by Melissa W. Weaver
...I wanted someone who respected my intelligence...

...I didn’t wait long before going the nonholistic route...

I certainly accepted the notion of healing with energy, which was my understanding of how homeopathy works.

I was being asked for all kinds of intimate information...

Then I asked the name of the remedy he would be giving me so I could do some research. He said that he didn’t want to tell me...

Dr. X seemed very pleased with my results.

He had emphasized the need to avoid antidotes several times...

When I visited a friend the following month, I didn’t refuse her offer of recreational drugs. After all, it was my birthday, and I deserved the treat.

It just felt as though he was saying that I had failed to stay with the program, so I shouldn’t even attempt homeopathy until I had more discipline and resolve.

When I explained that I was taking some ayurvedic herbs, he said I would have to wait until I was finished with that to try homeopathy again.

I also think it is very possible that Dr. X was not adequately trained as a homeopath...

I never felt really comfortable with this doctor on a personal level.

The Search

I was looking for an MD, but one who respected and explored various holistic options and didn’t go for their prescription pad at the drop of a symptom. I wanted one who was at least a few steps ahead of me when it came to knowledge about holistic resources ¾ what was available and what was indicated, the latest findings and the ancient wisdom. One who shared my philosophy, preferring holistic approaches but resorting to allopathy for acute or very dire circumstances.

I especially wanted someone I felt comfortable with, particularly when it came to two-way communication. Someone who took the time to listen to me and to explain my options and their recommendations, to make sure they understood my problems and preferences. Someone accessible who didn’t talk down to me and who didn’t rush through either my questions or their own explanations.

Above all, I wanted someone who respected my intelligence and my part in the process, so that I could learn more about how to participate in my own health. I wanted to feel confident that this doctor and this care were the best for me.

The Practitioner

In circumstances that escape me now, my husband found an MD who had an interest in holistic health and practiced with a number of other people in various fields, including chiropractic and bodywork. This seemed ideal; here was someone who knew the value of alternative methods and had resources readily available for referral if necessary.

When I got a bladder infection in 1994, I went to see him. Unfortunately, I had suffered stoically through my symptoms for a couple of days before I sought help, trying to knock it out on my own with lots of water and cranberry juice. By the time I arrived at his office I was in great pain. He suggested uva ursi and cranberry juice. Skeptical about how well herbs would work on my condition, at least at this stage, I told him I would try his recommendations but asked for some medication as back-up. He wrote the prescriptions I asked for, admonishing me to take acidophilus if I used the antibiotic.

I dutifully went to three different stores to find the uva ursi, but I was pretty sure I would fill the prescriptions too. I ended up taking one or two doses of the herb, drinking tons of unsweetened cranberry juice ¾ and starting the prescriptions almost immediately. Due to prior experience with bladder infections, I had specifically asked for a prescription for pyridium. This helps bladder pain, which can be excruciating, particularly because you have to drink a lot of fluids to help flush out the infection. Since I wanted the pain gone now, I didn’t wait long before going the nonholistic route, even though I certainly would have tried the herb-and-juice treatment alone if I’d known what to take when I first had symptoms.

The Entrance into Homeopathy Land

Later I went to see the doctor for a follow-up and to talk about some other health issues. He mentioned that he practiced homeopathy and said this might be of great help to me. I had a passing familiarity with homeopathy from my research into holistic health research, from friends who used it, and from trying remedies from the health food store on occasion. I had even successfully treated my cat for her asthma with Pulsatilla, which a friend had recommended. My cat had had no attacks and no need for prednisone since I’d given her the remedy, so I was sold on the concept already.

When the doctor (I’ll call him Dr. X) said that he felt very optimistic that constitutional homeopathy could help me with some long-standing problems, I was excited. Although I knew the general principle of homeopathy ("like cures like"), I knew nothing about constitutional remedies. Previously, I had been given some remedies by a chiropractor who practiced applied kinesiology, and had taken stuff like combination cold remedies on my own, but other than a brief seminar and some casual reading I had no background in homeopathy. However, I was intrigued, and I certainly accepted the notion of healing with energy, which was my understanding of how homeopathy works.

Dr. X gave me his standard patient handout, with information about homeopathy in general, his approach, and antidotes to avoid. He said that he charged $500 for taking the case initially and giving the remedy, so I left that visit and thought about it very carefully. That was a lot of money, and insurance presumably wouldn’t cover it. But he had been enthusiastic and reassuring, and I really felt drawn to it. Perhaps I am a holistic health dilettante, but when I hear about something that makes sense to me and intrigues me (particularly when someone makes grand claims for that approach), I usually want to try it!

The Interview

So even though I wasn’t working at the time and finances were tight, I made the appointment eagerly. He had me fill out a questionnaire and he videotaped our interview, which took about an hour and a half, so he could review the tape to determine the right remedy and refer to in the future. Answering all sorts of unusual questions didn’t bother me, because I knew that was part of the homeopathic procedure.

I was somewhat uncomfortable with the videotaping, however, even though I had been a drama major in college; I was certainly no stranger to the process of filming, nor was I a shy person. But this was different ¾ I was being asked for all kinds of intimate information. I tried to forget about the camera, and I succeeded pretty well until Dr. X asked me to show some of my more embarrassing physical symptoms for the tape. Seemed like there wasn’t a lot of sensitivity or delicacy, but I guessed this was just a normal part of the process, and I reminded myself that it was a medical setting.

The Treatment

I thought I had a pretty good grasp of what sort of treatment was involved. After all, I thought I was educated about holistic medicine in general, and even about homeopathy. I was certainly willing and able to ask questions and participate in my treatment. And Dr. X had given me his handout. So I had all the information I needed, right?

Wrong. I had no concept of what constitutional homeopathy entailed at all. This became evident at the end of the first homeopathic visit. Dr. X told me that he thought he knew what remedy he wanted to give me, but that he wanted to review my case to make sure, and that he would have to order the remedy because he didn’t have it on hand.

When it came time for questions, I asked how long I would have to take the remedy. Remember, my experience was with the minor-ailment, health-food-store sort of homeopathy, and with what my kinesiologist had done, where I took a remedy for a few days or maybe a couple weeks. Dr. X said that this was very potent, and that I would only need one dose.

I was very surprised ¾ all these results from one dose? Why hadn’t he mentioned this before? Then I asked the name of the remedy he would be giving me so I could do some research. He said that he didn’t want to tell me, at least for a while, so that my research wouldn’t affect the results.

I noticed that his handout mentioned this possibility, so I agreed.

He went over his handout concerning antidotes, being very emphatic about the necessity of avoiding everything on the list. The list and his instructions were a little confusing, so I had some questions. For example, his handout said herbal teas were okay, but in the visit, Dr. X said to avoid "strong" herbal teas. So which herbal teas were forbidden? He gave Good Earth cinnamon tea as an example, but after asking a few questions, I couldn’t discern any real guidelines about what was acceptable and what was not. So I resolved to avoid all herbal teas for a month and bring a list of herbal teas I wanted to drink at the next visit. I guess I could have called him about whether a particular tea was okay, but it seemed silly to bother a doctor with such a minor thing, and while he said he was available for questions, his manner didn’t really invite calls like this.

Before I left, he carefully went over the instructions for taking the remedy: no food or drink for a half hour before or after, and he warned me again about avoiding the antidotes rigorously. I was still very excited about the promised results, so I went home and eagerly awaited a call from his office telling me the remedy was in.

About a week later I took the remedy, and about a month after that I went for a follow-up visit.

The Follow-Up

Dr. X seemed very pleased with my results. I had spontaneously stopped biting my nails, without even trying, and I had become much more mellow in LA traffic. He said that such positive results made him certain that I could look forward to even more improvement. I didn’t feel nearly as triumphant or optimistic because these seemed like very small, insignificant things that had nothing to do with what I had sought treatment for.

When he asked if I had any questions, I asked for the name of the remedy. At this point, he told me, spelling it for me so I could look it up. Then I asked how long I would have to avoid the antidotes. Six weeks? Two months? He looked surprised, and he replied that I would have to avoid them for at least a year, maybe two.

The Patient Reacts

I was completely taken aback. I had had no idea that I would have to give up the things on his list for that long, and I certainly wasn’t psychologically prepared for this. He made sympathetic noises about how hard it was to give some of these things up. He tried to joke about it, saying that his wife was in the midst of constitutional treatment and sometimes even dreamed about coffee. And he continued to reassure me about all the positives I would be experiencing.

I was very upset and resentful. His handout had been a little vague on this subject of how long I’d have to avoid these things, and he hadn’t elaborated or pointed this out in any of our office visits. He had emphasized the need to avoid antidotes several times, but he hadn’t said for how long. To me it was a major omission.

None of these antidotes were things that I couldn’t give up for quite a long time, but many were things I am quite fond of. Not just coffee (I really liked it but could live without it). Not just mint (the only non-mint toothpaste I had found was a horrid-tasting fennel). But "strong" herbal teas, with no real guidelines for which ones were acceptable. And aromatherapy, which I loved in my bath and massages. And, worst of all from my standpoint, a certain recreational drug that was my cocktail and my preferred self-medication for stress.

These were things that I certainly could give up. I’d stopped drinking coffee for years when I first got interested in holistic health. When I started again, I had just one or two cups a day and sometimes none at all. And I hadn’t used any drugs, recreational or otherwise, for several years when I was trying to get pregnant, and I had continued to abstain when I was pregnant.

I felt blind-sided, disappointed, and almost betrayed. I felt that I had had no opportunity to prepare myself to give up these things or voluntarily agree to do this. The decision-making power had been taken from me, I felt, since the length of time that I was going to have to avoid antidotes was never explained until after I had taken the remedy.

So I became resentful and rebellious. It felt like I’d been put on a diet without my consent, and the forbidden foods held far more attraction than they would otherwise. When I visited a friend the following month, I didn’t refuse her offer of recreational drugs. After all, it was my birthday, and I deserved the treat. Maybe a little coffee, too.

The Patient Returns to Dr. X

When I went back for my second follow-up visit I dutifully reported these lapses. Dr. X concluded that I had partially antidoted the remedy, and he admonished me to follow the antidote instructions carefully. He tried to encourage me about my prospects for good results, but all I heard was something vaguely parental about giving up what I liked.

What good results? I couldn’t see anything other than my nails. This was nice, but not worth paying $500 and giving up my favorite vices! I got even more resentful ¾ and continued to lapse. At the next visit, Dr. X didn’t seem to focus on my symptoms, just on my reported occasional use of drugs and coffee. He said that I had antidoted the remedy and basically said to come back and try again when I was willing to follow instructions.

At the time I didn’t have enough knowledge to realize how poor the communication and treatment had been. Dr. X did not suggest retaking my case. He did not offer to give me another dose of the same remedy or to try a different remedy. He didn’t even discuss why it was difficult for me to avoid the antidotes, nor did he offer any support or strategies. It just felt as though he was saying that I had failed to stay with the program, so I shouldn’t even attempt homeopathy until I had more discipline and resolve. I left his office very upset and disappointed.

The Patient Moves On ¾ The Doctor Doesn’t

A year later, I decided to get Rolfed. The Rolfer’s office suggested that I see an MD they were associated with to get a medical evaluation in case my insurance would pay for the treatment.

Small world ¾ the MD turned out to be Dr. X. After he examined me for range of motion and asked about symptoms that might justify physical therapy, I mentioned that I had been disappointed with the communication problems we had had, particularly on the issue of antidotes. I told him that I hadn’t felt prepared to give up certain things for an extended period of time, and that I wanted him to know, so that he could learn from that incident.

His response was to send me another copy of his handout and suggest that I try homeopathy again. I marked in the margins of the handout where I thought it was deficient on the issue of how long to avoid antidotes. It turned out it did have some vague information about how long treatment might last, which I had either completely missed or misinterpreted. I sent this back to him, trying to explain once again that I thought his poor communication had contributed substantially to my "poor outcome" with homeopathy (refraining from saying I thought patients deserved much better for so much money).

Dr. X called me when he got my notes. But instead of discussing the communication problems or thanking me for bringing this problem to his attention, all he wanted to do was make an appointment! When I explained that I was taking some ayurvedic herbs, he said I would have to wait until I was finished with that to try homeopathy again.

I was thoroughly disgusted when I got off the phone. This guy just didn’t get it, nor did he seem to want to get it. I had offered him valuable feedback. I had given him the benefit of the doubt, assuming that the problems I encountered were completely inadvertent on his part and that he would welcome learning how he could better serve his patients. But he basically shrugged it off, which made me more frustrated than ever.

In retrospect, having learned much from participating in the Lyghtforce homeopathy mailing list, I think that Dr. X’s communication failures were tantamount to malpractice.

The Education of the Patient

The essence of patient consent is informed consent. If the patient doesn’t have critical information ¾ information that might make the patient delay or even forego treatment, information the lack of which contributes to aborted treatment ¾ then that patient cannot truly give consent. In these circumstances, she doesn’t even really know what she is consenting to!

Informed consent is not just a matter of using layman’s terms to describe homeopathy to the patient, then having the patient swallow the remedy of her own accord. It is giving the patient all the information she needs in order to decide whether to follow this type of treatment. Just as allopaths must tell patients about common drug side-effects and the pros and cons of a lumpectomy versus a radical mastectomy, homeopaths must make sure their patients understand what is involved in their treatment and for how long. It may be even more important for homeopaths to do this careful education, because homeopaths often rely on the patient’s cooperation and open communication more than allopaths.

The Education of the Homeopath

I also think it is very possible that Dr. X was not adequately trained as a homeopath, since he didn’t offer me any alternatives for continuing my treatment when I ran into difficulties with antidotes. I also think this is likely because MDs are often permitted to practice in holistic areas with far less training than non-MDs. In California, for example, MDs can perform acupuncture after very brief training, hours compared to the years that licensed OMDs must have. I think this attitude may pervade other unlicensed areas, like herbalism and homeopathy, perhaps permitting them to think they are qualified when they actually have comparatively little knowledge.

Understand that I have not for a moment considered bringing any legal claims against Dr. X, nor am I advocating that homeopathy patients do so under similar circumstances. But if my ailments had been more serious, the consequences of Dr. X’s poor communication could also have been more serious.

Far more disturbing to me, though, was his apparent unwillingness to learn and grow from the experience. Had I encountered that attitude after a similar experience with more serious health problems, I certainly might have sought legal help.

If I’d Known Then What I Know Now . . .

I know that health care is a cooperative process and that I’m responsible for my own health, so what could I have done differently?

Well, first of all, I could have done a little more homework on homeopathy. Had I done that, I would have understood the necessity for avoiding antidotes for a year or two. But I don’t feel that patients should have to become experts on a subject before they seek help. I think I was as intelligent, informed, and involved in my health care as anyone should have to be. For better or for worse, patients rely on their doctors to tell them what they need to know, so it will always be up to the doctor to try to anticipate the level of education that is necessary.

Second, I could have listened to my gut more. I never felt really comfortable with this doctor on a personal level. I always felt that I had to pry information out of him, that I didn’t even know what questions to ask or how to get more information when I found his explanations sketchy and unsatisfactory.

Third, I could have asked for recommendations and referrals when I decided to do constitutional homeopathy. I relied on this practitioner’s enthusiasm for homeopathy, but I never researched whether he was the best homeopath available. I also never asked him about his training. (Frankly, I had no idea at the time that so much variation in training existed.)

And while there was no such remedy then, I hope that someday there will be professional homeopathic licensing standards so I and other patients at least won’t have to guess about their homeopath’s training. This won’t necessarily weed out communication problems, but it will give patients some comfort and knowledge without having to become experts themselves.

Oh, well, live and learn. Amazingly, this experience has not soured me totally on homeopathy. I know that every field has its duds, and I attribute the problems I experienced to Dr. X personally and to our interaction, not to homeopathy in general.

When I was sick last summer with tonsillitis, Dr. X’s office called me, asking whether I wanted to come in for a follow-up homeopathy visit. Apparently Dr. X still doesn’t get it.

Copyright 1996 by Melissa Weaver. All Rights Reserved