Why Many are Called, but Few are Chosen

Patients at times ask me an innocent question: if alternative medicine works so well, why are there so few physicians who do this kind of work? I wondered also when I was just starting out in orthomolecular psychiatry. I think this question deserves a thorough look . . .

Not all doctors, as you know, are the same. What’s more important, not all doctors’ hearts are the same.

I remember sitting in the library at the University of Utah as a pre-medical student. Across from me was a young man who was also a “pre-med.” We were talking about what we wanted to do if we were to get accepted into medical school. He looked at me with a confident gleam in his eyes and said, “I’m going to be a plastic surgeon, and I’m going to charge exorbitant fees for everything, because people think that the more you charge, the better the service.” I was struck speechless, wavering between admiration and shock.

Once I got into medical school, I saw the same habits that got so many students in, continuing, although these habits were neither necessary nor admirable. One common weakness that I noticed was that of being dishonest for the sake of appearances.

An example of this occurred during a physical examination rotation during my first year of medical school. There were four of us in the group, surrounding a fellow medical student, and the attending physician asked us if we could see our fellow student’s thyroid. Everyone said that indeed they could see the student’s thyroid–except me. The instructor kept pointing to the spot on the student’s throat, where the thyroid was supposed to be clearly visible, expecting me to be able to see it. And I obstinately stuck to my unseeing status. During my junior year rotation in endocrinology, however, I overheard an attending say to his colleagues, “The only thyroid these first years can see is one that’s enlarged!” At that moment I wondered if the other students who could “see” the thyroid weren’t just agreeing that the emperor had new clothes.

As I continued with my training, I saw the bizarre and twisted world of medicine– like a competition consisting of body builders who only exercised one side of the buttocks, but who neglected all other parts of the body– elevating and rewarding all the body builders with the biggest one-sided buttocks. Memorization was one major muscle on that buttock. Questioning was not.

Finally, after ten staggering years of training, as I struggled out of my highly educated corsets, I encountered another factor that posed as a selection barrier for doctors choosing alternative medicine . . .

A patient had been having uncontrollable jerking and spasms of muscles in his body for many hours, delaying a trip to the Emergency Room because of financial concerns. When the jerking did not stop, he finally gave in and went to the E.R. for help. Although the physician in the E.R. initially talked about his condition as a type of seizure, he changed his mind after he had seen the results on the EEG (electroencephalogram). After the EEG, he pronounced the patient as pretending to have seizures. He insinuated that the patient wanted to have his muscle jerks for attention, and he summarily referred him to a psychiatrist. The patient was incensed by the E.R. physician’s attitude.

Over the course of treatment, the patient’s problem with episodic “pretend” seizures disappeared with an anticonvulsant and reappeared when the patient became negligent about taking his medication. They were obviously linked to a physical problem regardless of what the insensitive EEG was unable to detect. The E.R. physician was so confident that he already knew everything–that everything could be detected through his trusted EEG– that he lost an opportunity to learn something new from the patient.

The “obstacles” to a physician choosing alternative medicine are not created artificially by selection committees. These obstacles exist because each physician, before they would consider alternative medicine, must pass tests of character. Like a warrior being tested by his teachers upon graduating from a mystical martial arts school in the mountains, these tests are both of brawn and heart.

The physicians that pass these obstacles have to demonstrate an uncommon level of courage, love, unselfish service, and humility. Physicians in alternative medicine must have the ability to be open-minded and flexible, to question accepted dogma, to maintain humility in the face of the unknown, to be advocates for patients despite the risk to their own licenses, and to have an ongoing love of learning as well as a healthy dose of curiosity. Alternative medicine offers few attractions to those who are greedy, hypocritical, rigid, and overconfident. It is definitely not for know-it-alls.

Yes, there are many good doctors in traditional medicine. Many are kind, do their best, and care deeply for their patients. But when the moment comes when these doctors encounter information that could be important, life-saving truths, but would cost them dearly to embrace . . . Let’s say that to embrace these truths they may become pariahs to their own colleagues, may face a severe loss of income, may flounder in the unknown for years, and may even lose their licenses . . . Then, how many of these kind, well meaning doctors would pass the obstacles that measure the readiness of their mind and heart for the challenges inherent to practicing alternative medicine?

Is it any wonder then that so many are indeed called to this work, but so few are chosen? Knowing the many obstacles that stand between the tradition-bound physician and alternative medicine, perhaps we should exclaim instead, “Why are so many physicians now going into alternative medicine!”