness of functions. Efforts at restoration of health are defined as healing, and a person who practices healing is called a healer. Hence, the adjective holistic is relevant to all aspects of human activities in the sphere of healing.
This perspective of what health is and how to practice healing arose from an early view of mankind. In that, all forms of illnesses were caused by deities in response to human violations of divine commandments. Ancient civilizations, including Egypt, Greece, Rome, India and China, each practiced a type of healing which appealed to gods for restoration. Some primitive religions seem to have considered a human being as a single entity without subdivided categorization into different parts—mind, body and spirit.

Historical Views of Healing

Hippocrates, also known as the “father of medicine” to the western world, was a fifth century B.C. member of the priesthood of Asclepius—the Greek god of healing. It was later in life when he considered that a complete knowledge of the body was necessary for the practice of medicine. He is thought to have been the first person to believe that illnesses were caused naturally and not because of superstition. He separated the discipline of medicine from religion, believing and arguing that disease was not a punishment inflicted by the gods. Rather, despite his limited anatomical knowledge, he argued that they are a product of environmental factors, diet and living habits.
In Alexandria, during the third century B.C., Herophilus and Erasistratus became the first individuals to perform systematic human cadaver dissections. However, subsequent development of rational Greek medicine as championed by Hippocrates was hampered in Greek culture and later by the Christian Church of the later centuries. The prohibition of the dissection of human cadavers limited necessary exploration of the cadavers to understand the detailed anatomy of the body and its functions.
The convergence of civilizations at that time in the ancient world, between 500 B.C. and 300 A.D., at the crossroads of Asia, Europe and Africa, there produced a new perspective about the nature of the human being. The view that the human being was a single entity was replaced by a perspective which understood his existence as an assemblage—a combination of a visible body, an invisible mind and a soul. Saint Augustine, the Christian theologian of the fourth and fifth century, seems to have accepted this tripartite view of the human being and helped implement this view as part of Church doctrine.
By the ninth century, the Arab civilization brought a greater knowledge of human anatomy to Europe. From Greece, the Hippocratic Corpus appeared. Vesalius, the Flemish Physician, produced accurate anatomical drawings of the human body in the 16th century. William Harvey published a detailed description of the human circulatory system. In 1655, Robert Hooke identified cells as the basic structural and functional units of plants and living tissue using an optical microscope. By the 17th century, the practice of healing had become scientific in its methodology. In the middle of the 19th century, Virchow identified cellular pathology as an inevitable accompaniment of many diseases.


Growth of Knowledge and technology 

The centuries since have seen enormous advancements in the treatment of many illnesses. Technological advances result from better knowledge and technological utilization of physics and chemistry. The causative factors responsible for those changes have altered, for the better, our understanding of the nature of health and the processes of healing. 

Scientific medicine is much more now than diagnosis, prognosis and minimal treatment as it was in the days of Hippocrates. It has become a globally-accepted system of knowledge which can treat most diseases effectively, identify new diseases as they arise and even correct genetic errors that cause great suffering. Efforts now abound to create new forms of treatment for ancient diseases, and rehabilitation using electronics has made it possible for the blind to see, the lame to walk, the deaf to hear and the “dead” to be raised. Mankind has gained a great deal because of the departure of healing from its ancient, largely superstitious context and perspective.
However, I believe that in doing so, humanity may have lost an important emphasis critical to our understanding of human nature—its personal as well as social dimensions. At one time, not so long ago, a special personal relationship between the healer (“doctor” or “physician” during the last three centuries) and his patients who were bonded together by trust and caring has been replaced by an impersonal relationship between the two, marred by many intrusions, including those by insurance companies, governmental regulations, drug manufacturers and a host of other dominating influences.

Holistic Healing: Mind, Body, Spirit

More significant than even this may be the understanding of human nature into three unrelated compartments of experience described as body, mind and spirit. This view is accompanied by the false notion that each can be dealt with in isolation by experts who often do not often have an adequate insight into the holistic nature of an individual. Perhaps, it is not the academic practice of scientific medicine per se that has caused a diminution in the value of the holistic understanding. The emphasis on “holistic healing” has waned because of a shift in philosophical attitudes and the emergence of material reductionism as adequate to explain the nature of human beings. The transformation of a reflective mind into spirit, when it realizes that mankind must accept the responsibility to care for the welfare of all human beings, has fallen by the wayside. In the realm of scientific medicine, care is more often used as a suffix in such bureaucratic nouns as Healthcare, Medicare, Wellcare, Connecticare etc., without an adequate acknowledgement that all physicians, must have a sensitive understanding of the total needs of those who seek healing. We must actively care and attend to them all, if scientific medicine is to achieve a fuller measure of wholeness for every person. 
There is an unwillingness to take time to acknowledge and appreciate that many of the non-specific physical maladies and disease states (the sense of not feeling well, without being able to identify a diagnosis) that individuals report to their physicians are the result of unsatisfactory social contexts, including financial poverty, lack of information and probably even the discipline necessary to utilize the available knowledge. This results in a failure to recognize that the healer or his assistants have an obligation to further instruct those who seek help, so that every person becomes an informed individual about his own responsibility for maintenance health to the extent that is within his capacity.

“It is not merely the sick, but also the healers who need to understand that modern medicine has a lower appreciation of the full context of illness. “

Today the stresses of the lack of social relationships, or the stresses that arise from them, are often not recognized as a major factor in the reasons for seeking medical help. Many psychological problems present as psychosomatic complaints associated with unsatisfying social life. The amount of psychotropic drugs, which are handed out by physicians is an important measure of the incorrect assumption that psychosomatic illness can be adequately treated by drugs. It is unlikely that individuals can restore themselves to optimum health without help from psychological and social measures appropriate for the healing of sustained emotional distress.

Physician Care Through Holism


“The attempt of patients to seek alternate medical treatments, which are often not scientifically validated, is an indicator of the longing for a personal relationship of trust and caring from the physician. “

A battery of sophisticated or expensive diagnostic procedures, which are common in modern scientific medicine, is practiced for the exclusion of serious pathological processes within the body. This practice seldom satisfies the individual who experiences persistent pain or constantly worries about the fear of cancer or the possible occurrence of future serious illnesses. Chronic anxiety manifested by“doctor

However, it is also true that many chronic illnesses of the skeletal system or the muscles of the body are treated more effectively by practitioners of Yoga, acupuncture or massage, as well as different forms of ancient medical practices. It is unfair for practitioners of “scientific medicine” to maintain that relief reported in such instances is entirely due to the effect of autosuggestion or placebo effect, rather than due to reproducible effects that should have a place in the modern toolkit of methods for healing.
Finally, modern scientific medicine has failed in that it has not found an effective way to protect the health of all citizens in the United States of America. This may not be the fault of scientific medicine itself, but the reimbursement expected by physicians for their services and the unnecessary use of expensive procedures and the cost of medical practice, administration and litigation. Medical care is still one of the most common reasons for financial bankruptcy in the United States. That our nation has not found an appropriate system to provide adequate care for its citizens at reasonable costs is a major cause of worry for most citizens. The chronic anxiety this reality creates in the minds of most of the citizens of our country can be fully addressed only when holistic health and the best way to achieve it becomes recognized as fundamental to the care of our people.

  • By Abe Kurien, MD – Abe Kurien is a resident at Brookdale Cypress Village in Jacksonville, Florida. In his spare time he enjoys photography and service roles in his community. Dr. Kurien believes in a holistic approach to medicine, which he applied throughout his career.