Musings Of A Modern Day Witch Doctor

Musings Of A Modern Day Witch Doctor "Healing the Mind*Body*Spirit" by Rick Chavez, M.D. \Phy*si"cian\, n. [DE. fisician, fisicien, OF. physucien, a

physician, in F., a natural philosopher, an experimentalist in physics. See Physic.] 1. A person skilled in physic, or the art of healing; one duly authorized to prescribe remedies for, and treat, diseases; a doctor of medicine.

Synonyms: bones, butcher, croaker, doc, expert, general

practitioner, healer, intern, medic, medical man, medicine man, medico, physician, professor, quack, sawbones, scientist, specialist, surgeon, curandero. Roget's Interactive Thesaurus captures all the definitions of a doctor. In the many years of practice as a "physician", shaman, "witch doctor", "healer", and Curandero, and not necessarily in that order, I discovered that the one key "clue" in diagnosing what I have come to call the "pain paradox", is very simple--so simple, it seems obvious. But it isn't. How many times has a patient come to me, at the end of their pain rope after having seen countless physicians: anesthesiologists, gynecologists, rheumatologists, neurologists, orthopedists, neurosurgeons, and the list goes on with despair in their eyes, hoping that their visit to me will be their .last. The numbers are great. Nearly eighty million Americans suffer from some form of chronic pain. As Medica! Director of The PA.I.N. Institute it is my mission to help patients reclaim their lives: painfree or as painless as possible. Not an easy task. A few years ago, I realized that there was something sorely lacking in our system of health care when I had the opportunity to do utilization review for a very large Medical Group in the South Bay. Patients suffering from slipped disks, sciatica, pinched nerves etc. had series after series of costly epidurals and other injections with little, if no results. Yet most of them continued to get more injections knowing that the chances for their pain relief were slim to none. Case after case proved my hypothesis. It was time to get back to my roots, time to embrace my Native American Indian and Mexican heritage. As a young boy growing up in Northern

California, I spent summers roaming the high sierras of Modoc County with my great Aunt Bessie, a member of the Honey Lake Maidu Indian Tribe. Bessie was a wise "medicine" woman and natural healer. Sometimes I think that I became a doctor because I was so impressed with Bessie's healing skills. It was all a mystery to me at the time, but somehow I realized the role of the spiritual dimension for healing solutions. In an age of high-tech, highly specialized medicine, complicated new machines, EMR, and laser technology, the ancient healing arts are a welcome alternative, especially when

"Which Doctor Do I 'Turn'To?"

treating patients in chronic pain. Be it a curandero or medicine man, the secret to their restorative powers were not only' the herbs, potions, rituals, etc. but also the "laying on of hands" personal approach. Mind, body, and spirit are all taken into account when dealing with the pain paradox. Curanderismo evolved from the culture that grew out of the Spanish colonization of Mexico hundreds of years ago. "Curar: to heal. Guadalupe is the Mexican embodiment of compassion. Her modus operandi was not different from my great Aunt Bessie's. Ultimately, the curandero's healing awareness is elicited from a wellspring of sympathy, Quite often, a practitioner is called upon to treat the physical symptoms that patients have come to believe will always exist. Among many Mexican-American communities, curanderismo is seen as an alternative form of medicine. It has remained popular because it offers a spiritual treatment for disease and illness which conventional medicine often fails to take into account. A perfect case in point occurred when a woman was referred to me by her primary physician. She suffered from chronic back pain for years, and had become addicted to Vicodin to quell the pain. I suggested that she might not be in pain, but that her body had become so physically and mentally addicted to eradicating her pain, she couldn't see the forest from the trees and that the Vicodin had altered her perception of pain. She was in denial. Initially, she scoffed at my diagnosis and thought I was minimalizing her pain. She had heard far too often that the "pain was all in her head," and she certainly didn't ~ want to hear that from me. I was the end of the line. Her last

hope. "La Cabeza"...Mind, Body, Spirit. The pain was both real and the pain was all in her head, if you get my gist. The mind is the body's most powerful instrument of healing. I discovered that years ago when I would watch my great Aunt Bessie, a woman of few words, work her magic on the sick. People came to her because they "believed" she would cure them or remove their pain, or whatever ailed them. And I was always amazed that a visit or two with Bessie would invariably cure their maladies. After ordering an MRI of my patient's back to reinvestigate what might be the root of her back pain, I discovered that there was no sign to indicate what was causing her chronic pain. After several visits and counseling, I recommended that she undergo chemical detoxification in the hospital, under my supervision. I also explained that I would be using a new drug that had a remarkable track record when it came to helping .

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ease the pain and discomfort of withdrawal, a safe, easy drug to use, one with minimal adverse side effects. The new drug was Buprenorphine, a derivative of thebaine. Subutex, and a buprenorphine/naloxone combination product, Suboxone@, was designed for use in opioid addiction treatment. I had my "magic potion" and my patient was finally willing to admit that she was addicted to her narcotics. That was the biggest hurdle in treating her. I had instilled "faith" in her: not only did she have faith in me and my diagnosis, but she started to have "'faith" in herself and her own ability to heal. Her treatment also involved family members who for such a long time had tried to be supportive, but they too were having a hard time maintaining the level of compassion needed to see their loved one through her struggles. Remarkably, my patient's stay at the hospital was relatively pain-free, and after five days, her body was completely devoid of narcotics. But the greatest miracle, as far as she was concerned, she had minimal pain! And she told me that she felt like a teenager again. Her body pulsed with a new energy and vitality that had been suppressed by the effects of the narcotics after so many years. This experience confirmed my belief that curanderismo should be looked at more closely by conventional medicine. I associated my patient's new state of "'wellness" with understanding her fears and beliefs while taking the time to listen to her pain complaints. I offered her a solution to her problem and she had enough faith and trust in me to give it her all. Shaman, Medicine Man, Curandero . . . Which Doctor is it? It is time for all physicians to continue to get in touch with our roots. Folk medicine, and especially good old fashioned caring and compassion, might help physicians treat their patients

more effectively. Taking the time to understand a patient's fears and beliefs, is crucial in treating people who suffer with chronic pain. Curanderismo has survived because it encompasses many healing traditions. A true multidisciplinary approach to pain management incorporates this philosophy. Treating the whole patient and not just the disease, is where the art of medicine comes into play.

This is an excerpt from Dr. Chavez forthcoming book, "Musings Of A Modem Day...Witch Doctor?" For additional information visit CaLMA's website

Ri Rick Chavez, M.D. is Medical Director of The Pain Institute at Little Company of Mary. is He is a Diplomate,of The American Academy of Pain Management, and The American Academy of Family Practice. Assistant Clinical Professor of Family Medicine at The UCLA David Geffen School of Medicine. Certified by The American Society of Addiction Medicine (ASAM)