Medicine from the heart . . . Vincent Minichiello SOM ’13

On Thursdays, the Daily Voice showcases selected Thursday Morning Memos, reflective essays about clinical experiences written by faculty, alumni, residents and students of the Department of Family Medicine & Community Health and, occasionally, contributors from other departments. Thursday Morning Memos is UMass Medical School’s homegrown version of narrative medicine, in which the authors process their experiences through writing. To learn more, visit: http://www.umassmed.edu/news/articles/2011/personal_stories.aspx.

Medical student Vinny Minichiello is planning to enter into family medicine next year. It is clear from his reflection that he has already embraced what many of us in family medicine find most important—holistic health. Vinny reminds us of the importance of looking beyond our standard care and embracing both basics of health (that we may have forgotten about) and new practices that we do not use often. –Hugh Silk, MD

Finding Health with Integrative Medicine

“What am I supposed to eat?! How do I make the pain go away?!” An exasperated man in his 40s with Crohn’s disease spoke to me in confidence upon his second hospital admission in two weeks for flare-ups of his inflammatory bowel disease. He was diagnosed with Crohn’s disease nearly 10 years ago and, up to this point, the only form of treatment he had been given was a single prophylactic pill that he took daily to hold the flares at bay. Unfortunately, it was no longer working and he yearned to stay out of the hospital—to spend pain-free time with his wife and two children.

The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” As a fourth-year medical student looking back on my education, I cannot help but notice the focus on making sure there is an “absence of disease.” We devour books on the bugs that make us sick and the drugs that eliminate these infections. However, whether it is due to the time constraints of our current medical education or our health care system’s desire to cling to conventional medical practices, we rarely focus on the true meaning of health: whole person, social, emotional, spiritual health and healing.

Here enters the field of integrative medicine, defined broadly as “the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals and disciplines to achieve optimal health and healing.” This definition comes from the Consortium of Academic Health Centers for Integrative Medicine, which includes 50 academic medical institutions throughout the country, including UMass Medical School. Integrative medicine is not a new term for so-called “alternative medicine,” but instead it represents an innovative approach to patient care that advocates for an individualized treatment plan combining our traditional Western medicine with the most effective non-conventional therapies available.

By utilizing the philosophy of integrative medicine, the hospital residency team and I came up with a comprehensive treatment plan for my patient with Crohn’s disease. To answer his first question, we researched and found the Anti-Inflammatory Diet, which consists of common foods known to decrease inflammatory markers throughout the body. In addition, we spoke to him about lifestyle modifications such as exercise, quitting smoking and avoiding caffeine and alcohol. We were able to identify various vitamins and minerals frequently deficient in Crohn’s patients. And lastly, we referred him to a local community acupuncture clinic, since this form of traditional Chinese medicine has been shown to be effective in people with mild to moderate inflammatory bowel disease. Our patient was discharged from the hospital, empowered by the knowledge of having received the complete care that he had been seeking.

As medicine in the 21st century progresses, the practice of integrative medicine will grow to simply become good medicine: individualized care that uses the best possible treatments to promote whole person health.

Related links on UMassMedNow:
Envisioning an alternative future for medicine
A chance to try complementary and integrative therapies