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If you have comments, suggestions or praise of this piece, please visit our contact page. We will forward your comments to Dr. Chase. |
YAAWPAILY I have a delightful marriage with the practice of medicine. We live in an age of marvels. While many have been mankind’s accomplishments in industry, exploration, politics and finance, medical progress has been singularly remarkable. In my own eight decades I, a family pediatrician, have witnessed the conquering of polio, smallpox, whooping cough, childhood leukemia, epidemic tuberculosis, hemophilus influenza meningitis. In addition, academic training is now so advanced that young doctors leave medical school with skills and knowledge that awe us older physicians. Also, one must consider the new instruments of medical practice such as intravenous catheters, computers, MRI’s, endoscopes and prostheses. Surgeons can now extricate diseased organs through a dime-sized incision. Researchers and pharmacologists have blessed us with one wonder drug after another. However with these advances in the three genre of medical inquiry and application, the somatic or that which deals with bodily ailments, the psychic or that which deals with mental ailments and the psychosomatic or that which deals with bodily ailments induced by mental quirks, one, the psychosomatic, has been neglected. Since most patients who consult a physician are eventually shuffled into the psychosomatic category, this neglect is reprehensible. Few doctors are comfortable with dealing with psychosomatic ills. Such attention takes time, is frustrating and frequently is not rewarding in that insurance companies want definitive, not fuzzy, diagnoses for each of the services they underwrite. Then patients do not want to be told, "Your headache is not due to a real illness: ‘It’s all in your head.’" Young physicians, not yet having learned as much from their patients as from their textbooks, frequently dismiss a psychosomatically distressed persons with the label "crocks." The old time country doctor, as depicted by Norman Rockwell, handled these cases better than many of today’s highly trained, intelligent practitioners. In management of these conditions, patients, after being dismissed by their own physicians, seek help not only from over-the-counter medication but from faith healers, herbalists, acupuncturists, naturopaths, chiropractors and shamans. Not a few resort to addictive substances. Traditional academic medicine and its literature devote attention primarily to somatic and psychic ills, diseases of the body and the mind such as diabetes, pneumonia, gastroenteritis, appendicitis, schizophrenia and bipolar disorder. After graduation from medical school, I steeped myself into the diagnoser and treater of these conditions. I was a Disease Doctor. Then after 25 years of directing my attention to these maladies of the obvious variety, those in which the patient was "really sick," I turned to managing those of a more obscure kind, the variety in which the patient merely "thought" he or she was sick. I discovered that some children whom I considered cured of manifest disease did not necessarily feel better. In an effort to have these unfortunates leave the office smiling not frowning, I began telling each of them: "You are a wonderful child and I love you" without realizing I was taking the first step in managing psychosomatic illness. This salutation was particularly effective with the underserved Mexican children who came to me from fringe neighborhoods. Many such youngsters suffered from social, economic and intellectual deprivation. Seldom in their lives had a doctor or anyone else affirmed them as worthy individuals. I became a doctor who treated patients primarily, not diseases. I transformed myself into a People Doctor. After seeing how this simple greeting lifted down-directed spirits, I began to greet anyone, children and adults alike, with YAAWPAILY (the acronym for You Are A Wonderful Person And I Love You). Thus I expanded my wealth of patients in which adults not children came to predominate. These persons did not expect to pay anyone for something so inconsequential as my salutation. It was just as well, for most of those I recognized and treated had neither health insurance nor disposable income. I conclude that many Americans do indeed suffer from a significant pathology of body and brain, but are even more are afflicted by pathology of the spirit. To counteract this enervating disability, I believe the first step in helping the poor or diseased in spirit is to tell the sufferer that they are worthy of being loved. So I tell them that I myself love them. They then need to be assured that their life style is an acceptable one, that indeed they are not seriously impaired persons. Thus my words of parting to all, "Now don’t change. I love you the way you are." In these last years of my delightful life, ministering to children and those who love them has so lightened my heart as to help me to reach my goal: I want to mature into a child. I can say that I have been most successful outside not inside my office. Others may consider my career moderately noteworthy as a treater of diseases, an M.D.. (Doctor of Medicine). Still I find more satisfaction as a caretaker of the animating force within living beings, their spirits; thus I might be better identified as a S.D. (Doctor of Spirit). Is the Ralph Chase mode of ministering to patients a first step in the management of psychosomatic illnesses plaguing Americans? It may be, but we shall not be able to find out immediately. At near 80 years of age, I can look behind with some degree of satisfaction but I shall not be able to monitor more than few years yet to come. Younger physicians can document the future. I entered medical school because I wanted to become a physician who helps people to feel better. This I have done. I cannot consider myself being any happier. Ralph Chase, S.D. Copyright, Ralph Chase, 2002 |
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