The Altar of Objectivity in Medicine
How many of you have had this experience?
You’re not feeling well, and things are not getting better on their own. So you go to your doctor, who orders all manner of tests run, investigating things from multiple angles -- only to be told that “you’re fine,” “there’s nothing wrong with you,” and that your symptoms are “all in your head.” And yet, you’re clearly not “fine” -- you’re suffering and looking for relief -- but because there are no answers on the lab reports, there are no solutions to be offered. At worst, you get dismissed, shamed, or labeled as crazy.
It’s an unfortunately all-too-common experience. ”Being ignored by your healthcare professional is one of the most common complaints heard by patient advocates, healthcare reporters, and now social media,” says Helene Epstein of The Society to Improve Diagnosis in Medicine.
I’ve personally experienced this several times, beginning in my childhood. And I hear this from my clients, as a homeopath and health coach, so much it’s like the Harry Potter audiobooks that my son listens to on repeat. It’s just part of the background noise at this point.
It’s a conundrum that frequently drives people to seek other options outside of the medical system. Yet, not everyone has the ability to do this. It’s also a conundrum that medicine gets upheld as the standard of care, the best way to manage one’s health; yet, that’s simply not the case for so many of us.
When Objectivity and Subjectivity Don’t Line Up
Is there such a thing as true objectivity? And when it comes to healthcare and treatment of the sick, what are the advantages to prioritizing objectivity over the patient experience, as our healthcare system seems to do?
My experience reveals that an overemphasis on objectivity can erode patient trust in the system and lead to poor patient outcomes. If true objectivity is indeed something to strive for in the healthcare field, it should enable us to realize the limitations of the current system. Rather, it is upheld as the default solution, despite so many of us being failed by it.
Science tells us that our subjective experience doesn't matter as much as commonly agreed upon facts.
It scoffs at anecdotal "evidence."
In medicine, objectivity is the domain of the doctor, while subjectivity is the domain of the patient.
But what happens when the objective “evidence” conflicts with the patient’s subjective experience? What happens when there is a dearth of objective “evidence” for someone’s very real, very felt, subjective, symptoms?
The Roots of My Objection to Over-Objectivity
My mother was a distinguished doctor when I was growing up. As a little kid who frequently didn’t feel well, I was looking for my mommy to comfort me. In those moments, however, my mom would typically be wearing her Objective Doctor hat. In lieu of the maternal soothing that a child of a differently-educated parent might receive, I would get a laundry list of possibilities of what might be behind my headaches (this would range from dehydration to brain tumors) or tummy aches (possible causes were something I ate, anxiety, or an ulcer).
While this was not an ideal way to grow up, my experience of my mother, along with subsequent experiences of doctors ignoring the subjective, has deeply shaped me, both personally and professionally.
My mother’s willingness to give me the often-scary possibilities behind my symptoms, coupled with a distinct lack of findings from the test results, fed something in me. I became fascinated with understanding what was behind one’s symptoms, with how we make meaning of them. This would become an obsession with health, the mysteries of the body, and the role of the mind in both sickness and healing. It also forged an urge to cultivate a more nurturing, healing presence; develop real compassion and empathy; and, above all, retain my humanity by not pretending that I have all the answers.
Although my own experience would dictate otherwise for many, many years, I’ve always maintained a somewhat irrational belief in our power to heal.
When I didn’t get the answers I sought from medicine, I looked elsewhere. This quest would shape certain multi-year arcs of my life. It would bring me to study nutrition, many energetic healing and vibrational healing modalities, somatic and nervous system healing, herbalism, massage therapy, yoga, and ultimately, homeopathy.
As a homeopath, I rely heavily on the subjective experience of my clients. Your descriptions of the sensations in your body matter. I want to know, for instance, if your pains are burning, throbbing, or aching. And not just because it feels good for you to tell me about it; not just because I’m a good listener; but because it makes an actual difference to the solution that I can then offer you.
Lab tests can be helpful as metrics and data points, but homeopaths don’t treat lab scores -- we treat people. Homeopathy is a modality that offers a solution for those of us who live beyond labs. You can feel crappy and not have anything to show for it at a doctor’s office. And if they can’t find “evidence,” they can’t offer effective solutions. Homeopathy fills the void, both by caring deeply about your subjective experience and also offering effective healing tools, even when there’s a lack of diagnostic evidence. It’s an antidote for these allopathic ills.
The Costs of Over-Objectifying Patients
Objectivity is a movement towards linearity, rationality, and logic. None of these are bad qualities, of course; but if a doctor, or a system, is not balancing objectivity with subjectivity, compassion, and empathy, there can be an over-reliance on things like test scores, lab results, and a tendency to dismiss the patient’s experience.
Not only is this problematic from a patient-care point of view, but there are other problems with this approach, including:
Reliability concerns of labs and tests:
False positives and false negatives are abundant. The incidence rates of these vary with each test, but most tests do not offer 100% certainty of results. Thus, a patient can receive a diagnosis for a disease they do not actually have; conversely, a patient can be told that they are “fine” when their disease goes undetected and proliferates.
Not measuring the right thing:
Scans measure tissue changes, which are often the end result of pathology; as opposed to more functional changes that might account for a person feeling ill. Even then, there are different ways of measuring functional changes. The field of functional medicine offers a different way of looking at labs than conventional doctors, often measuring different indices or looking at tighter ranges to arrive at the idea of what constitutes healthy or optimal.
The Art of Interpretation:
Let us not forget that lab results mean nothing in themselves. It’s the context and the interpretation by an actual human being that gives meaning to the numbers and images. And different practitioners can look through different lenses, through different shades of context, to provide different meanings of what could, objectively, be “hard fact” because they’re numbers on a piece of paper. I’ve personally had the experience of having two different practitioners look at the same set of test scores and offer completely different interpretations. (I mean, if true objectivity really existed in medicine, why do so many look for the proverbial “second opinion” when faced with a major medical decision?)
Human Error:
And let us also not forget that, for the time being, at least, human beings are conducting these tests. So when Brenda doesn’t have her coffee that day, or Jim gets rattled by something he hears on the radio on his way into work, or Susie simply spaces, these things can all affect how the tests are labeled, conducted, etc.
By contrast, subjectivity often does not fit neatly into categories, frequently defies logic, and includes more “soft skills” such as bedside manner, compassion, and empathy. And as human beings, we are a swirling, imperfect mix of both. Although technology offers some more data points for us to consider, so much of what goes into determining a patient’s health status is actually subjective. When people’s health is on the line, it’s a disservice to state things in absolutes, to act as if there isn’t a massive grey area that many of us can fall into.
When we worship at the altar of objectivity in medicine, we sacrifice patient experience and outcomes.
The medical system does not have answers for so many of us (about 20% of UK patients). And because the system is predisposed to the assumption that modern medicine DOES have all the answers, there’s the tendency for doctors to blame, dismiss, or make wrong those of us who simply don’t compute within the system. According to modern medicine, our experiences are simply incorrect.
This ruthless pursuit of objectivity in medicine is something that erodes trust in our healthcare system, when patient experience is undermined. Yet, our medical system continues to be upheld and defended as the dominant paradigm, while homeopathy is marginalized as pseudoscientific quackery. I hope I’ve poked enough holes in the argument of science and medicine being the end-all-be-all, to expand your idea of what constitutes “pseudoscientific.”
We should stop thinking that we know all the answers, and start being more honest with ourselves and our systems.
We need to stop holding up medicine as the objectively “right” way of managing healthcare, when so many people are failed by the system. Homeopathy, and other modalities, offer real solutions to those of us who live beyond the labs.