It has to be one of the oddest moments in the annals of modern medical diplomacy.
Standing over platters of cheese cubes and bowls of guacamole in the refined quarters of the faculty club at the University of Texas Southwestern Medical Center at Dallas, Kern Wildenthal, the center's distinguished but stiff-necked president, looks for all the world like he is undergoing a root canal.
At this moment, Wildenthal is reluctantly making the acquaintance of Dr. Dashima Dovchin, a Dallas-based, Mongolian-trained practitioner of something called manual therapy. This includes, among other things, cupping, a procedure in which she presses a heated glass cup into a person's back to unlock energy blocks; and pulsing, in which she detects the health of internal organs by feeling different pulse points at the wrist.
The daughter of a wealthy Southwestern Medical Center benefactor, who is making the introduction, tells Wildenthal she believes Dovchin is the most gifted healer in Dallas.
"Um, do you have a license?" Wildenthal asks Dovchin, who replies that she is in the process of studying for the state licensing exam. After a few more awkward minutes, Wildenthal beats a hasty retreat from the reception, which is filled with all manner of alternative medical practitioners--naturopaths, chiropractors, acupuncturists, massage therapists--as well as the occasional doctor of conventional medicine.
That the president of one of the most conservative and prestigious medical centers in the country is breaking bread with a woman who heals people with glassware is one indication of how far alternative medicine has come.
If Louise Gartner has her way, it is going to come a whole lot further.
And Louise Gartner usually gets her way.
A tiny, white-haired wisp of a woman with a resolve of steel, Gartner recently founded the Alternative Medicine Research Foundation of Texas. Its purpose is twofold: to fund well-controlled clinical studies to evaluate nontraditional therapies for prevention and treatment of common illnesses and to educate physicians and the public about this undeniably growing and controversial area of health care.
Funded with a generous seed grant by Gartner, the foundation boasts an impressive roster of board members, including Dr. Ron Anderson, president and chief executive officer of Parkland Memorial Hospital. It conducted its first educational program in September: a panel discussion with experts in alternative medicine held at Southwestern Medical Center, followed by one open to the public at Southern Methodist University. The foundation also brought in as a special guest speaker Dr. David Eisenberg, director of the Center for Alternative Medicine Research Center at Harvard Medical School, where he also is an assistant professor of medicine.
More than 1,000 people--nurses, doctors, and physicians' assistants--attended the conference at the medical center, for which they received credits in continuing medical education. Though a conservative, cautious group by nature, they were fairly receptive to information about a field that is often dismissed as quackery.
But dismissing the field, attendants learned, is shortsighted. According to a large survey Eisenberg conducted in the mid-1990s, more people in the preceding year had visited practitioners of alternative medical therapies (including acupuncturists, herbalists, and energy healers) than visited their primary care physician. Eisenberg's study unmasked, in the words of one of his colleagues, "a hidden mainstream." Moreover, more than 70 percent of the respondents did not tell their primary care physicians about their use of alternative treatments.
Numerous health maintenance organizations have caught onto the trend and now are offering their participants the option of seeing chiropractors, massage therapists, and acupuncturists as part of their medical plan.
Just how effective these treatments are is not known. But scientists are finally beginning to try to find out. To that end, the National Institutes of Health recently funded alternative medicine research projects at 10 medical centers around the country. In Houston, a study is being designed to investigate the effectiveness of alternative treatments on cancer. At Harvard, Eisenberg and his colleagues are studying the effectiveness of traditional therapies for lower-back pain versus that of treatments such as chiropractic, massage, and acupuncture.
"It's going to be a shoot-out at high noon," said Eisenberg, who has extensively studied Asian medicine and was a consultant to Bill Moyers on his Healing and the Mind PBS series.
How big a part a patient's belief in the treatment plays in its effectiveness is not known. But Eisenberg instructs physicians and research scientists not to dismiss the power of the placebo effect, an area that has been understudied itself. "Perhaps these patients' brains are wired in such a way that allows their beliefs to bring about biological changes," Eisenberg suggests.
Belief can go only so far in explaining why some treatments work. Eisenberg points to studies of successful acupuncture procedures done on animals as proof that something else besides blind faith is at play. Double-blind studies at Oxford show that homeopathy, minute dosages of natural medicines, may have some benefit in treating allergies.
William Craig, a Fort Worth physician who participated in the panel, became a true believer in acupuncture, he told the crowd, when it cured his wife's crippling migraine headaches, from which she suffered during the first 10 years of their marriage. Craig decided to study this Chinese pain-control method, which involves carefully placing needles along the body's nerve pathways. To improve upon the procedure, Craig began experimenting, using electrical currents attached to these needles. With funding from Fort Worth's Bass family, researchers at Southwestern compared Craig's invention with other, more conventional pain-reduction therapies on 65 post-surgical patients who suffered from chronic lower-back pain. Craig's method worked the best by far and got dramatic results, according to Dr. Paul White, a Southwestern anesthesiologist and research scientist who conducted the study.
But for every anecdote about miracle cures and every study that shows that alternative treatments are more than voodoo, there's a story of the unscrupulous charlatan who preys on people's weaknesses.
Donald Kennerly, a doctor at Southwestern, told the audience about the poor soul he treated who was convinced by a previous doctor that he became deathly allergic to formaldehyde after plugging in his television set and getting shocked. Kennerly surreptitiously exposed the man to high levels of formaldehyde, and he had no reaction.
The point of Kennerly's story was not to denigrate all forms of alternative medicine, but to underscore the importance of subjecting the entire field to rigorous examination in order to weed out the professionals from the hacks, the successes from the snake oil.
And that's where Gartner and her Texas Foundation come in. "We want to raise the consciousness of the public and people in medicine," she says. "And we want to know what works and doesn't in the world of non-conventional medicine."
A lifelong Dallas resident, Gartner herself is not someone you would exactly call conventional.
In the 1940s, she and her sisters founded Page Boy Maternity, a chain of maternity clothing stores where Gartner was the designer. In the early 1960s, she visited a spa in Mexico where she first was introduced to yoga. When she returned from Mexico, she introduced yoga breaks in her company's factory. A local newspaper article on Gartner from the mid-1960s features her standing on her head.
So began her lifelong interest in unconventional yet time-honored approaches to better health.
In the mid-1990s, Gartner, whose late husband had marshaled a significant fortune in real estate, endowed a research chair in biochemistry at the Weizmann Institute in Israel.
"I wanted to do something significant in my life, and I thought that was going to be it," says Gartner.
But it was just the beginning. In 1994, she founded the Charitable Produce Center at the North Texas Food Bank, which was initially unsure it could handle the program. Gartner funded the fresh produce program for its first six months; it has since given out 5.5 million pounds of fresh fruits and vegetables.
Gartner came up with the idea for the alternative medicine research foundation several years ago, after funding some research projects in Israel. Through Israeli doctors, she learned about similar initiatives in the United States. After spending four days at a Harvard symposium on alternative medicine--she was one of the only non-health professionals in attendance--she decided to share her idea for a foundation with the honchos at Southwestern, particularly Wildenthal.
It took a while, but the ever-persistent Gartner finally got an appointment with Wildenthal. He was originally lukewarm to the notion of the foundation, which Gartner wanted to see housed at the medical center. Over the next few months, Gartner continued to send him articles about the field.
Gartner eventually came to the conclusion that the foundation should be independent, but was still interested in an association with the medical center. When she approached Wildenthal about approving the recent conference, he did so enthusiastically.
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"Louise is not someone to be denied," says Parkland's Anderson, who supported Gartner's efforts from the outset.
Anderson, originally from Oklahoma, says his interest in alternative medicine was piqued by his close proximity to American Indian healers. He also was a consultant to Moyers on his Healing and the Mind special and wrote a chapter in Moyers' Healing and the Mind book on the physician-patient relationship, which Anderson believes is being compromised by mass care and increased dependence on new medical technology.
"The art is definitely being lost in medicine," Anderson said during the reception following the conference at Southwestern.
Anderson applauds Gartner's efforts to fund studies of complementary medicine. "I think we have to better understand these techniques," he says. "Some of them must provide some value. But there are also a lot of questions. As doctors, we should have open minds.