Once every few years a book comes along that is destined to become an instant classic. The Four Pillars of Healing by Dr. Leo Galland is such a book. Even before its publication this summer, I was impressed by Dr. Galland who combines common sense with medical science. His previous book, Superimmunity for Kids, has been a best seller for several years. After I heard him speak recently in New Jersey at “Keeping Our Kids Healthy…Naturally,” I felt as if I had known him all my life. Since I am a “diagnostician,” trained in labeling children’s learning problems, I was validated by his approach. I sent him a packet on the DDR, and he offered to speak for us in the Washington D.C. area on September 5, 1997.Dr. Galland is a Harvard-trained physician with impeccable medical credentials that take five pages to enumerate. What makes him stand out is his insistence on putting the patient back into the healing process. As he details the history of medicine in the first chapters of his new book, I savored every word. I was fascinated by his description of how society has moved from treating illness or sickness as a disharmony between the person and his environment in ancient times, to focusing on disease as a separate entity today. For centuries, Greek, Indian, Chinese, Japanese and tribal healers all attempted to regain balance. By the beginning of the 20th century, “the patient had become an object of study, stripped of personal identity, plucked from the context of his life and placed in a hospital bed.” From this time forth “the process of diagnosis and treatment would be directed by the wonders of modern technology as manifested in the laboratory of the X-ray department.”
I could not help but compare this medical scene to the educational one I encounter daily. Although for thirty years I have administered increasingly more sophisticated “tests,” I am depending more and more on interviewing than testing. Finding out about a child’s medical, social, sensory, and familial history often is far more enlightening than giving an IQ test.
Dr. Galland distinguishes between sickness and disease. He believes that sickness is not caused by disease, but by disturbed function, which involves a complex set of phenomena with physiological, psychological, and cultural dimensions. Patient-centered diagnosis combines the biological and behavioral sciences to identify mediators (something that produces symptoms), triggers (anything that activates a, mediator), and antecedents (risk factors that predispose a person) of the illness in a particular individual.
According to Dr. Galland, the first step is to understand that what appears to be a disease is, in fact, no more than a pattern of signs, symptoms, behavior and tissue pathology appearing in unique human beings. These, in turn, are produced by a group of disease mediators, which we call causes, but are, in truth, intermediaries.
Mediators vary from subatomic to societal. For instance, “autism” or “attention deficit disorder” are labels for clusters of symptoms with which most readers are familiar. In some children the mediator is a vaccine, while in others it may be dairy food or a parasite. The antecedents that predispose a child to a trigger are in many cases related to an immature or weak immune system.
Looking past the label or disease to search for the mediators and triggers is the next step in patient-centered diagnosis. No health care practitioner should treat a disease without gathering as much information as possible to clarify the identity of a person. Dr. Galland does not throw out the science, however. He still does a complete physical examination and orders relevant laboratory tests, putting the results into the context of what he finds out during the interview. He then moves on to treatment which is compatible with his ideas about healing, using an integrated, functional approach.
The goal is restoration or enhancement of health, not suppression of disease. The principles that guide him are the improvement of the physiological, emotional, cognitive, and/or physical function of an individual: the very same goals as the mission of the DDR.
This book offers some very interesting and enlightening reading that may change your thinking about health care
[New Developments: Executive Director’s Column, Summer 1997]
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