About Us

Ann McKay, R.N.C., John McGonigle, M.D. and Mark Brody, M.D. have devoted themselves to homeopathy and related alternative medical treatments. In keeping with the spirit of homeopathy's founder Samuel Hahnemann M.D., we utilize treatments that emphasize safety and the restoration of the sick to health.

Monday, February 22, 2010

Beginnings

I began my own homeopathic journey because of growing frustration with my practice. It seemed that too often, too many people were not responding well to all of what my many years of training had taught me should help them. I think of a young woman who I saw for several years, sometimes 2, sometimes 3 times a week in a psychoanalytically oriented psychotherapy. I thought I was doing pretty good work with her. After several years, it was hard to find anything all that different about her, much as I wished to justify all of my work. Finally she stopped coming in after her father, who had been financing her psychotherapy up until then, pulled the plug. I remember feeling dismayed and vaguely resentful that he didn't understand the deep and meaningful journey towards health that his daughter had undertaken. That was one half of me. The other half thought he was probably right: she wasn't getting any better, so why keep forking over $1000.00 or more a month for that?

I also think of a hospitalized young man who had tried over many years just about every medication that modern psychopharmacology had devised, without a mote of improvement. While it seemed to me pretty obvious that the correct conclusion to this fiasco of medical care was that medications just didn't work for this individual, I still had colleagues encouraging me to try yet another newfangled medication, because he had never been on it before.

Modern medical treatment can help, but all too often, especially in psychiatry, it produces no improvement, or only partial improvement. It is often a long and expensive affair. It may be complicated by side effects, either the life-threatening kind, like anaphylaxis or neuroleptic malignant syndrome, the slowly wring-the-life-out-of-you kind, like metabolic syndrome or tardive dyskinesia, or the slow torture kind, like sexual dysfunction, weight gain, dry mouth, or personality suppression. Overall, it's a very mixed bag, and I felt almost ashamed to tell patients, or the families of my child patients that this was the best I had to offer.

While it was a lack of results that launched me into homeopathy, it was not long before other reasons grew alongside to buttress my interest in this brave new field. Not the least of these were the sordid tales that began to multiply during the first decade of the 21st century about the unsavory behavior of pharmaceutical industry -- suppressing unfavorable data, currying favor with physicians to improve sales, paying off politicians and government agencies to protect their economic interests, and masquerading as having only the noblest of motivations for all their actions when it was clear that economics were playing a huge role.

The actions of doctors added to my sense of outrage. Doctors were developing lucrative relationships with pharmaceutical companies and medical device industries, but continued to deny that pharmaceutical companies' gifts influenced their prescribing habits, even though pharmaceutical company research showed that it did. Even worse, they had the chutzpah to say that it affected their colleagues prescribing habits, but not their own. This was yet another poke in the eye.

The extension of marketing into television took advertising to a new low. Television advertising revealed the most base pandering to people's fears and the shameless use of not so subtle psychological tools by the advertising industry to increase sales. All this was repugnant to me. It made ever so ridiculous the claims of so many high-browed physicians that we ought to be practicing evidence-based medicine. The evidence seemed very clear that chicanery-based medicine was the prevailing culture, not scientific medicine.

The actions and inactions of the FDA, and the lack of reaction to their missteps by the media has been the coup de grace. That so many drugs could be permitted to be put on the market, at the cost of so many lives and injuries is horrible to contemplate. From the latest squabble over Avandia, going back to Vioxx, HRT, SSRI's, and the whole lot of drugs that have been black-boxed or withdrawn from the market over the past decade, it seems that the industry should be held in disgrace. Yet because of their financial pull, they remain in relatively high standing with the media, physicans and the populace. It still seems people can't get enough drugs, except, that is, when they are trying to detox from them. The scandalous level of missteps and miscalculations by the FDA in regulating the medical device and pharmaceutical industry and safeguarding the public welfare has been brushed aside by the media as a virtual non-issue. I guess we still need our drugs, even if they are being produced under conditions of criminal negligence. A doctor would be sued for such negligence.

This, dear reader, has fomented my interest in homeopathy. Homeopathy is a fascinating and wonderful field, but, to be honest, it's pretty difficult to master, it's a lot of work, and it is often frustrating, in terms of less than desirable results, being very time-consuming, and it is not the most lucrative field, unless one wants to restrict oneself to treating the super-wealthy. When I look at the alternatives though, I find I have to turn back to homeopathy. Homeopathy is safe and often effective. It fails a lot, or offers only partial benefit. But it is completely non-toxic. It is relatively free of adverse effects, and virtually completely free of any serious adverse effects. Treatment can often lead to a complete resolution to a health problem, or to a sustained benefit without the need for ongoing treatment. It furthers our patients' health in general. It is inexpensive. It can amaze and astound, although this is merely a side effect. It is always challenging and interesting for the practitioner. It is free from noxious and immoral financial influences (which is also why it is not more lucrative or popular). It is holistic, in the sense of viewing not only the local problem, but also the patient's overall health, physically, mentally, spiritually, and interpersonally. It can positively effect most major as well as minor illnesses. It can bring hope when all else has failed. It is a good friend to humanity. Perhaps one day humanity will understand this more. In the mean time, we homeopaths need to work on improving our skills. Because nothing speaks more loudly than our success.

Sunday, January 31, 2010

What is health?

An upcoming psychoanalytic conference in my town will be addressing the challenging question,"What is mental health?" This will be answered from a psychoanalytic perspective, presumably, which will shed some light on the matter, no doubt, but is likely to be somewhat unidimensional, because of the monochromatically psychoanalytic perspective. Cognitive and behavioral psychologists might define it quite differently, and biologically oriented folks would have their own viewpoint too.

As a homeopath and partisan of bio-energetic healing modalities, I thought a more broad view of health itself would be valuable to the discussion of what mental health is. After all, isn't mental health a subset of health?

In tackling this question, I started with the homeopathic answers proferred by Hahnemann, but quickly bumped up against a number of unsettling questions. First, we tend to assume that the physically sick person is not healthy, but what of the physically well person? Are they by definition healthy? For those with mental illness, the answer seems simple enough - of course not, they have an illness that affects their mind or their brain, whichever you please. But this seems a bit narrow still. Is the sum total of human function a matter of mind and body? And what about those who have been derogatorily referred to as the "worried well" or "neurotic"
individuals. Do they have "mental illness" or is this some type of non-illness problem?

Let's consider the individual who engages in criminal or abusive behavior. They appear to have a moral defect, as they do not seem to feel guilty about their behavior. Or perhaps they are just impulsive. Is lack of morality an illness? What about poor impulse control?

What about those well adapted folks on Wall St. who scammed poor America and our government into wrecking our economy? Is greed or perfidy an illness? Or is it just an example of healthy capitalism (caveat emptor!)?

Some of us may be quite well adjusted in some ways, with no clear mental or physical illness, but have greatly troubled relationships, that cause us a great deal of stress. Is stress an illness? How about relational difficulties. Does being healthy mean you should have harmonious and successful relationships, or does this go too far?

Then there are those of us who seem to get along apparantly quite well, but who live what Kierkegaard describes as "lives of quiet desperation." These individuals seem to be spiritually adrift. They may include hedonists and materialists, or those for whom what Hahnemann termed in the Organon "the higher purposes of our existence" are irrelevant. Is it necessary to have some type of spiritual vibrancy in one's life to be healthy? Is there such a thing as spiritual health?

In many religions, a high premium is placed on altruism or giving to and sympathy for others. Does this mean that those who give more are more virtuous? Is there such a thing as healthy selflessness? What about healthy selfishness, as Ayn Rand (and Neitzsche) proposed. Is being virtuous a sign of health? It seems easier to regard lack of virtue -- i.e., miscreancy, turpitude and subterfuge for example as signs of illness. It is not uncommon for one to hear those who commit horrible crimes referred to as "sick." But does this mean philanthropists are necessarily morally healthier than the rest of us?

Many of these questions have no easy answers, of course, but the point is that our definition of health can be as broad as we would like it to be, and it can easily be too narrow. It may include, along with what I have already mentioned, namely, physical health, mental health, interpersonal health , moral health, and spiritual health, any number of the following:

Creative health. Isn't being a creative individual a healthy thing, and being dull and unimaginative a sign of our failed human capabilities?

Social and community health. In that we are social creatures, isn't it a necessity for us to be connected to our neighbors and community, with which we share an interdependent relationship?

Economic health. Can we truly be healthy if we are poor? Isn't poverty a sign that we have not succeeded in the basic biological function of self-sustenance?

Environmental health. How can we be considered healthy if we are constantly destroying the world which gives us life? To thoughtlessly pollute and defile the earth, and undermine the earth's livability for our descendants if not us seems to be manifestly against the interests of our health.

Mental health might be broken down into various components: there is cognitive health, which itself can be dissected into various capabilities, such as verbal reasoning, mathematical reasoning, spatial conceptualization, executive function, problem solving and abstract reasoning.There might also be categories for emotional health, perspective taking (also known as ego functioning), flexible thinking, empathic abilities, the ability to separate emotion from thought, or to recognize emotional reasoning in oneself, and verbal and non-verbal communications skills. One might leave a space for intuitive capabilities as well.

This leaves us with a potentially colossal list of parameters to track in our patients. When someone comes in with a sore throat or sleep problems, should we be looking for signs of ill health in all of these areas? The answer is probably that there just isn't time. But it is useful, as we get to know our patients as individuals a bit better, and those of us who do primary care, or have long term treatments with our patients will get to know our patients quite well, that there are multiple realms of health. And when our treatment is truly helpful, as deep healing sometimes can be, we are apt to see improvements in all of these realms.

It is also worth thinking about, as we try to "educate" our children, that just teaching the curriculum created in most of our schools is just a small part of what we should be doing to mold our children into healthy, vibrant, and successful adults. There is a moral, spiritual, social, interpersonal, emotional, community, and global developmental process going on along with the cognitive development, upon which we put so much emphasis. And intangible as these developmental processes may be, we as adults neglect them at the peril of our children. A roof over their heads, good food, clothes and reading, writing and arithmetic are only the platforms from which are children are launched into lives potentially rich and deep, or poor, shallow and riddled with the subtle or sometimes not so subtle stigmata of ill health.

Sunday, January 17, 2010

Doctor knows best

In the beginning, learning and practicing a new type of treatment, homeopathy, I felt I had undertaken a revolutionary change. It was a confession to myself and my patients that my training as a psychiatrist and child psychiatrist was inadequate to the task I had taken up so many years before. After 8 years of practicing and studying in my chosen field, I had essentially given up on my long nurtured hope that the field could provide the necessary tools to a successful practice. By successful, I mean having successful outcomes, not having financial success. It was also an admission to my colleagues that I had found the practice of medicine wanting. Although I certainly was not the first to reject the calling I had once embraced, there was a very personal sense of guilt in effectively criticizing what had been given to me with what had appeared, for the most part, to be a sincere and honest effort to develop my professional capabilities.

Now 10 years after my personal peripety, my questions have turned to other matters, although there is still some lingering discomfort over what in some manner, still feels a little bit like a betrayal. As my skills in homeopathy developed, it slowly became apparant to me that homeopathy, much as I love to practice it and broadly applicable as it is, still is unable to touch many of my patients. Thanks to the inspiration of some of my homeopathic mentors, I've undertaken to learn yet another modality, Bowenwork. This type of body work, named for the late Australian Tom Bowen, is perhaps somewhat more narrow in its scope of action than homeopathy, but quite inspired, and sometimes able to produce results where homeopathy (and allopathy) have failed. It has all the hallmarks of what I consider a good treatment to be: high success rate, gentle, with low morbidity (and no mortality), quick results (at least measured by the standards of modern medicine), low expense, and broad salutary effects, not merely to the symptoms or illness of clinical focus, but, above and beyond that localized problem to the patient's overall health.

As the power of Bowenwork has opened up to me, it has come into my awareness that these both Bowenwork and homeopathy are but two of many unconventional approaches to treating illness which have as a primary goal improving the individuals' overall health. Indeed, I can now see that it is possible to divide health care into two broad categories: the health-promoting and the illness-managing. Conventional medicine, for the most part falls into the illness managing category. In spite of its greater status, conventional medicine is relatively bereft of tools to improve health. All of the conventional research and treatment that is done in the great social/medical problems of our times --smoking, drug abuse, nutritional problems, lack of exercise, and iatrogenic illness, has yielded little to medical treatment. Although many fine people in ancillary services, such as dieticians, respiratory therapists, physical therapists, social workers do commendable jobs, often exhausting themselves in the process, the medical acumen they bring all too often leads to rather disappointing results. The limitations of the drug-oriented and surgery-oriented physician's services are well-reported in the scientific journals and in the many books available in the popular press on the pharmaceutical industry. Ultimately, while much good does occur, little is accomplished to make people healthier. The diseases are being well-managed, but the diseases persist, and now often are complemented by new drug-induced illnesses, which have to be managed themselves.

The implications of this are profound. In promoting health, a good deal of illness may be ameliorated if not eliminated. This leads not only to happier outcomes (who doesn't want to get better?), but also to fewer consumption of resources in those who do experience broad health improvements from their treatments. If you are healthier, it stands to reason you need fewer health-maintaining resources. What conventional medicine calls health is in fact a misnomer: it refers to the illusion of health created by a menagerie of pharmaceuticals that keep illness out of awareness by suppressing the symptoms of illness. Why doctors and in fact a whole health care industry would prefer to maintain this illusion of health rather than deliver the real thing should not be much of a mystery. Physicians want the best for their patients: they simply have no training in health. The modern health care worker (of the conventional stripe) is an expert on illness, but severely challenged when it comes to understanding and improving health. Modern health care is expert at removing the symptoms of illness, but not in making us healthier. And when we can't make you better, we sometimes just take out what is ill and replace part of you with a machine or other device, as in hip replacements or valve replacements.

Physicians are thought of as experts in health. In fact they know less about it than many lay persons. It was only after I learned about health for myself that I realized how little I had known about it. The public at large, the media, and most of the health care world will continue to believe that the high cost, high intervention, high risk approach to health care that our current medical system has become is the supreme wisdom as long as the illusion that the doctor knows best prevails.

Saturday, January 2, 2010

The Peculiar Inspiration of Allopathy

I was a reluctant convert to homeopathy. Like many homeopathy patients, I came to homeopathy as a practitioner only in desperation, after having tried "everything else." After graduating from residency, I felt very well prepared to practice, having done 3 years of residency training proper and 2 years of fellowship. My training had been exemplary, and I had worked hard. I couldn't have been less prepared however, for how unprepared I felt as I began my practice. Whereas my mentors seemed to be sagacious if not omniscient in their guidance, the uncomfortable truth that slapped me in the face every day I came to the office was that my patients weren't getting much better. Sure, some improved, but so many did not. I went back into supervision, which I now had to pay for, and then sought additional training for 3 years at the local psychoanalytic institute (Boston Psychoanalytic Society and Institute). 6 years after graduating from residency, I felt oh so much smarter and more skillful, but the uncomfortable truth of treatment non-response continued to smack me in the face. All of my years of training had made me a much better physician and psychiatrist, but patients didn't seem to care. There continued to be far too many cases where improvement seemed so tenuous, so evanescent, so intangible that I could hardly congratulate myself on my good work. It was my own failure to acheive what I thought my medical training should enable me to achieve that sent me, as an act of desperation, for something "other."

It was only a few years after this, after much exploration, both inward and outward, that I found myself dispensing my first homeopathic remedies. To say that I lacked confidence in my first sallies forth into this realm could not be more of an understatement. I found myself looking at what I was doing and praying that it wasn't some incredible bone-headed act of folly that at some future date would represent to me, in utmost mortification, the most colossal failure of judgment in my entire life history. Even to this day, I sometimes reflect upon what I do, and how I describe myself and my work to my patients, and wonder briefly whether I am sure about what I am doing.

What has sustained my commitment throughout has been a combination of things: inspiring mentors, the wisdom of Hahnemann himself, the success stories I read about in journals and books, or hear about from colleagues, my own personal successes, and above all, the inspiration (in a negative sense) of allopathic medicine. Regarding the latter, although allopathic medicine continues to be a significant part of my daily practice, it is there more out of reluctant necessity than desire. Although a lack of success (as I defined it) drove me to expand my boundaries outside the realm of conventional medicine, my grudge with allopathic medicine has metamorphosized into a different creature altogether nowadays.

What irks me most about modern medicine is a congeries of quarrels of more momentous importance than mere lack of efficacy. I list them here in no particular order:

  • Modern medicine all too often (most of the time, to be sure) offers only palliation when a cure for the problem is possible. We have become so used to expecting that relief from symptoms and acceptance of the chronicity and inevitable slow progression of illness is the most we can expect from our medical care. How tragic it is that the majority of people could experience true improvements in their health, and expunge all or part of their illness, but choose not to do so out of ignorance. It is unconscionable to me, as a homeopath, not to offer to people the possibility of getting better when I know that it exists. If I fail to acheive a cure, palliation then seems more acceptable as a second choice.
  • Modern medicine refutes the possibility of cure largely out of ignorance and a mind-boggling lack of curiosity about the untapped potentials of approaches to healing that fall outside the tight box of orthodoxy. While healthy skepticism always deserves applause, the attitude of modern medicine smacks too much of elitism for my tastes. Elitism repels me, and pushes me towards those with more broadminded ways of thinking. Conversely, I might add that elitism sometimes exists amongst homeopaths and other schools of thought, medical or otherwise and is something that sours me, whenever it is apparant, and in whoever.
  • Modern medicine is so technologic that it seems to lose its connection with the human. The wish to make medicine more scientific is admirable, but what we see in modern medicine is a gradual erosion of humanism. There are spokespersons for humanism within the conventional medical world, to be sure, but they often appear to be the voices of reactionaries speaking out against the massive and more prevalent inertia of the techno-medical world.
  • There has been a disturbing lack of honesty amongst the dual forces of the pharmaceutical industry and modern medicine. The mercenary activities of physicians in the service of the pharmaceutical industry has demonstrated that physicians are just as corruptible as anyone, and just as willing to lie or distort about their corrupt activities as anyone as well. The suppression of research, the fudging of data, the massaging of statistics, and the failure of the medical industry, including the FDA, to ensure safety of the medical devices and pharmaceuticals that are permitted on the market has perhaps more than anything else, turned me away from these industries and what they represent. Thich Nhat Han, in one of his books, encouraged the idea that when you eat, you not only consume the food itself, but the energy that went into producing it. When this is the energy of humans trying to bring to other humans something of use to them, to help them become healthier, then we consume a healthful product. But when we consume something that is manufactured in a spirit of dishonesty, with undue emphasis on profit and personal gain, and with a negligent attitude towards those who purchase that product, we absorb into ourselves this dishonesty, this greed, and this insensitiveness. It becomes a part of us. This may not be provable, but it makes a certain kind of sense to me. I do not feel I am offering something that is truly an agent of health and positive change when I offer products that are made in this spirit. So, helpful as these products are in one sense, they violate my moral aesthetic, so that even if their effects are measurably beneficial, the symbolic noxiousness of them still repels me.
  • While the moral repugnance of dishonesty, greed, and, irresponsibility are in themselves certainly enough to make me want to run in the opposite direction, the actual harm that is done because of these factors and because of the medicines themselves is also a powerful deterrent to using conventional medical treatments. Statistics (for what they are worth) have repeatedly shown that iatrogenic illness, whether in the form of nosocomial infections or iatrogenic harms (through exposing people to radiation, drugs, or other risky procedures, including surgery) is consistently one of the top causes of death and disability in our country. I find it hard to recommend wholeheartedly treatments that have even a small risk of harm, when that harm may be irreversible, fatal, and possibly avoidable. It is small consolation knowing that other physicians have no compunctions about making the recommendations that I eschew. I know they have a different perspective, and it is one that does not make sense to me.

So, while many of the healing practices that comprise alternative medicine sometimes lack the rigorousness of much of modern medicine, which at least espouses to be science-based, if not to go to the even higher ideal - being representative of the truth about health and healing, they also lack many of the dangers and moral flaws of modern medicine. I do attempt to see the virtues of both sides, because they both do have virtues, but regrettably, the transgressions of the conventional medical system have morally tainted them in my mind. Homeopathy inspires me, interests me, and convinces me, but I continue to come to it not just because of these feelings, but also from a very different set of feelings that allopathic medicine awaken in me.