The shortcomings of our health care system are becoming more obvious: rising costs, the professional “territoriality” of physicians, the narrow perspective of Western medicine, the enforced passivity of the “patient.” In 1976 there was an international conference on the issue of medical self-care. Reporting on the meeting, Lowell Levin wrote about the traditional model of the patient “as the largely passive recipients of professional services. Technical procedures related to examination, history-taking, diagnosis and finally treatment, emphasize the mystique of the omniscient technical expert and healer. Patients are generally not given their medical records; their questions are frequently met with discouraging cursoriness or superficiality.” (Self-Care: Lay Initiatives in Health; Levin, Katz, Holst, 1976.)
This suggests a major obstacle in assuming greater control of our health — the lack of easily available, sound information. There is much complaint in medical circles that the system is overburdened by people with problems they could take care of themselves. And yet there has been no concerted effort at health education to share the necessary knowledge and skills. Lay practitioners are dishonored and legally restricted. Attitudes become sadly polarised; people choose either western medicine or alternative healing, rather than taking advantage of the benefits of many vital traditions.
Fortunately, there are now several good books on the subject. Rather than talking-about-doing, it is possible now to begin educating ourselves. The books listed below focus on Western techniques, and use standard disease classification. Clearly this represents only a limited aspect of well-being and self-care, but it is a convenient starting point. Resources on alternative healing, nutrition, stress and coping, body work and oriental medicine will be presented in later issues.
Tom Ferguson, editor
Inverness, California 94937
Tom Ferguson is medical editor of CoEvolution Quarterly, a newly graduated physician, and an early practitioner of self-care education. His quarterly journal includes practical articles such as “Kids and Self-Care,” “Being Your Own Paramedic” and “Medical Self-Care awards for 1976.” The access section uses the let-the-product-sell-itself format of the Whole Earth Catalogue. Highly recommended for sound, well-researched information.
The Well Body Book
Hal Bennett, Mike Samuels
Bookworks: Random House
My favorite all around book because of its practicality, comprehensiveness, respect for, and integration of, various approaches to healing, and, above all, its humility. There are excellent chapters on taking a health history, using medical tools, performing a physical exam, and identifying and treating common diseases. Health problems are indexed both by diagnosis and symptoms. There is an excellent annotated bibliography, plus discussion of drugs, emergency treatment, and how to best use a doctor as resource. There is an extensive section on prevention, calling attention to daily rhythms and habits which collectively foster joyous well-being. Above all, there is great reverence for the power and mystery of the body’s self-healing, regenerative capacity.
Take Care of Yourself
Donald Vickery, James Fries
Addison-Wesley Publishing Co.
This is a book by physicians about negotiating the health care system — how to decide when you may need a physician, how to choose one, how to maximize benefits and minimize cost, and how to apply basic principles of self-care.
The most useful section is a series of flow charts which outline common symptoms which may indicate serious disease. For example, the chart on headache helps distinguish pain caused by meningitis or stroke (seek help now) from less acute types such as migraine and tension headaches.
The authors are most comfortable with the concepts of western medicine and give little, or unfavorable, attention to alternative therapies. However, they give useful information about symptom assessment and efficient use of our existing health system.
Toni Beard, Kathleen Tinker, Donald Kemper.
Healthwise Inc., 1977, $12.00.
Using a loose-leaf format, this is one of the few textbooks for self-care. It covers basic skills in physical assessment, recognition and management of common problems, and choosing and using medical tools and supplies. Tom Ferguson comments, “The elementary course, Self Care 101. Makes you wonder what advanced courses will be like — probably more detailed teaching about chronic disease, more extensive treatment of stress, exercise, counseling skills, human sexuality, medical consumerism and healing traditions other than western medicine. But for getting a first class started, it seems about right.”
The Essential Guide to Prescription Drugs
James W. Long
Harper and Row
Written by a physician, this book provides drug profiles of the most commonly used prescription medications indexed both by generic and brand names. There is detailed, understandable information about how drugs work, common side effects, interactions between drugs, contra-indications to their use. Special attention is given to drug use by pregnant and breastfeeding women.
Colton, California 92324
This is a nationwide service, based in California. Each regional office has a library of tapes on various health concerns (appendicitis, vaginitis, sexual response, blood in urine). Tapes are played free of charge over the phone. Some offices have statewide toll-free numbers. To locate the nearest office, write Tel-Med headquarters. Regional offices will send a catalogue of available tapes on request.
Medical school libraries
These libraries are open to the public, and generally have open stack policies. They are an invaluable source for textbooks in general medicine, journals and audiovisual materials.
Medical school bookstores
Again, these are open to the public and often carry material of general interest. Many bookstores also sell medical tools such as stethoscopes and blood pressure cuffs.
In cities with medical schools, there is often a store which sells second-hand medical texts, at considerable savings. (In the Durham-Chapel Hill area, the best bet is the Book Exchange in Durham.)