Book Review

Reinventing Medicine

Written by Larry Dossey

Harper San Francisco 1999, 271 pages (hardcover) ISBN 0-06-251622-1 $36.50 CAN

There are many aspects of medical treatment which lie outside the boundaries of the raw science. Indeed, many common observations in medicine (the placebo effect, for example) rely on psychological factors which are not readily explained by our current knowledge.

The degree to which these factors influence outcomes in medical treatment is a subject of dispute which Larry Dossey addresses in his book, "Reinventing Medicine." In order to explain this point of view the author has divided medicine into three eras. Era I started in the 1800's when medicine began to be practised with attention to evidence and science. In this era, only physical phenomena were considered and the superstition and "pseudoscience" of the ancient times were given less credibility. Eventually, near the time of the second World War, experiments showed psychological effects in medical treatment, most notably the placebo effect. This marked the second era of medicine, characterised by the consideration of both physical and psychological aspects in medical treatment. The principles of era II are those currently practised by medicine.

In era III, the author claims we will additionally make use of other special insights, which are referred to as "nonlocal." The idea of nonlocal phenomena originates from quantum physics: two particles which have a nonlocal connection are able to influence each other instantaneously, no matter how large the distance between them. Some physicists, like Albert Einstein, were so surprised by this they called them "spooky" phenomena.

The author claims that for lack of a better word, "nonlocal" best describes the new way in which medicine should be practised. For the purposes of this book, nonlocal phenomena are defined as a number of interactions (such as prayer and intuition) which have effects that cannot be accounted for by our current scientific understanding. The discussion in the book which follows is a lengthy review of experimental studies which have shown (among other things) the ability of prayer to destroy cancer cells in culture, and improving treatment outcomes in mice and even in hospital studies on humans.

These ideas are problematic for most individuals, and the author points out that many people have the reaction that "this is the sort of thing I wouldn't believe, even if it was true." This may reflect the general attitude of the scientific community, which does not place faith in nonlocal phenomena despite the large number of scientific studies which have demonstrated their effects. One explanation which is offered claims that the nature of our education and society results in a great personal reluctance by numerous individuals to even consider the concepts of era III medicine.
The last (and shortest) part of the book describes how nonlocal phenomena can be employed within the health care system. The emphasis in this section is that all nonlocal "treatment" is only to be combined in addition to (and not instead of) the best medical treatments that exist. Furthermore, any such treatment should be given only to those who request it. However, despite giving an interesting practical discussion of how these ideas might be implemented, there are areas which could have been given further consideration.

For example, the author's vision includes a network of praying volunteers, who receive photographs and descriptions of individuals recently admitted to hospital. These volunteers are then instructed to pray for the health of the patients. One important question here (among others) is whether this goes against the spirit of prayer. There is something that seems intuitively wrong about having a whole sector of health care praying for people they never meet. There is also no discussion on how medicine would be perceived within society if these changes took place; even if it is proven that nonlocal effects are true, many people might wonder why these effects are being exploited, when it is impossible to know why or how they work. I believe these are fair questions which would have been appropriate for discussion in a book regarding the reinvention of medicine. Instead, the book focuses mainly on convincing the sceptical reader about the truth of nonlocal effects.

This book is mind-opening in its discussion of the various types of nonlocal effects, but does not go to sufficient length to explain its main objective. It is an interesting emerging area of medicine which should be considered, and this book represents the background and main practical principles of this area well.

Gerald Pfeffer
Faculty of Medicine
McGill University

Gerald Pfeffer is a second year medical student at McGill University. His research interests are in signaling pathways in bone development.