Contradiction and vision

Ted Kaptchuk, in The Web That Has No Weaver, puts forward the notion that Western medicine has more promise for incorporating Eastern ideas than vice versa.  He suggests this difference derives from basic tenets of Western ideology, which put forward fundamental seeming contradictions and ask us to find a greater truth which envelops them.

Western thought, at its most noble and honest, is nourished by the constant tensions between unkown and known, imperfect and perfect.  Western humanity is quickened by a metaphysical dilemma — on the one hand, it was created in the image of the Almighty, and on the other, it was created from dust.

And now I hold these two opposing viewpoints and try to unify them (does that make me the quintessential Westerner?):

1. Unlike the West, Chinese philosophy sees apparent contradictions as part of life.

To be bent is to become straight.
To be empty is to be full.
To be worn out is to be renewed.
To have little is to possess.
– Tao-te Ching, as quoted in Kaptchuk

2. Holding apparent contradictions is fundamental to Western thought (see above).

Perhaps the two trains of thought are not so different after all.  Or perhaps the difference lies in what we choose to do with our perception of contradiction.  Perhaps the Eastern way is to simply notice what is — ‘Ah look, the fabric is all red and all blue’ — and the Western way to search for an underlying greater truth.  For example, fabric is woven from cross-fibers that appear blue when at one angle to the light, and red at another.

In the West, we want a vision of what will be — a vision that is better than what we see in the external world, an unachievable pinnacle to aspire to.  Not Buddha (a human), but Adonai (super-human).  Not just peace on Earth, but the Messiah.  Is this delusional?  Is this the definition of hope?  Is this at the very core of Westerners’ thought patterns?  The 2008 Obama campaign would suggest it is — hope quickens our blood, brings fire and water to our eyes, enlivens our gaze.

Okay, Ted Kaptchuk, I’m on board with this: the Western paradigm is open to change and improvement.  We just need the East to enter with West flare, with vision.

What does this vision look like?

It includes Western primary care physicians embracing other modalities.  Perhaps learning to practice them on their own, otherwise knowing when to refer.  It suggests the importance of the Doctor-patient encounter.  If any specific Western doctor does not want/need/have the capacity do this, they must be required at least to have the analytic capacity to know when it would be beneficial to the patient and respect that.  The notion that healing can take place in a human encounter must be demonstrated and ingrained into Western medical training so that when a patient has such an ailment (and, as I have argued before, these are in fact the most common ailments primary care physicians see), their healing is put first and foremost and they are guided toward the most useful resources.

As I have said, it means changing the system, broadening our view, using our Western ability to sit with opposites and opening medical education to new ideas.  This includes continuing education for practicing doctors.  It also means changing the insurance system to promote people’s health.  And it means educating ourselves, after all, we are the patients, on how we can hope (how quintessentially American!) to achieve health and vitality.


2 responses to “Contradiction and vision

  1. This is not a new idea. Some “western” medical schools/doctors already try and incorporate what we call “CAM” therapies (complementary, alternative medicine). Pain docs already incorporate biofeedback, massage, and acupuncture, while some of us already recommend things like cranberry juice for preventing utis. Some disciplines are more suitable for incorporating alternative medicine (fam medicine, internal medicine > surgical).

  2. Thanks for taking the time to read and reply, Hangyul. The idea of incorporating CAM therapies is certainly not new, and it is good to hear they are being taught at some med schools. Do you know how many schools are teaching these?

    I would also love to learn more about how these other modalities are presented. Are they part of the standard curriculum? Who teaches them — western doctors or practitioners? What is their value? What kind of evidence raises these particular therapies to the level of rigor necessary to be taught at a med school? Randomized controlled trials?

    As you point out, some disciplines are more suitable for incorporating CAM. I am especially interested in primary care physicians and the most common issues people present to them, all of which are ‘lifestyle diseases’ (see and associated links).

    I posit that these are diseases for which alternative therapies may work in part because of the paradigm in which the treatment is given, a paradigm that views a person as an integral whole, with no clear division between mind, body, and soul. The treatment is consequently geared toward the person as an irreducible system, with all parts interacting in a way practitioners do not claim or even try to fully understand; nonetheless, the patterns and the human to human encounter can guide people toward healing. For that reason, it seems that primary care physicians, in particular, may have a lot to gain from modalities that are rooted in this very different perspective.

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