Medical Acupuncture
A Journal For Physicians By Physicians

Fall 1999 / Wiinter 2000- Volume 11 / Number 2
"Aurum Nostrum Non Est Aurum Vulgi"

book review

PARADOX AND HEALING

By Dr Michael Greenwood and Dr Peter Nunn
PARADOX Publishers, Victoria, BC
3rd edition, revised 1994

     Paradox and Healing begins with 3 hypothetical stories that stimulated and challenged me with a series of paradoxes. The book then moves on to introduce the alternative system based on a different philosophical basis than conventional medicine.

     It was difficult for me to accept and follow the shifting of perspectives from conventional to alternative medicine. However, the concept of using both functional analysis and patients' feelings to guide the diagnosis and treatment plan later became more appealing. This approach is especially valuable for treating patients in whom the cause of illness is opaque.

     "Phase Transition," an interesting concept that offers healing perspective instead of conventional medicine perspective, is described in Chapter 5 of the book. It is at times disappointing to realize that there is no alternative in conventional medicine for treating chronic pain. The perceptual transformations are perhaps threatening to a physician's ego since the patients themselves need to be the authority, be responsible for change, and use their healing power within.

     I was trained as an anesthesiologist with a pain management subspecialty, and work in a university tertiary care medical center. Treating acute and chronic pain problems daily is a tremendous task. In the book when I read about "Jack," the patient who suffered a whiplash injury, I agreed that his treatment course reflected the journey through conventional medicine for chronic pain. I then read the next chapter about "Jill," who suffered thoracic outlet syndrome Her diagnosis process and treatment course were typical of the structural bias that dominates mainstream medicine. I found it debatable whether the structural abnormality is the cause and chronic pain is the effect, or vice versa. We all know the importance of appreciating patients' response to injury, and to identify other factors associated with injury. Both of these hypothetical cases reminded me not to fixate on the structural basis alone to treat chronic pain.

     The phenomenon of pain is interpreted as an "energy block" in Traditional Chinese Medicine, as the authors point out in Chapter 12. Conventional medicine recommends differential nerve block to identify the etiology of pain, and moves on to a pharmacological or interventional approach. Conventional medicine also emphasizes the structural abnormality without addressing the functional aspect.

     The concept of energetics and transformation is absent in conventional medicine. Physicians often assume the decreased energy level is due to physical deconditioning or situational depression. Medical acupuncture can be used to address energetics.

     I highly recommend this book to patients with chronic pain as well as to health care professionals who are involved in pain management. The concept of alternative medicine can be introduced to medical students through this book. Medical schools should consider adding this book to their libraries. As for practicing physicians, this book will aid them in becoming more open-minded, and consider recommending alternative medicine to their patients.

REVIEWED BY

Eric S. Hsu, MD
200 Medical Plaza, Suite 660
Los Angeles, CA 90095-1778
Phone: 310-794-1841 - Fax: 310-794-1511 E-mail: P16066@MVS.MEDCTR.UCLA.EDU

Dr Eric S. Hsu is an Assistant Clinical Professor in the Department of Anesthesiology at UCLA School of Medicine, practicing medical acupuncture as well as conventional medicine. He is a Diplomat of the American Board of Anesthesiology with subspecialty certification in Pain Management.

(Editor's Note: We encourage your submissions of book reviews and critiques.)

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