- Dr. A. K. Tharien
Christian Fellowship Hospital, Oddanchantram,
Tamil Nadu, 624 619 India

We are on the threshold of a new century. Science and technology have made tremendous progress in the recent past. Science is revealing startling discoveries like DNA, genetic manipulation, embryo experiment, cloning, and human embryonic cells. At a world conference of scientists in Tokyo, the scientists were saying that by genetic manipulation they can make a baby of ones choice - the complexion, the gender, the height, qualities of brain and other features. The growth of science in isolation has ignored human and ethical values. It is in this background and context that we are discussing the significant theme of wholistic health and healing.

WHO once defined health as a state of well being in physical, mental, social, and (later added) spiritual dimensions. To expand further, health is a state of vital and harmonious well being, harmony extending beyond the person to include relationships, relationship within oneself, with the neighbour, environment and his or her creator. So health is essentially the function, a quality of life, unfolding of a personhood which is dynamic, comprehensive, wholistic, and forward looking aimed at a purposeful living. In short health is, to use a Hebrew word "Shalom". This includes: Fitness in - body; Sanity in - mind; Harmony in - relationships; A living response to the creator - spirit.

An Indian view of a healthy person is that of one who is in harmony (Rhythm) within himself and with the whole universe. A dynamic view of health is reflected in Bhagvad Gita where the picture of Vocation (Swadharma) is preached by Sri Krishna. The purpose of human life is to fulfill this vocation and health is a means - and not end - to equip and do it. In this view sickness and suffering can also be signs of health so far as it contributes to the fulfillment of vocation. The danger in total secularization of health as this scientists try to protect is that it takes man / woman as simply a machine waiting for repair and to then be put back to use.

Illness (not well being) may be defined as the disturbance of the right relationships. Including: Within one self- one part of the body or one system to other; A disturbance of social relationship - tension with another person; A disturbance of the right relationship with ones creator, e.g. tension due to unresolved or unforgiven sins or sense of guilt.

The Cartesian idea once popular in the West was that the human body worked as a machine composed of different parts. Diagnosis and therapy were based on the single cause leading to lab investigation and termination of microbes etc. Adequate emphasis was not given to the complex interdependence of body, mind, spirit and environment. For example, excessive use of antibiotics caused reduced resistance to the increase of bacteria or virus which become resistant to all known antibiotics as in the case of AIDS.

2. Basic human needs

Abraham Maslow speaks of 5 basic needs of a person: Physical - food, shelter, sex, rest etc.; Security - protection. Job, pension; Relationship - sense of belonging to love and loved. Family, friendship; Self esteem - education, recognition, leadership, achievement, and optimism; Self-actualization - freedom, religion, creativity, contribution, self development. If a person can not meet these needs he or she becomes ill.

Besides these there are a few other causative factors in mental illness such as: Fear (e.g. one who accidentally locked himself into a cold storage. When it was opened he was found dead though the temperature was normal.); Self centeredness (Rockfeller who was thought he was ill till he gave away all his wealth on foundations.); Resentment (e.g. a sane person who had to undergo 3 operations on his stomach says that because he held resentment against colleague he suffered from stomach ulcer.); Guilty conscious (An M.Sc. youth who attempted suicide because of guilty conscience. He had killed his father by giving a wrong medicine to inherit his properties.)

3. Healing

Healing is restoration of normalcy - i.e. repair or setting right of any aspects of a person's life that may fall short of wholistic health. It is a comprehensive health involving the total person. Its object is to help the person to fulfill the purpose for which he / she is created. It may be concerned with remedies that are physical, psychological, spiritual, social or even political to restore a broken mind, broken life or broken society or unhealthy environment.

The human body is phenomenally intelligent, dynamically creative and highly self-correcting, mainly through the immune system. The body's self- healing mechanism is activated by nutrition, exercise and stress management through harmony. David Faltons study revealed that the amygdala and the hypothalamus make the lymbic system that influences the state of mind and emotions. Positive attitudes like love, happiness, and peace stimulate the immune system and negative attitudes like loneliness, low self esteem, envy, aggression, hatred, guilt feeling, and suppressed anger act against healing and the immune system.

Healing has the following 3 components. 1. Healing is restoration of the functions that has been lost. Restoring a person to the purpose for which he was created. 2. Healing is reconciliation: Making reconciliation after estrangement - within oneself, with others and with God. 3. Healing is renewal: It is the discovering of purpose and plan in ones life, ie finding a vision to live. Death itself can be an act of healing if recognized as within the purpose of God. We should help person to die victoriously peacefully and hopefully.

The West is now turning round to see the values in some of the oriental traditional healing like yoga and Ayurveda. Ayurveda was primarily emphasizing the enabling aspect in health such as: Life style; Morality; Hygiene; Nutrition; Positive emotions; Spiritual values. A great deal of research is going on to unravel the incomprehensible complex areas in the mystery of the healing process. Sir Aaron Klug, Nobel Laureate, said science will not offer all answers to the illness of humanity. We have to look other options like spirituality, faith healing pneumo, psychoimmunology and so forth.

A recent five year study on healing done in Wickinberg, USA revealed that 20% patients benefited through drugs, surgery and other scientific technology, 35% by placebo effect, 15% by Halthrow effect, 30% by unknown x factors. This unknown x factors may be prayer, meditation, and such other spiritual exercises.

There is a close interaction among three body systems, endocrine, nervous and immune systems (Pneumo - Psycho - Neuro immunolgy). A study of 2754 people over a ten year period in Michigan by James House found a link between the brain and the immune system. Certain neuropeptides are produced in the brain by positive emotions. Pain can thus be reduced by half. Neural mechanisms modulate the body defense. The power of prayer is acknowledged as important in healing process. Dr. John Webb former director of CMC Vellore in India narrates the story of an 8 year old baby who came to CMC with an advanced inoperable cancerous tumour. After investigation he was discharged predicting that he may not survive for more than two weeks. On his way home he went into a faith home and had a prayer. The boy recovered and is still alive after 25 years. It is said neuropeptides produced in the brain can stimulate production of T cells, the immune body.

1. Wholistic healing

Wholistic healing is a total healing - body, mind, spirit, social factors and environment. I will illustrate this by two case studies, which reveal that physical healing alone is not enough. A patient was brought to one of our prestigious hospitals with a severe wound inflicted on his leg after a fight. The leg had to be amputated. After healing an artificial leg was fitted and he went home walking like a normal person. Two months later police discovered a dead body in a well with an artificial leg with a written note saying - I took my revenge. I don't need this artificial leg anymore. Here though physical healing was perfect, mental healing of hatred and revenge was not dealt with.

I had a similar experience where the thumb of a man was cut off after a fight. Before surgery I asked the patient what would you do with your enemy. I will cut off his hand. He may in turn cut off your neck. So by repairing your hand I am helping you to hold a knife for your revenge. After a period of silence he hold my hand and said, "No doctor I will not use this hand to injure anyone". Reconciliation had taken place. This is wholistic healing.

We health professionals are indeed privileged group entrusted with great responsibilities. We have to understand patients as persons (children of God) in need of total healing including spiritual healing.

5. Some ethical issues in conclusion

In their enthusiasm for scientific achievements, there is a tendency to ignore human values. The sanctity of the embryo is often ignored in embryo experiments. Biological pregnancy is the product of human love. But in cloning the asexual reproduction of a baby no such human love is involved. It is a laboratory product. In the production of human embryonic cells the brain tissues of fetus is used. To get sufficient fetal tissue abortion is induced for commercial gains. To produce an ideal baby by genetic manipulations the principle of eugenics is brought in. in this process the value of diversity, as seen in the natural biological production is lost. Researchers have proposed to create a new race by using human genes in chimpanzee monkeys to create a new species of monkeys which can be added to our labour force.

Another ethical issue particularly in India is the recent tendency for commercialization of the medical profession. Kidney transplantation had become a profit making enterprise. Sale of organs for a price and exploiting the ignorance of the poor village folks forced the government to bring in some new laws. This again is circumvented. For instance there was a rule that kidney should be donated by close relatives or spouses. It is reported that rich patients from Gulf countries marry a kidney donor and divorce soon after kidney donation.

With a great demand for admission in medical professional colleges substandard and spurious teaching institutions have come up charging high fees. Some of these had to be closed as they could not get the required recognition. This resulted in throwing away the students on the street. With profit motivation many private or cooperative hospitals have sprung up. Many of these do not follow the traditional ethical or moral values in their practice. Operations are done where there is no indication and investigations are done just to make more income. We should oppose this commercialization by creating public opinion and if necessary by introducing legislation to prevent exploitation.

One of my teachers Prof. Wilfred Jones used to say he will ask himself before treating a patient: Will I do if it is my sister? Is what I do is for the ultimate welfare of the patient? We have to adopt a code of ethics for medical profession and hospital and save the patients from exploitation in any form.