I was working at the Owning Pink Center, the integrative medicine practice I founded in Mill Valley, California, when I met Sandrine, who had been diagnosed with endometrial cancer, an often-curable type of cancer of the lining of the uterus. Her doctors moved quickly to get her scheduled for a hysterectomy, which is standard treatment for someone with endometrial cancer. But Sandrine didn’t want treatment. It’s not that she had a death wish. In fact, she had never been happier in her life, and she was doing everything within her power to cure her cancer, including radically changing her diet, meditating, and engaging in guided visualization. Cancer, she said, was the best thing that ever happened to her.
But her decision to opt out of treatment didn’t go over well with her doctor, who promptly dismissed her and insisted she find a more “open-minded” doctor who would be willing to support her self-healing journey, which is how Sandrine wound up in my office.
She had read some articles I had written in magazines and on the Internet and felt intuitively guided to me as the doctor who could help her navigate her self-healing journey.
Conventional medicine for cancer vs. self-healing
I felt torn. On one hand, I totally believe we hold within us the power to heal ourselves. On the other, I believed that her cancer would likely be easily cured with surgery and worried about facilitating any delay in treatment that might cause her cancer to spread. I also worried, in this medical-legal climate, that her family might blame me if she died as a result of declining treatment after I supported her autonomy.
So I straddled the fence. I told her I believe conventional medicine has much to offer and that cutting out her cancer could hasten the process while she activated the self-healing mechanisms she would need to make sure the cancer disappeared for good. For medical-legal reasons, I made it very clear that my advice would be to proceed with the surgery while also engaging in self-healing behaviours that would facilitate a full recovery. I recommended a surgeon friend and told her I would even come to the visit her if it would make her more likely to seek treatment.
She believed she could heal herself
But Sandrine was adamant about refusing treatment. So I agreed to support her, offer her tools and monitor her progress with endometrial biopsies so she could follow whether her self-healing methods were reversing the disease.
At least once a week, I received an email from Sandrine, chronicling her mystical self-healing journey, ripe with intuitive dreams and signs from the universe that she was on the right path. She fully, 100 percent believed full recovery would ensue. She tingled with excitement.
But each time I read her emails, I felt a pang in my chest. The skeptic in me was kicking and screaming “Stop the madness! Make this delusional woman get a hysterectomy! Save her life, doctor! Remember, first, do no harm.”
But another part of me thought, “Who am I to say she can’t cure her own cancer?”
For a few weeks, I hedged my bets, responding to her emails with support and affirmations of belief.
Then I went out to dinner with a friend of mine, who is a famous physician, a medical intuitive, and the bestselling author of many books. Seeking guidance from my open-minded colleague, I told her Sandrine’s story, and she closed her eyes, sat in silence for a moment, and then shook her head across the dinner table.
“Lissa,” she said, “It’s just magical thinking on Sandrine’s part. The cancer is getting worse. Do what you can to help her get treatment.”
The next day, I saw Sandrine at the office and I got all flustered. She nearly danced into my office, full of faith and hope from another dream she had that told her the cancer was getting better. I had trouble making eye contact with her. I couldn’t exactly tell her what my friend had said. My research shows that such a proclamation can serve as a sort of medical hexing.
But I also couldn’t pretend I was happy she was still refusing treatment. I’m sure I acted squirrely, and I could tell she knew something was amiss.
Covering my ass
Right after she left the office, I called the lawyers in risk management that work for my malpractice insurance carrier and coughed up the story of what was going on with Sandrine. As I suspected, they freaked out and insisted I send Sandrine a certified letter informing her of the dangers of refusing treatment, even though we had already covered this verbally and I had written my recommendations in the chart.
The lawyer drafted up a letter he wanted me to send, but when I read it, I refused. There was no way I could send such a hopeless, fearful letter. I tried modifying it to make it more optimistic, until the lawyer and I came to a compromise, but I still hated it. At their insistence, I sent off the letter, feeling positively nauseous.
A few days later, I received a heartbreaking letter from Sandrine. She said she understood why I needed to send such an awful letter. She knew it wasn’t my fault. But she just couldn’t keep seeing me if I didn’t believe wholeheartedly in her capacity to heal herself.
I wept when I read the letter. A lengthy appeal aimed at convincing her that I wasn’t abandoning her went unanswered. I learned a painful and valuable lesson in the process of losing Sandrine as a patient. I realized what a fine balancing act it is to support a patient’s desire to self-heal when, as a physician, I’m trained to optimize all that conventional medicine has to offer before giving up hope.
I also learned that it’s no easy feat to be a physician who aims to support people in a self-healing journey given the state of our medical-legal system.
What the doctor believes matters
It wasn’t until much later, when I started researching my next book Mind Over Medicine, that I began to wonder whether, by doubting her ability to cure her own cancer and making attempts to cover my ass from a lawsuit, I may have done Sandrine a profound disservice. As it turns out, the clinical data suggests that the right healing practitioner makes all the difference, and what a clinician believes about a patient may actually affect the patient’s outcome.
And yet, even still, I feel torn. As a physician dedicated to helping my patients in the best way I know how, I’m also bound by my own ethics to do what I believe to be right. Had Sandrine wanted to try healing her migraines without medication, I would happily and easily have supported her. But I found it much more challenging to witness her withholding what I genuinely believed would be life-saving treatment.
Marrying self-healing with conventional medicine
It’s not that I don’t believe miracles can happen and we can heal ourselves from cancer, heart disease and other life-threatening illnesses. But when evidence-based medicine has been proven to be effective, why would we deny it?
In placebo-responsive, non-life threatening conditions where conventional medicine has little to offer—conditions like chronic fatigue syndrome, fibromyalgia, migraines, and irritable bowel syndrome—I’m all for ditching standard medical treatment and trying to heal yourself if that’s what your Inner Pilot Light feels is best for you.
But Sandrine pushed my limits. When early stage cancer can be easily cured with a surgery, why push our luck? Why not cut out the cancer AND activate the self-healing mechanism that will ensure the cancer doesn’t spread?
Must it be all or nothing?
It seems that many in the self-healing camp think we should ditch doctors all together—get off your insulin, stop your heart pills, refuse surgery for cancer, deny antibiotics for pneumonia.
But must it be all or nothing? Can’t we take the best of modern medicine and marry it with the mind’s power to heal ourselves?
Let’s not throw out the baby with the bathwater. Let’s choose the best of both worlds.
You on board? You disagree? What do you think?
Rallying for middle ground …