For centuries, when medicine couldn't heal the sick...

Coping/Mortal Matters

December 23, 1991|By Sara Engram

For centuries, when medicine couldn't heal the sick -- which was often the case -- its practitioners concentrated instead on making their patients comfortable. Providing physical and emotional comfort for the sick was considered its own form of medicine.

As medical science grew more sophisticated, the notion that emotions could affect the outcome of a disease fell into disfavor. As recently as 1985, the prestigious New England Journal of Medicine published an editorial pronouncing such thinking as nothing but "folklore."

Not surprisingly, that smug attitude has come under closer scrutiny in the past few years. In a recent review of research in this area, New York Times reporter Daniel Goleman cited several studies that have given scientists pause. The mind-body relationship is apparently more complicated than many clinicians would like to believe.

Consider a 1990 study at Stanford University of women with advanced breast cancer. Researchers found that support groups apparently extended these women's lives an average of 18 months beyond the time they could have been expected to gain from the chemotherapy they were taking. Simply by participating in a support group, these women lived twice as long as other women with equivalent prognoses and medication.

A study at the University of Minnesota found that depression was a significant factor in the death rate of leukemia patients. Of 100 people preparing for bone marrow transplants, 13 were highly depressed and 12 of them died. But 34 of the 87 patients who were not depressed were still alive two years later.

Goleman also cites a study in which elderly patients admitted to the hospital for a fractured hip were given mental health care if they needed it. These patients left the hospital an average of two days sooner than patients who only received treatment for their hips.

These and similar studies are getting more attention in the medical community -- especially as evidence accumulates that tending to emotional needs can help cut health care bills, as the study of patients with hip fractures indicated.

For the rest of us, such ideas may not be so revolutionary. After all, the American public has made people like Bernie Siegal wealthy by turning books like "Love, Medicine and Miracles" into best-sellers. Siegal has grown famous by making explicit connections between mental outlooks and medical outcomes.

Common sense tells us that the will to live is a formidable asset in any brush with death and that a bright outlook on life helps strengthen the will to live. But in correcting one mistaken notion about the complexities of human disease, it is important not to go too far the other way.

Yes, emotions can have an effect on the human body -- and even play a part in the recovery of a seriously ill patient.

However, emotions aren't the only factor at work. Sometimes even the strongest will to live and the cheeriest, most optimistic outlook is not enough to win the battle.

If we put too much stock in the role emotions may play in recovering from illness, we may set ourselves up for a cruel trap -- the notion that if we do succumb to illness, if the cancer returns or the hip refuses to heal, it's our own fault for not mustering up the proper emotional attitudes. That's a guilt trip nobody needs.

Of course the mind and the emotions affect the body -- how else would anyone ever complete a marathon or get through any grueling experience without giving up? But the mind-body connection is more complex and mysterious than we can now comprehend -- as mysterious, in fact, as mortality itself.

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