Musings Of A Modern Day Witch

Doctor
"Healing the Mind*Body*Spirit"
by Rick Chavez, M.D.
\Phy*si"cian\, n. [DE. fisician, fisicien, OF. physucien, a
physician, in F., a natural philosopher, an experimentalist in
physics. See Physic.] 1. A person skilled in physic, or the art of
healing; one duly authorized to prescribe remedies for, and
treat, diseases; a doctor of medicine.
Synonyms: bones, butcher, croaker, doc, expert, general
practitioner, healer, intern, medic, medical man, medicine
man, medico, physician, professor, quack, sawbones, scientist,
specialist, surgeon, curandero.
Roget's Interactive Thesaurus captures all the definitions of a
doctor. In the many years of practice as a "physician", shaman,
"witch doctor", "healer", and Curandero, and not necessarily in
that order, I discovered that the one key
"clue" in diagnosing what I have come to
call the "pain paradox", is very simple--so
simple, it seems obvious. But it isn't.
How many times has a patient come to me,
at the end of their pain rope after having
seen countless physicians:
anesthesiologists, gynecologists,
rheumatologists, neurologists,
orthopedists, neurosurgeons, and the list
goes on with despair in their eyes, hoping
that their visit to me will be their .last. The
numbers are great. Nearly eighty million
Americans suffer from some form of
chronic pain. As Medica! Director of The
PA.I.N. Institute it is my mission to help
patients reclaim their lives: painfree or as
painless as possible. Not an easy task.
A few years ago, I realized that there was something sorely
lacking in our system of health care when I had the
opportunity to do utilization review for a very large Medical
Group in the South Bay. Patients suffering
from slipped disks, sciatica, pinched nerves
etc. had series after series of costly
epidurals and other injections with little, if
no results. Yet most of them continued to
get more injections knowing that the
chances for their pain relief were slim to
none. Case after case proved my
hypothesis. It was time to get back to my
roots, time to embrace my Native American
Indian and Mexican heritage.
As a young boy growing up in Northern
California, I spent summers roaming
the high sierras of Modoc County with
my great Aunt Bessie, a member of the
Honey Lake Maidu Indian Tribe.
Bessie was a wise "medicine" woman
and natural healer. Sometimes I think
that I became a doctor because I was
so impressed with Bessie's healing
skills. It was all a mystery to me at the
time, but somehow I realized the role
of the spiritual dimension for healing
solutions.

In an age of high-tech, highly specialized

medicine, complicated new machines, "Which Doctor Do
EMR, and laser technology, the ancient
healing arts are a welcome alternative, I 'Turn'To?"
especially when
treating patients in chronic pain. Be it a
curandero or medicine man, the secret to
their restorative powers were not only'
the herbs, potions, rituals, etc. but also
the "laying on of hands" personal
approach. Mind, body, and spirit
are all taken into account when dealing
with the
pain paradox.
Curanderismo evolved from the culture that grew out of the
Spanish colonization of Mexico hundreds of years ago. "Curar:
to heal. Guadalupe is the Mexican embodiment of compassion.
Her modus operandi was not different from my great Aunt
Bessie's. Ultimately, the curandero's healing awareness is
elicited from a wellspring of sympathy,
Quite often, a practitioner is called upon to treat the physical
symptoms that patients have come to believe will always exist.
Among many Mexican-American communities, curanderismo is
seen as an alternative form of medicine. It has remained
popular because it offers a spiritual treatment for disease and
illness which conventional medicine often fails to take into
account.
A perfect case in point occurred when a woman was referred to
me by her primary physician. She suffered from chronic back
pain for years, and had become addicted to Vicodin to quell
the pain. I suggested that she might not be in pain, but that
her body had become so physically and mentally addicted to
eradicating her pain, she couldn't see the forest from the trees
and that the Vicodin had altered her perception of pain. She
was in denial. Initially, she scoffed at my diagnosis and
thought I was minimalizing her pain. She had heard far too
often that the "pain was all in her head," and she certainly
didn't
~ want to hear that from me. I was the end of the line. Her last
 hope.
"La Cabeza"...Mind, Body, Spirit. The pain was both real and
the pain was all in her head, if you get my gist. The mind is the
body's most powerful instrument of healing. I discovered that
years ago when I would watch my great Aunt Bessie, a woman
of few words, work her magic on the sick. People came to her
because they "believed" she would cure them or remove their
pain, or whatever ailed them. And I was always amazed that a
visit or two with Bessie would invariably cure their maladies.
After ordering an MRI of my patient's back to reinvestigate
what might be the root of her back pain, I discovered that
there was no sign to indicate what was causing her chronic
pain. After several visits and counseling, I recommended that
she undergo chemical detoxification in the hospital, under my
supervision. I also explained that I would be using a new drug
that had a remarkable track record when it came to helping

..
.
ease the pain and discomfort of withdrawal, a safe, easy drug
to use, one with minimal adverse side effects. The new drug
was Buprenorphine, a derivative of thebaine. Subutex<B>, and
a buprenorphine/naloxone combination product, Suboxone@,
was designed for use in opioid addiction treatment.
I had my "magic potion" and my patient was finally willing to
admit that she was addicted to her narcotics. That was the
biggest hurdle in treating her. I had instilled "faith" in her: not
only did she have faith in me and my diagnosis, but she
started to have "'faith" in herself and her own ability to heal.
Her treatment also involved family members who for such a
long time had tried to be supportive, but they too were having
a hard time maintaining the level of compassion needed to see
their loved one through her struggles.

Remarkably, my patient's stay at the hospital was relatively

pain-free, and after five days, her body was completely devoid
of narcotics. But the greatest miracle, as far as she was
concerned, she had minimal pain! And she told me that she felt
like a teenager again. Her body pulsed with a new energy and
vitality that had been suppressed by the effects of the
narcotics after so many years.
This experience confirmed my belief that curanderismo should
be looked at more closely by conventional medicine. I
associated my patient's new state of "'wellness" with
understanding her fears and beliefs while taking the time to
listen to her pain complaints. I offered her a solution to her
problem and she had enough faith and trust in me to give it
her all.

Shaman, Medicine Man, Curandero . . . Which Doctor is it?

It is time for all physicians to continue to get in touch with our
roots. Folk medicine, and especially good old fashioned caring
and compassion, might help physicians treat their patients
 more effectively. Taking the time to understand a patient's
fears and beliefs, is crucial in treating people who suffer with
chronic pain.
Curanderismo has survived because it encompasses many
healing traditions. A true multidisciplinary approach to pain
management incorporates this philosophy. Treating the whole
patient and not just the disease, is where the art of medicine
comes into play.

This is an excerpt from Dr. Chavez forthcoming book,

"Musings Of A Modem Day...Witch Doctor?"
For additional information visit CaLMA's
website

Ri Rick Chavez, M.D. is Medical Director of The Pain Institute at Little

Company of Mary. is He is a Diplomate,of The American Academy of
Pain Management, and The American
Academy of Family Practice.
Assistant Clinical Professor of Family Medicine at The UCLA David Geffen
School of Medicine. Certified by The American Society of Addiction
Medicine (ASAM)