Warts And All

When first we moved to an office in a bohemian section of town, my marketing efforts were as naive as they were enthusiastic.  I walked into every shop in the neighborhood to introduce myself as a physician and psychiatrist who had recently moved in, and did some innovative things.

I especially remember my visit to a salon, where the customers, all male, (I said it was a bohemian section) told me about various troubles with their physical appearance; hardly my specialty, but I am open to doing what I can do in many context.

As soon as I returned to my office, I got a phone call asking if I could do a wart removal, and how quickly.  I declined. I cannot be all things to all people.

Years before, when I had been in the rural mid west, I found several booklets, published locally (usually by rural newspapers) of folk remedies.  Ever interested in alternative medicine, I bought a few, and had a collection for a while. Now it has disappeared in moving, like most things, but I have a vivid memory of the largest of them, purchased somewhere in Kansas.  It said something about burying a toad at a crossroads to make warts go away.

Move up to very recent.  The new frontier is clearly the mind and healing.  I have a book I dearly love, Claude Bristol’s “The Magic of Believing” which is not about believing as much as a then hard core news reporter who spent a long time, with an initially cynical attitude studying “fortune tellers” and others whom he thought were using the science of belief.

He cited the same method for curing warts; the one about burying a toad at a crossroads.  Also having someone count warts and make them disappear, and several similar “cures.”  His observation was that all of them worked, as long as the person invoking them believed in them.

He told how he had shared this observation with physicians.  The specialists were the ones he found most “closed minded” about these matters.  But one, presumably on some level a generalist, told him that many such cures had been documented.

I fully believe this, although I have not seen it work for warts, because I do not usually occupy myself with warts.

I do have one that bothers me.  I am highly unlikely to locate a toad to kill where I am in Southern California, let alone survive a crossroads without being crushed by oncoming cars.  Even if I could, belief is awfully hard to muster.  I know, like lots of people, that a wart is a viral phenomenon, so it is hard for me to generate any real belief in toads or crossroads.

I did tell myself the wart was not there, affirm it, focus on its not being there.  It has shrunk and flattened in a most impressive manner, and will probably disappear.

If for any reason it fails, there are lots of do-it-yourself methods on the net, which have do to with smothering it, first and foremost.

I can certainly buy this.

But most of the concoctions they tell you to put on it are difficult to attribute any antiviral action to.

There I go again, screwing up simple beliefs; maybe knowing too much for my own good.

They call it psychoneuroimmunology.

Most people seem to trace the genesis of the field to the guys who invented the word; Adler and Cohen at the University of Rochester. Basically, they took rats and gave them saccharine water with Cytoxan (cyclophosphamide) — a drug which is a nitrogen mustard and is used to treat some cancers and immune disorders by screwing up the DNA.
 
Now “conditioning” the central nervous system is well-known, I mean by now everybody has heard of Pavlov’s dog with the bell, the salivation and the steak.  The dog ended up salivating to the bell, even if he didn’t get a steak.

The rats ended up getting their immune systems messed up just by getting saccharhine wate (which does not by it self cause this) and some of them died.

This was the first real proof that the nervous system could affect an immune response.

I think general doctors have known about this, through inductive reasoning, for a lot of years.

At this point I think most decent clinicians have noticed that the psychological state affects the progression of illness.The person who thinks he or she is ready to die often does.

Someone with, for example, HIV can get an emotional upset before a decompensation. It is hard to find literature on this, but I have seen this.

Researchers seem to be looking for a mechanism by which this happens. I hope lots of them get tenure, but this is why I am frustrated with research.

Most data about the effects emotions have on healing seem to come from either wound care or infectious disease.

It would make a lot more sense to me if people were trying to use this to fix people.  I do not see infectious disease drowning psychiatry (or psychology) with consults in any system known to me.

Since happy immune-strengthening ought to work, I do it to myself.

I recently had to survive a four week assignment to a clinic so rich in mold in the air that several staff had come down with asthma.  I took precautions ranging from decongestants to walks around the building at regular intervals, working with an open door, etc.

Every morning before going to work my husband would play me some happy song videos. Perhaps the strongest involved tap dancing, for although some things are still tough to do, every time I tap it is “happy fun time.”

I think the most powerful was the number from Girl Crazy, “Bad mood go away…” which in other forms I used as my “antidepressant song and dance” with patients.

Show tunes!  Even if they are only tapping their feet in time, we need this in HIV wards…

I am talking science here.  Only a little of this is inductive.

Our idea of what constitutes medicine is crazy and limiting, being without solid evidence for its limits.  We limit how we can treat people in ways that are financial (who would pay a dance teacher to come into an HIV ward?” ) or ideological (I am sure plenty of people would volunteer.  Nobody seems to have asked….)

So much of life I cannot influence; only my world, my patients.  I can be optimistic and happy for them.  I can, very often, dance them through wating rooms and corridors.

I have tried explaining to incredulous colleagues.

Somewhere, I pretty much stopped caring what people thought of me.  I think that it is through my husband’s strength that I have learned what it means to be confident enough to rely on science I know is true, on opinions that seem wacky, when I know what is right.

We need dancing!