I will never forget attending a pediatric orthopedic clinic in medical school. I studied medicine in a town called Beer Sheva in the South of Israel that was a medical home to both local Jewish-Israeli and Bedouin-Israeli populations.
Since many Bedouin-Israelis intermarry, we encountered there some rare genetic disorders; one being a condition known as Congenital Insensitivity to Pain (CIP).
Kids with this rare genetic disorder suffer an essential absence of pain.
Why would I use the word suffer? I mean, would the lack of pain not essentially be a state of bliss, or at least a kind of saving grace? I learned by seeing children with this affliction, that the answer is no.
Kids with CIP don’t feel pain with stubbing their toe or forming blisters, bruises, sprains, burns—they can bite off pieces of their tongue, fingertips, develop ulcers, abrasions, infections, repeatedly traumatize their physical body and have no perception that harm has come to them because of their inability to feel pain. They lose limbs, have abnormal bony growth, suffer life-threatening infection—all complications of the lack of ability to feel pain.
Since then, I have often reflected on the life and limb-saving function of pain, even as I experienced different kinds of pain throughout the continuum of my medical training, both vicariously, and personally. Sometimes the vicarious pain I felt was unbearable. I used to ask myself in my residency training if there was a limit on the magnitude and variations on human suffering I could bear witness to, or try and ameliorate. It seemed limitless.
The magnitude of suffering we experience as healthcare providers forces us to develop coping strategies. In order to get through a day and accomplish everything we are asked to accomplish, we have to try and compartmentalize our feelings, push through our own fear and exhaustion and grief to function and fulfill endless assignments—order placements, plan making, lab ordering, consultation calling. Imaging arranging, emergent phlebotomy and IV placements, communication coordinating between teams, talking to and examining patients—there were never enough minutes in the day.
I tried to never forget the pain. I had a deep-rooted sense that forgetting the pain, not feeling the pain, although relieving in the moment, could lead to downstream complications for me as a practitioner.
I might forget the at the end of the day what was most healing for another human to experience by me (once of course all my assignments were completed well—that MUST be a given), was compassion—the validation and the bearing witness to suffering and the voicing of that suffering—even if but for a moment. It was suffering that brought another human into the hospital to seek care—and it was the alleviation of suffering that they sought most- and many times I saw that alleviation—steroids resolved an asthma flare, IV antibiotics resolved cellulitis, diuretic medications reduced fluid burden in a human with a weak heart relieved symptoms of congestive heart failure. However, we also frequently experienced our tools as too few, too late, or even powerless in the face of a greater problem than we could fully understand or resolve.
Pain forced me to ask big questions of myself and of my training and of the healthcare system I was part of. I became a hospice and palliative care physician to fulfill my personal mandate to be able to hold pain—so that I could extend not just medicine, but also the deeper healing intention that dwells at the heart of compassion.
I also studied traditional healing systems previous and simultaneous to my formal medical training—and discovered functional medicine during my residency training and sought (and continue to seek varied training) to assist me in my endless quest to address the countless manifestations of human suffering.
I have learned over the years, in clinical practice in the functional medicine space, that so much of our suffering is rooted in the sum total of our environmental exposure—physical ones like environmental poisons (heavy metals, pesticides plastics, and toxic substances in our food, for example), and spirit ones like trauma. My work is centered on a human and clarification of the sum total of what they might be struggling with—on all levels—and address those factors as comprehensively as possible to resolve suffering and rekindle vitality and joy.
The work I do has grown out of painful pieces of my medical training that I am trying to correct for and it is driven by an ethos of the golden rule. I deliver the care I would wish to receive—or at least I endeavor to deliver such care.
So what does all this have to do with COVID-19 and what is happening in the world today?
We are in an incredibly heart-wrenching painful time—where mainstream strategies are failing both healthcare workers and patients alike.
However at Rahav Wellness we have a different story to tell.
We have been seeing folks with COVID-19 every single day. We are using high dose IV vitamin C, often tempered with other nutrients such as b complex, magnesium, taurine, glutathione, and supported by judicious supplementation to continue at home, along with some dietary suggestions (if possible) to address as many aspects of the pathophysiology of COVID-19 as possible, even as our understanding of this clinical entity continues to evolve. Our clinical outcomes have mostly been overwhelmingly positive and, therefore, hopeful and joyful. We are experiencing resolution of myalgias, malaise, chest tightness, nausea, anorexia. A cough might linger on a bit—and so we have tried to center supplementation around resolving lung inflammation and cough. We have combined acupuncture and a technique called neural therapy into our in-office protocols to help address the lung meridians and some immune points known in acupuncture, that have helped speed symptomatic resolution of COVID-19. We have kept our center physically open to deliver in-person healthcare at a time when people need it most—and we have effectively saved an ever-growing number of people the need to be hospitalized, in our own attempt to flatten the curve.
However, I cannot help but notice and feel frustrated to observe how small the voices of practitioners like me are—when faced with the mainstream narrative of not enough beds, PPE, ventilators, or chlorquine.
I strongly feel, since my clinical outcomes are so starkly different from hospital outcomes, that there needs to be space held for medical doctors like me who dare to think on their feet and incorporate old and new clinical experience to address COVID-19 in the present.
Why are practitioners like me so marginalized? Are we so resigned to pain and suffering that we dare not strive for better? Is better not possible? DO I have to procure a double randomized controlled trial even as I devote my life to in-person excellent clinical care?
Our system’s response to COVID-19 is NOT yielding acceptable clinical outcomes. Why then are we towing the line and thinking that staying locked up at home on our computers for longer is the answer when I do not see the mainstream suggestions for our response meaningfully alleviating human suffering?
I am just as interested as the next clinician in pathophysiology, toll like receptors, ACE-2 receptors, cytokine mediators and all the other pieces of how we might better understand and manage this viral illness.
If we were not inured to shortcomings of our healthcare systems, trained over so many years as doctors and as a society to accept chronic disease’s ever-increasing burden on our population, would we accept the current system’s response even as I have such a different story to tell?
From my point of view we have been societally desensitized to our collective pain—forced to accept a mainstream narrative of isolation and slowing the rate of viral transmission as the gold standard of our care model with some pharmaceuticals and convalescent immunoglobulins into the mix—all resource intensive and therapeutically less effective (apparently) than the tools I have been implementing daily. Worth at least testing, no?
Ask our patients? (Even if they wanted to volunteer their experience, I, of course, legally, cannot make that request.)
Is this a collective spiritual insensitivity to pain—a resignation to fail, a disbelief that better is possible? If this is the case—and we live in this space- what will happen when the next pandemic comes along?
Are we inure to fear and failure as our currency of societal response.
Are we not going to connect pandemics with greater questions—the way the bubonic plague challenged us to understand urban planning and hygiene? The plague led to an overhaul of systems. Why should not COVID -19 represent a similar catalyst to change? And I do not mean immunization—that doesn’t seem to have solved healthcare system burden of ills as all chronic disease continue to burgeon.
We are not without answers—but it is my fervent belief that many more of us need to start asking big questions.