The medical motif

Recently I was recommended a book.  The book was written by a physician (John E. Sarno, MD) and it addressed medical conditions – some of which (like chronic back pain) was not foreign to me.  Oddly the thesis of the work was mental care for physical ailments.

One thing that is abundantly clear about the cause and treatment of TMS is that it is a striking example of what might be called the mind-body connection. The history of medicine awareness of this interaction is long and checkered. Hippocrates advised his asthmatic patients to be wary of anger, which suggests that 2,500 years ago there was some appreciation of the impact of the emotions on illness. That concept was dealt a crippling blow by the seventeenth-century philosopher and mathematician René Descartes, who held that the mind and body were totally separate entities and should be studied separately. Matters of the mind were the concern of religion and philosophy, according to Descartes. The body, he said, should be studied by objective, verifiable methods. To a large extent, Descartes’s teaching remains the model for contemporary medical research and practice. The average physician looks upon illness as a disorder of the body machine and sees his role as discovering the nature of the defect and correcting it. Research in medicine rests heavily on the laboratory, and what cannot be studied in the laboratory is widely considered to be unscientific. Despite the obvious fallacy of that idea, it remains the guiding research principle for most medical investigators. The spirit of Descartes is still very much alive.

Tension myositis syndrome (TMS), also known as tension myoneural syndrome or mind body syndromeis a name given by John E. Sarno to a condition of psychogenic musculoskeletal and nerve symptoms, most notably back pain.

“According to Sarno, TMS is a condition in which unconscious emotional issues (primarily rage) initiate a process that causes physical pain and other symptoms. His theory suggests that the unconscious mind uses the autonomic nervous system to decrease blood flow to muscles, nerves or tendons, resulting in oxygen deprivation (temporary micro-ischemia) and metabolite accumulation, experienced as pain in the affected tissues.

Yesterday I had a telephone conference with my family physician. Aside from the routine discussions peculiar to an annual check-up (a custom which by the way is now avoided in place of response to prevalent need only) he arranged extensive bloodwork and a chest X-ray.  Both requisitions issued immediately from his office; and today I attended Life Labs and the X-ray department in succession. It speaks to the convenience of small-town living that both appointments were within minutes of my residence.  The fulfillment of those examinations is for me not a purely medical venture. I pursue the enquiries as investigation.  Admittedly it pleases me to complete that agenda so efficiently; however I do not discount the prognosis of Dr. Sarno. Indeed there often appears to be a direct relationship between my physical status and my state of mind. Once again it affords me an undeniable element of relief to have conducted those two matters.  The plain truth is that they were on my agenda and it gives me satisfaction to have completed their enactment.  Naturally I await the results – which I hasten to add are the curiosity and domain of my family physician.

Never have I interfered with the opinion of a professional upon whom I rely. This qualification captures my persuasion concerning the professionalism of those whom I consult. It prevents me from pretending to make critical decisions based upon amateur analysis. Nonetheless I retain as far as possible an open mind about any dilemma. It amuses me that Dr. Sarno introduced his key chapter “Mind and Body” by referencing René Descartes. The allusion was to a prime member of my Bachelor of Arts in Philosophy. I feel however that Dr. Sarno made an inductive leap when postulating that the mind/body distinction isolated the two. The entire “Cogito, Ergo Sum” chronicle affirms the interdependence of the two (there must be a thinking entity—in this case the self—for there to be a thought). Though the inclination is to dwell solely upon the legitimization of thought, one mustn’t neglect the other part of the conclusion; namely, the “thinking entity” or the body itself (or if you prefer to be completely sparse, the brain attached to the body).

One unmistakable result of allowing professionals to usurp one’s private diagnosis is the unwitting distance afforded by the abandonment. In an era when social-distancing is much touted, I must similarly rejoice that, having accomplished the research, I leave it to the professionals to sort out the conclusion. This is all part of the arrangement of order in one’s life.  Notably order is a mental condition; and as far as contentment goes, it is as much a part of enjoying life as repairing a scrape. I have no intention of diminishing the value of open-heart surgery or the implant of a Pacemaker, but within the sphere of medicine that I can fathom with some measure of accuracy, today’s adventures with the needle in the arm and the zapping of the abdomen render a welcome tranquility.