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Friday, March 17, 2000

'Healing power' requires the human touch

Patients facing surgery fare better when physicians foster a healing environment and encourage patients to participate in it, said psychiatrist, author and lecturer Carl A. Hammerschlag, MD, in an instructional course entitled "The Journey of Heroes: Utilizing our Healing Power."

"What we minimize as the 'placebo effect' is simply a manifestation of the importance of one's own participation in the process," he said.

To illustrate his point, Dr. Hammerschlag described a 10-patient study of arthroscopic knee surgery conducted in the mid-1990s in which patients were anesthetized and assigned to one of three procedures: scraping out the knee joint, washing the joint, or sham operation. Two years post-procedure, the sham surgery patients reported the same amount of relief in pain and swelling as those who had the real operation.

This phenomena cuts across cultures, according to the speaker, who described a study in which Japanese subjects acutely allergic to poison ivy were put in a hypnotic trance and rubbed with a poison ivy leaf. In this suggestible state, some patients did not break out, while others rubbed with a leaf that was harmless, yet described to them as poison ivy, broke out.

"The fact that we have difficulty explaining it doesn't minimize the impact," he said.

Dr. Hammerschlag, who de-scribes himself as a doctor-turned-healer, has spent more than 30 years working with Native Americans. He spent 14 of those years as Chief of Psychiatry at the Phoenix Indian Medical Center in Phoenix, Arizona.

Patients get well not only through the "genius of our technology" but through "the spirit of our humanity", according to Dr. Hammerschlag. He noted a Massachusetts General Hospital study, in which patients who had a 10-minute conversation with an anesthetist one day before surgery had significantly less post-operative morbidity than patients who had no such discussion.

Physicians who strongly emphasize their professional role over their role as a healer "dramatically underutilize" their healing power. Deprived of that aspect of care, people seek out alternative sources. "There is a desperate need for that kind of contact-not solely the genius of your hand, but the capacity of your heart."

Economic pressures are making this kind of outreach more difficult all the time. Dr. Hammerschlag noted that the average time a physician spends with an individual patient today is 6 to 8 minutes, down from an average of 20 minutes some 25 years ago.

Even so, physicians may minimize the impact of care if "we deny patients the privilege of not only touching our heads, but touching our hearts," he said. "This is not a business-it is a healing ministry, though the contemporary atmosphere tends to steal the spirit and reduces what we do simply to some 'customer relationship' in which customer service does not become the primary motive of our connections."

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