John Robbins is not a physician. Nor is he a researcher. But, from this perspective as an "outsider," he is in a unique position to take an objective look at the health care system in the United States--a long, harsh look. This is similar to the scrutiny he focused on the societal, environmental, and personal impact of our food choices in his classic Diet for a New America nearly a decade ago. And like that previous volume, Robbins' current offering is far from a hypercritical collection of hand-waving opinions; it consists of well-constructed, rational arguments, fully referenced from leading journals and health authorities. My first reaction after reading this expose was, "This should be required reading for everyone at NCC."

Robbins begins with over one hundred and fifty pages covering women's issues in medicine today. He describes the paternalistic, male-dominated field of obstetrics and gynecology (over 80% of obstetricians and gynecologists are men). This section was most enlightening for me, as it would be to other single men; for female readers, perhaps it depicts experiences that are all too familiar. Birth in a hospital, supervised by an obstetrician, is considered standard of care in this country. However, an examination of the statistics for uncomplicated pregnancies does not justify the high-pressure, high-technology, assembly-line-like atmosphere in the hospital maternity ward. In fact, many of the "necessary" medical interventions in such cases may be a result of the stress that the hospital atmosphere places on the mother, which inhibits normal labor physiology. The midwife community in the US has been persecuted by the medical profession even more vehemently than has chiropractic.

The economic aspects of this branch of medicine are examined as well. For example, when a major HMO in Kansas recently reduced its reimbursement of Caesarean sections to the same as that of vaginal deliveries, the C-section rate in the state dropped from 28.7% to 13.5% in one year. While some hysterectomies are indicated and necessary, many are routinely performed with little therapeutic justification. The OB/GYN seems to take the same "shotgun" approach as the orthopedist confronted with a chronic back complaint, as indicated by the chapter title, "When in Doubt, Take It Out." Finally, the question of menopause and estrogen replacement therapy is considered; a large body of evidence points to dietary and lifestyle changes that can be just as effective. The underlying theme in all of these issues, and perhaps the most important, is the attitude of the allopathic profession toward women. Beginning with medical education, natural processes such as menstruation, pregnancy, and menopause are viewed as diseases to be conquered, controlled, or corrected.

Robbins next tackles the cancer industry in the United States. Chemotherapy, the omnipresent tool of oncology, saves the lives of only two to three percent of cancer patients. The rest fare little better in terms of extended life expectancy or even improved quality of life. The National Cancer Institute, the leading educator in oncology for both the public and professionals, has disturbingly intimate connections with the pharmaceutical companies that produce the vast majority of chemotherapy drugs. It is then not so surprising to discover NCI's defense of chemotherapy as a necessity, and its relentless suppression of "alternative" cancer treatments, often using bad science, or worse yet, no investigation at all.

An analysis of the state of health care in the US would not be complete without mention of the megalithic American Medical Association. Robbins begins these two chapters with a quotation from Dr. Benjamin Rush, one of the founding fathers over two centuries ago: "Unless we put medical freedom into the Constitution, the time will come when medicine will organize itself into an undercover dictatorship." The AMA seems to have fulfilled that prophecy from its very inception; it was founded in the mid-nineteenth century to contain the growing threat of competition from the homeopathic profession. A full ten pages are devoted to a description of the AMA Committee on Quackery's attempt to eliminate chiropractic, and the eventual triumph in the Wilk vs. the AMA trial. In spite of this, the AMA continues to maintain a vast collection of negative literature on alternative therapies, some of which is supplied to agencies of the US and foreign governments as authoritative fact. The AMA's priority of economic and political self-preservation is best exemplified by its history of close financial ties to the tobacco industry for many years, even two decades after the Surgeon General's declaration of the dangers of smoking in 1964.

The final section of this volume considers the differences between allopathic medicine and holistic forms of health care. As symbols, Robbins uses the Greek myths of Asklepios, god of medicine, for the former, and Hygeia, goddess of healers, for the latter. The Asklepian system which reigns in this country is based upon a "dominator" model of health care that could better be described as disease management. On the Hygeian side are not only holistic health practitioners, but also the great strides in public health and sanitation. These contributions have gone largely uncredited as perhaps the most important to the improvements in health and longevity in the industrialized world.

What I find most satisfying about Reclaiming Our Health is its conclusion--the need for a partnership paradigm in health care. Each model of health has its strengths and weaknesses; therefore, each should concentrate on its strengths. The Asklepian system is very good with acute infectious disease, emergency care, and surgery; the Hygeian system is more well-equipped to deal with chronic disease, pain, and prevention. Robbins constantly stresses the wonderful and necessary contributions that modern medicine has made--his own life was once saved by antibiotic therapy. The goal is not to blindly negate those contributions; rather, it is to seek an integration that is currently inhibited by allopathy's claim to be the only legitimate form of health care.

It is rare to find an advocate for holistic health who takes such a balanced, intelligent approach. So if you're hungry for inspiration amongst all the studying, research, and examinations, take time and put this volume on your list of required reading.

Reprinted from The Synapse, February 1997.