I wish that House MD from the long-running TV show were my real doctor: he’d start with my stated problem, notice symptoms didn’t even know I had, investigate my lifestyle, diet, home environment and personal history, write out all the possible causes on a large blackboard, systematically evaluate each one and come up with the final brilliant insight that would pull all the data into a grand unified diagnosis. Source identified, problem solved. If only real-life medicine worked like that.
Treating symptoms is easy; finding root causes is hard. No wonder real-life medicine is symptom-oriented: red pill for blood pressure, blue pill for cholesterol, white pill for thyroid regulation. Drug prescribed, problem solved. With one-off or short-term problems, this approach is often good enough.
But for chronic issues, treating symptoms without addressing underlying causes is like a game of Whack-a-Mole: smash down those symptoms, and whatever is aggravating the system will just pop up in another place. Pharmaceuticals are miraculous creations, but they are blunt instruments that often cause problems as they solve others. A lifetime of prescription medications seems like an idea born of convenience rather than wisdom.
Do we resign ourselves to chronic disease as an inevitable progression of aging? Epidemiological data point to many chronic illnesses – hypertension, high cholesterol, obesity, allergies, type 2 diabetes – not as a consequence age but of industrialized diet and lifestyle. I believe if we do the hard work to address root causes, we can all have a chance at unmedicated good health.
Like many others, I have a nagging but chronic issue. Mine happens to be eczema; yours may be sciatica, or arthritis, or a cough that won’t go away. I see a dermatologist; you may see an orthopedist, a rheumatologist, an otolaryngologist, or maybe even a whole series of specialists. Specialized medicine is well suited for serious injuries or acute illnesses, but it’s often stumped by unspecified ailments such as chronic fatigue, irritable bowel, fibromyalgia or many others. Even with eczema, the symptom is specific – skin rash – but the causes are anything but.
Doctors are only part of the solution. In today’s managed-fee environment, even the most caring doctors cannot afford to spend too much time with any one patient. Since root causes may lurk far from the symptoms, many health mysteries are unlikely to be solved by a single specialist. I play lead investigator in my own health mystery; doctors are expert witnesses who provide valuable insight and experience.
But as House MD always knows, the answers are not just in the medical office. You need to look at all the factors that feed into your body’s systems – where you live, food you eat, products you use, how you spend your time – then put that together with doctors’ theories and work to connect the dots. It can be a tedious exercise of trial and error. Even my wonderful dermatologist in California – a bright, curious researcher at Stanford – thinks the search for why is more trouble than it’s worth. We found cortisone creams that work, he says, why not rely on those?
But I know that the drugs tax my system, and after nearly 40 years of use they are less effective than they were. My eczema problem has gotten more severe in the last decade while my body’s response to steroid creams has diminished. Call me crazy, but I see a trend here, and I don’t want to wait around for it to get worse. I’d rather find the source and control the problem.
I believe a persistent health issue is our bodies’ way of sending the message that we are making choices it doesn’t like. We all have an Achilles heel, a weak link in the system. You and I may have the same problem but exhibit completely unrelated symptoms: my rash may be your migraines, sore joints or indigestion. For decades my body’s messages were polite taps on the arm. This winter’s message was a slap in the face. I’m paying attention now.
The good news is I might have some suggestions that may help you with your own chronic issue. And you might have some suggestions that could help me. So please speak up if any of this connects with you, and I’ll share with you what I’ve tried and learned along the way. My case is far from closed, but the knowledge I’ve gained has given me hope.