Mind Over Medicine and Surgical Techniques

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ORTHOPAEDIC surgeons don’t have a reputation for introspection, so I was more than a bit surprised when one I knew quite well told me he was spending time at Ian Gawler’s health retreat in Victoria.

This friend had a rare tumor and wasn’t doing well. He’d bailed me up after listening to a talk I’d given in which I railed against the potential toxicity of alternative therapies. He accused me of the ignorance I was ascribing to others and was lyrical about Gawler and his regime of meditation, diet, and other complementary approaches based on the former vet’s own experiences with cancer.

Far more recently, I was similarly – and naively – paused in my tracks when I heard that Chris O’Brien was using complementary therapies. O’Brien is a tough-minded, evidence-driven, high-performing cancer surgeon who had, until his diagnosis with a fiercely malignant brain tumor, been responsible for a cancer center that aspired to be Australia’s best.

Dementia Blunts Knowledge

None of us can be sure how we’ll think or behave should we have an idea of when we might die. For some, dementia blunts that knowledge; for others, it’s a sudden heart or brain attack. But the disease that will carry about a third of us off is one where we will often know or sense our fate in advance – and that’s cancer.

Cancer is different from other diseases. Once your body has shown itself capable of allowing a malignant cell to multiply, it’s hard to feel free, especially when treatment can be rugged. No disease takes away a person’s self-worth and confidence like cancer. People feel lost in a process where things are done to them and it’s easy to be beaten down physically and psychologically. Many feel unable to make decisions and express their distress, especially when there’s a pervasive belief that being positive is critical to how well you do.

People with cancer yearn for a cure yet cancer research has been frustratingly devoid of dramatic leaps. The story has been a grind of modest but steady increases in survival through improved scanning and testing, surgical techniques by better-trained cancer surgeons, and slightly more effective drugs and ways of giving them.

Guy Allenby’s biography of Gawler and O’Brien’s autobiography challenge attitudes and the way things are done.

Gawler is a vet who developed bone cancer in his leg, had an amputation followed by regular cancer treatment, and feels his life was saved by a plethora of therapies, from psychic surgery to coffee enemas to meditation and diet. After returning to veterinary practice briefly he turned to help others with cancer.

Allenby, while captivated by Gawler, doesn’t necessarily accept the aura. More than Gawler’s ’80s account of his illness in You Can Conquer Cancer, Allenby describes a complex character who can be infuriating. Gawler tried such a wide variety of treatments, therapies, and meditative techniques here and overseas that anyone wanting to know his secret would be hard put to discover it.

Gawler, though, has given people with cancer an avenue for asserting some control over their lives, and in the years he has been promoting the value of meditation evidence has emerged for the effectiveness of Buddhist-style (mindfulness) meditation in alleviating depression. In addition, integrative medicine, which aims to bring orthodox and complementary medicine together safely, has entered the mainstream.

But from this biography, it’s not difficult to see why orthodox medicine still has problems with Gawler and it’s typified by this sentence: “If there’s one fundamental thing that Ian has learned of his own healing, it is that his existing nature and his inner patterns were a key causal factor in his own illness.”

There is not a shred of evidence that personality type or a person’s psyche influences the development of cancer and it is, quite frankly, a cruel implication that if you have cancer it’s a character weakness. There are also judgments made – at least in the book – which many people with cancer would reject. For instance, there’s criticism of palliative chemotherapy – chemo is given without the prospect of cure – because it may add time but with disability. It’s a legitimate debate but, in fact, women with breast cancer have successfully mounted major campaigns for expensive palliative chemotherapy and have been very grateful to receive it.

O’Brien’s autobiography –

which will be popular with the thousands of viewers who got to know him over the years on Channel 9’s RPA – is a bit disappointing but typical of the man in that he refuses to dwell too much on his transformation from cancer doctor to cancer patient. Yet what he shows in spades – just like Gawler – is the true value of optimistic thinking. It’s not that your psychological state somehow affects your immune system and therefore influences your tumor biologically. Being in a good frame of mind allows you to participate in your own care more assertively and to not accept “no” for an answer from your doctors. In O’Brien’s case, he made sure he got into the hands of gun neurosurgeon Charlie Teo and accepts all that orthodox medicine has to offer. When people do that, the likelihood is that they’ll do better.

To help him along the way, O’Brien has come to terms with his spiritual self through religion and is prepared to try complementary medicine, including meditation, even though the evidence is weak or non-existent. Mind you, smart alecs would say, “Since when has lack of evidence stopped a surgeon?”

Both books are a bit domestic.

The bulk of the O’Brien autobiography relates to his medical training, which reads more like a diary and is not compelling. The book is better when he confronts the contradictions and dilemmas thrown up by his working-class, Catholic roots. Allenby’s writing is more even and the details generally serve to understand Gawler better.

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