June 1, 2013

Book Review: Anatomy of an Illness

“A hospital is no place for a person who is seriously ill.”

You’ve got to be intrigued by a book with a line like that!

Or these:
 “Perhaps the hospital’s most serious failure was in the area of nutrition…No wonder the 1969 White House Conference on Food, Nutrition, and Health made the melancholy observation that a great failure of medical schools is that they pay so little attention to the science of nutrition.”

Sound like a good read? You don’t know the half of it.

We had a lot to cover when I was in grad school. We couldn’t read all the books or get to all the material our professors would have liked. Early on, one of my professors recommended a book. It wasn’t required reading, but it probably should have been. In fact, I think it should be required reading for all healthcare professionals:  medical doctors, naturopaths, osteopaths, nurses, PAs, nutritionists, and anyone else who makes their living by helping people to get well and stay well.

It should probably also be required reading for most patients and clients who are dealing with anything as “everyday” as arthritis and indigestion, and on up the severity scale to heart disease and cancer.

Why haven’t you heard a ton of buzz about this book? Why is it not topping The New York Times bestseller list? Well, that’s probably because it was originally published in 1979, back when Amazon was just a river, and you couldn’t wish you had a book at your fingertips and make it a reality a few seconds later by pressing buttons on some newfangled, handheld doohickey. But just because something’s old doesn’t mean it’s not worth anything. (Just ask anyone who’s ever brought Great Aunt Hilda’s ugly bronze statue to the Antiques Roadshow and walked out $50,000 richer than when they walked in.) And hey, 1979 isn’t all that long ago, anyway. (Many great things—including me—are a vintage that goes back even further.)

So without further ado, I introduce to Norman Cousins’ classic, Anatomy of an Illness. Mr. Cousins was an editor for Saturday Review for over thirty years (1940s through 1970s), and was well-connected in the publishing world and Hollywood. My knowledge of him, however, is confined to this book, a chronicle of his recovery from debilitating illness. He takes us through his journey from barely being able to move to complete and total healing. Along the way, he speculates—profoundly keenly, for someone without a medical background—as to why and how he got sick, and shows us how his commitment to his own recovery (augmented by a supportive medical team) ultimately brought him back to wellness.

Cousins was way ahead of his time. This was the 1970s, long before acupuncture, massage, and Reiki practices were popping up on every corner like Starbucks, and when talking about “holistic” or “integrative” healthcare probably would have gotten a young student kicked out of med school. Back in the days of shag carpets and living room furniture perennially covered in protective plastic, Cousins was talking about adrenal exhaustion – something the modern medical establishment is only beginning to recognize for the epidemic it is (when they even believe it exists, which some people don’t). He acknowledged that his own stressful lifestyle probably played a leading role in his illness.

The basic premise of the book is that the ability to heal from even seemingly incurable and intractable illnesses is within us. In our bodies and minds, and when we give them the materials they need to rebuild and regenerate, they do. This could be a more nutrient-dense diet, therapeutic doses of vitamins and minerals, or JUST PLAIN LAUGHTER. Laughter, and lots of it. (If you’re a fan of Reader’s Digest, then you already know that laughter is the best medicine.)

Cousins, I’m sure, would agree with Voltaire: “The art of medicine consists of amusing the patient while nature cures the disease.”
Our bodies are incredible healing machines. They want to be healthy, well, and vibrant, and will generally stay that way unless something gets out of balance. Could be something we did or are doing, or it could be something we don’t even know about in our diet or environment. Whatever the cause, the solution—in most cases (but not all, obviously)—is threefold: remove the offending substance(s), give the body the good stuff it needs, and then stay the heck out of the way.
And speaking of the good stuff our bodies need, hospital food was no joke in Cousins' day:
“It was not just that the meals were poorly balanced; what seems inexcusable to me was the profusion of processed foods, some of which contained preservatives or harmful dyes. White bread, with its chemical softeners and bleached flour, was offered with every meal. Vegetables were often overcooked and thus deprived of their nutritional value.”
I wish I was kidding.
A man after my own heart! Jell-O, margarine, orange juice, white bread…my mother was hospitalized for an infection not long ago and her hospital-based registered dietician-sanctioned meals were appalling. Pancakes. PANCAKES! FOR A DIA-freaking-BETIC. (“Oh, no big deal, just take more insulin.” You have GOT to be KIDDING ME.)

But I digress…this post is supposed to be about the book, not nutrition. (Or lack thereof.)

Cousins was his own best advocate. He did a lot of research and suggested treatment ideas to his doctors—some of which the docs didn’t even know about! (Hey, those guys and gals were busy in the ’70s…they didn’t always have time to keep up with the latest journal articles. And if you think they’re less busy today, think again.) Some doctors were supportive, others not so much. (Turf wars are pretty serious stuff in healthcare. Not to mention lawsuits.) Cousins ended up leaving the hospital he was initially in for a treatment center where they were more supportive of him taking such an active role in his own recovery – especially when it came to some of the unorthodox stuff he wanted to try, like super-massive doses of vitamin C, and having marathon movie watching sessions composed solely of comedies shipped directly to him from his Hollywood buddies.

Trauma team? Yes, please.
Iridologist? Don't let the door hit ya
on the way out! 
Long story short, Cousins got well with a little help from his medical team, but his recovery was largely due to his own perseverance and his dedication to understanding the nature of his illness and the body’s mechanisms for repairing itself. I don’t want to bash conventional medicine here. Modern American hospitals are fantastic places, where very intelligent and hardworking people work their keesters off to make sick and injured people better. They seem to do much better with the injured than with the sick, though. If there’s one thing modern hospitals in the U.S. are great at, it’s trauma and emergency medicine. If I get hit by a car, please, by all means, get me a nice, modern ambulance, and speed me to the nearest nice, modern hospital. If I’m on the verge of bleeding out or losing a limb, do not call an acupuncturist, homeopath, chiropractor, or nutritionist. (If you do, I will punch you in the face…assuming I survive.)

But something modern conventional medicine doesn’t seem as good at is helping people really recover their health once they’ve lost it, or preventing them from losing it in the first place. Anatomy of an Illness shows us a couple of different ways that—even almost 35 years ago—treatment in modern hospitals was mechanized, institutionalized, and stuck in a paradigm of efficiency, schedules, and sticking to the script, even at the expense of patients getting better (y'know...the whole reason they're there). Cousins talks about:

“…the extensive and sometimes promiscuous use of X-ray equipment; the seemingly indiscriminate administration of tranquilizers and powerful painkillers, sometimes more for the convenience of the hospital staff in managing patients than for therapeutic needs; and the regularity with which hospital routine takes precedence over the rest requirements of the patient (slumber, when it comes for an ill person, is an uncommon blessing and is not to be wantonly interrupted)—all these and other practices seemed to be critical shortcomings of the modern hospital.”

Don’t get me wrong. Hospitals are businesses. They’ve got to make money. I get that. (I don’t necessarily agree with it, but I do get it.) They’ve got to have systems and processes in place to make everything work like a highly oiled machine so that not a single scrap of time or money is wasted. Fine. Except hospitals aren’t like shoe stores, toy stores, or any other retail outlet where you go in to buy something and then you walk out with it in a glossy bag. You give them money, they give you tangible goods. What you’re buying in a hospital—presumably—is your health. You pay the staff, they make you well.

But they can’t make you well all on their own. Like Cousins said, some of the procedures they have in place might actually interfere with you getting well. But more important, you’ve got to make you well. Remember, you are the customer, and you deserve to get the best care you can. (Or the best you can afford, which is a whole other topic that I won’t touch here with a ten-foot pole.) You are in the driver’s seat. You can fire a doctor. (Don’t worry; they can fire patients, too.) You can take charge of your healing, whether that means trying something unconventional or having the courage to suggest something new to your doc. (If you do this, be prepared. Don’t mention casually that you saw something about it on the interwebz; print out relevant peer-reviewed literature [if there is any]. Do enough research that you feel confident in your findings, and then stand your ground. Find docs who are willing to work with you. There are growing numbers of practitioners out there becoming as disillusioned with conventional medical advice as most of us are.)

Above all, be your own advocate. Remember, nobody wants you to feel better more than YOU DO.

Sorry ’bout that. Back to the book…
Other things Cousins talks about with surprising clarity and insight for someone outside the field are the stunning power of the placebo effect, the power the mind has over the body, and the overuse of “benign” things like aspirin and antacids, which do, in fact, have pharmacological effects and should not be given out like candy around the clock without doctors (or patients!) figuring out what is causing the pain or indigestion, and going after that.

“If ignorance about the nature of pain is widespread, ignorance about the way pain-killing drugs work is even more so. What is not generally understood is that many of the vaunted pain-killing drugs conceal the pain without correcting the underlying condition. They deaden the mechanism that alerts the brain to the fact that something may be wrong. The body can pay a high price for suppression of pain without regard to its basic cause.

I love it! So few of us recognize that pain, indigestion, hypertension, high or low blood sugar, and even acne and mood swings, are symptoms, not diseases. They are the canaries in our bodies’ coal mines, alerting us to the fact that something is wrong. Treating individual symptoms with laundry lists of potions and pills is like bailing water out of a leaky boat without ever stopping to patch the hole: you merely manage the results while the root cause continues wreaking havoc. Cousins knew his stuff, man.

And just in case you think the book is all about badmouthing hospitals, it isn't. Not at all. It's mostly about how to recover from illness by using methods that support and build the body, rather than further burdening and toxifying it. It's about what our bodies expect (nutritious food, adequate rest, sunshine, laughter, and joy), and what they don't (relentless mental and emotional stress, apathy, processed and chemically manipulated foods), and how a lack of critical inputs, or too much exposure to damaging inputs, throws us out of balance, and how to get that balance back. (Hint: the answer usually isn't at the bottom of an empty pill bottle.)   

Have I said enough good things about this book? Okay, so maybe this post was a little long (a little?!), but think of it like a movie preview: I’ve given you some pretty great scenes, but there’s enough good stuff in between that it’s worth seeing the whole thing. If you’re interested in recovering or maintaining your own health or want to help a loved one do the same, check out this book. In the words of Ferris Bueller, “It is so choice. If you have the means, I highly recommend picking one up.” (Of course, he was referring to his friend’s father’s 1961 red Ferrari GT California, but you can get Anatomy of an Illness for pennies, and no credit check!)

A great book to read this summer when it’s sweltering outside and you just want to spend all day on the couch in the A.C. It’s a quick read. Won’t take you more than an afternoon or two. And who knows? Ya just might learn somethin’!

A little book learnin' never hurt anyone.

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