We’re at a crossroads for the future of healthcare and, indeed, for our approach to urgent issues such as climate change. Will we fall into the trap of seeking technology solutions or is there a deeper approach? – Robin Youngson
My phone rang and I heard my favourite request for help: The ER doctors had tried and failed to insert an iv line in a patient with ‘poor’ veins. As the duty anesthesiologist, I could offer some advanced procedural skills but also empathy and kindness for a suffering patient.
This patient was anxious and had abdominal pain. Four dressings covered bruises on her hands and arms from earlier, unsuccessful attempts at iv insertion. I built some rapport, empathised with the patient’s distress, and sought her permission to search for a vein. I could see why others had struggled with the procedure, there were no visible veins. The patient became agitated.
The last time I faced this challenge, I resorted to a hi-tech solution. I asked the nurse to fetch the ultrasound machine and then I spent some time scanning for bigger veins deep in the tissues. Having found a suitable candidate I first used local anaesthetic, to numb the skin, then I advanced the needle and cannula into the deep vein, guided by the image on the ultrasound scanner. It’s a delicate and tricky manoeuvre requiring some skill and hand-eye coordination. I guess the whole procedure took me twenty minutes and needed a $15,000 scanner, which is not available in many departments. My success at this difficult procedure was a boost to my self-esteem.
On this day I took a radically different approach. Noting agitation, I asked the patient if she had a needle phobia? The story emerged of a severe, life-long phobia since the age of four when she was forcibly held down by a doctor and hurt with needles. I explained to the patient that a simple healing technique could permanently erase her needle phobia and it would only take about ten minutes. Would she like me to do that?
The patient was quite surprised but agreed to try it. I used a neuroscience-based technique called Havening Touch® and helped her to erase the neural pathway that encoded the distress, fear and pain of the trauma she suffered at age four. Less than ten minutes later, she was unable to recall any distress or fear related to the memory. When I asked her how she now felt about needles, she said ‘It’s just OK,’ shaking her head in some confusion and disbelief.
Now when I examined her hands they were warm, rather than pale and cold, and the veins were dilated and easily visible. We know that fear constricts the veins; if you relieve the fear, the constriction goes away. I quickly and painlessly inserted an iv line, using local anaesthetic. The entire procedure including healing the needle phobia and inserting an iv line took me perhaps twelve minutes. It’s my belief that her needle phobia is permanently erased so her future hospital care will be a lot easier. I left the ER with a deep sense of wonder and gratitude at the miracle of healing, which feeling lasted the whole day.
What we can learn from this story
It seems to me that this little story is a microcosm of the challenges we face in healthcare and beyond. Both approaches solved the immediate problem but they have very different long-term implications.
The first solution involved expensive new technology and advanced technical skills. The patient was a passive participant and is now dependent on the same hi-tech approach whenever the problem arises again. It was only a temporary fix. Despite these disadvantages, complex technology is our immediate go-to solution. Our modern society is addicted to technology and we see it as the solution to disease, declining crop yields, security issues, climate change and all the other complex problems we face.
The second solution used a radically different approach. It perceived the patient not as a passive participant but as a living being with remarkable powers of self-healing, which allowed us to collaborate in finding a simple and long-lasting solution without the need for technology. This strategy requires a skill set very different to that emphasised in my medical training. As the practitioner, I didn’t do the healing; I created a deeply safe, compassionate connection with the patient and used a combination of scientific knowledge, intuition and technique to facilitate the innate healing mechanism. I recognised that the patient’s problem was related to early-life emotional trauma, which can have a life-long impact on physical health and physiological function.
Let’s look at another example of the two different approaches, this time in agriculture.
Many farmers are embracing hi-tech solutions such as the use of drones for geo-spacial mapping and automated systems for precision application of fertilisers and pesticides. Ok, I’ll admit this is an advance of sorts, farmers can reduce input costs, improve yields, and reduce the harmful runoff of chemicals. But it’s still a hi-tech, temporary solution that doesn’t address long-term soil degradation and environmental damage.
The second (healing) approach is to convert the farm to multi-crop organic farming and to tap into the regenerative and self-sustaining properties of natural systems. The UN says this is the only solution to feeding 9 billion people:
Small-scale farmers can double food production within 10 years in critical regions by using ecological methods, a new UN report shows. Based on an extensive review of the recent scientific literature, the study calls for a fundamental shift towards agroecology as a way to boost food production and improve the situation of the poorest.
‘To feed 9 billion people in 2050, we urgently need to adopt the most efficient farming techniques available,” says Olivier De Schutter, UN Special Rapporteur on the right to food and author of the report. “Today’s scientific evidence demonstrates that agroecological methods outperform the use of chemical fertilizers in boosting food production where the hungry live — especially in unfavorable environments.’
In the developed world, organic agriculture is more labour intensive and the ‘profits’ are less than industrialised farming. However, if we use an accounting system that includes externalised costs – such as environmental damage – both the short-term and long-term economics of this approach are evident. And don’t we want more jobs where workers spend their days in a healthy, chemical-free environment, doing deeply meaningful work, building their deep knowledge and intuition of natural systems?
If we are to save healthcare and indeed the planet, we have to invest in solutions that tap into natural healing and regeneration, which are bountiful in complex living systems including human beings. Technology is wonderful but not when it traps us in chronic ill health or environmental degradation.
The healing solution is also the answer to the politics
Scientists are in agreement that the issue of climate change is a political problem, not primarily a technical one. Renewable energy generation is already cheaper than burning fossil fuels. But we need radical changes to agriculture, housing, transport, manufacturing and material management. The technical solutions already exist but the politics of climate change have become extremely polarised and even violent. Consensus seems impossible, even in the face of dire warnings of imminent and catastrophic climate change.
The same is true in the politics of healthcare; it’s become a fiercely fought, partisan issue.
When I look at the extreme behaviour of politicians in the USA and many other countries, I see the symptoms of trauma. When patients present to doctors with unregulated emotions, sudden outbursts of fear and rage, and extreme sensitivity to being ‘triggered’, we diagnose Post-Traumatic Stress Disorder (PTSD). Are these not the exact same behaviours we are seeing in our politicians?
There is no technological fix for PTSD, no drugs that help in the long run. PTSD is cured when the underlying trauma is healed. Likewise, there is no technological solution that can save us from the lack of political consensus and action on healthcare or climate change.
Dr Gabor Maté, the famous international expert on trauma and addiction, says that the opposite of addiction is not sobriety, it’s social connection. Criminalising drugs does not reduce drug addiction but treating it as a health problem and giving addicts compassion and support is much more effective. Perhaps the solution to our addiction to fossil fuels is not legislation that bans oil and coal but an approach that binds us together in a common humanity?
Our ideals of leadership often involve charismatic and heroic individuals who claim to have the solutions to complex problems and can mobilise popular support. But what we need now is a politics of healing, not a politics of persuasion.
Perhaps we need less ‘leadership’ and more ‘healership’? The politics of consensus require non-judgment, compassion, humility and generosity – these are the qualities of healers, not ego-driven leaders. Technological solutions are leading us to scarcity but healing solutions lead us to abundance. I know which I choose.
Most leaders are deeply passionate about their causes. But the root of the word ‘passion’ means pain. Many leaders are operating out of their emotional wounds, which subconsciously shape their thoughts, feelings, emotions, motives and behaviours. In my campaigning for more humane and compassionate healthcare, these emotional wounds led me to anger, judgment, righteousness and a need for approval and status. When I healed these wounds, I became a dramatically more effective leader and a more deeply compassionate and healing doctor. I share those lessons in my TEDx talk.
To be the healer means to transcend your own suffering, to heal your own wounds. This allows you to deeply know the miraculous potential for healing in others. And it allows the development of empathy, compassion, non-judgement, humility and generosity. This is where global issues become personal. What’s the most radical action you can take to address climate change? Maybe it’s establishing yourself in loving relationship to all living things including your fellow citizens.