Who benefits from alternative therapy? - culture

Harvey Ford was 40 years old when he received the news that he had rectal cancer, back in 1989. An African American factory worker in Chicago, Ford had family experience with the disease. His father had been diagnosed with the same cancer at the age of 80. Three years after a surgery to remove the tumor, the elder Ford died. A long fight and considerable medical care hadn't saved him.

Mindful of his father, Ford decided to explore his options as a patient. "I did a lot of reading books, anything I could find on the subject of cancer," Ford remembers. "What I realized is that doctors know so little about (cancer). They know how to treat it, but they know so little about the causes and whatever else you can do to fight the cancer and come back.

"I was treated very well by my physicians. I had no problem with them. It was just that if I could find another method--that's what I was looking for."

Ford eventually decided to see a naturopath, a healer who emphasizes herbal remedies, and through word of mouth he found an African American naturopath with a good reputation in the community.

This naturopath ordered Ford to fast in order to purge his body of toxins. So for 14 days, Ford fasted. He drank two herbal concoctions every day, but otherwise he ate nothing. He also underwent daily colonics. Ford paid for these treatments out of his own pocket while continuing the conventional care provided by his insurance.

After completing the fast, Ford discovered his tumors had shrunk. He eventually decided to have the same surgery his father had but nonetheless Ford credits his naturopath with helping him avoid radiation treatments and other painful therapies.

As treatments like naturopathy become increasingly common, they are also becoming increasingly contested. Contrary to Harvey Ford's experience, alternative medicine has long been out of reach for many people of color--despite its origins and liberal borrowing from many of their cultural traditions.

A Burgeoning Field

In the last 10 years, alternative medicine has become wildly popular in the United States. This popularity alarms many physicians. One study, led by Dr. David Eisenberg of Harvard Medical School, concluded that one-third of all Americans--that's over 90 million people--have tried some kind of alternative therapy, and the proportion is increasing rapidly.

This boom is driven in part by a justifiable dissatisfaction with modern medicine. After the remarkable breakthroughs of the mid-twentieth century, such as penicillin and the polio vaccine, Western medicine has so far failed to find answers to fatal diseases like cancer and AIDS. What's more, chronic conditions like arthritis and migraines are still, well, chronic.

It makes perfect sense that people suffering such maladies would eventually start to hunt for more effective treatments, and this is precisely what has happened over the last 15 years. Indeed, distinct therapies like naturopathy, Ayurveda, and acupuncture have coalesced into an industry that both works with and competes against mainstream medicine. Americans now spend $10 billion a year on alternative medicine, and much of that amount is cash; very few insurance plans cover alternative therapies.

And this exclusion radically limits who can enjoy the benefits of alternative medicine. Of the 90 million Americans who have dabbled in alternative medicine, the vast majority is white and middle-class. Alternative medicine has yet to reach the clinics and hospitals that serve people of color, and anyone with low income will find it even harder to follow in Harvey Ford's footsteps,

Superb Care, Out of Reach

Dr. Tim Tanaka, director of the Pacific Wellness Institute in downtown Toronto, is an expert on acupuncture, biofeedback, and massage, among other therapies. Tanaka is also an expert on alternative medicine's shortcomings--for one, its preclusive cost.

"Certainly fees are an issue," Tanaka concedes. "Some people charge $20 an hour, and some charge $100 an hour." Compounding these rates is the expense of multiple visits, which are often necessary.

However, the mainstreaming of such practices as acupuncture may be well on its way. In 2002, the National Center for Complimentary and Alternative Medicine, a center of the National Institutes of Health, made grants to support studies of acupuncture and its effects on conditions ranging from depression to diarrhea. These studies and further ones may lead acupuncture to mainstream clinics and hospitals. Until then, it will remain too expensive for huge chunks of the population.

There's another problem with alternative medicine that's rooted in race, an issue which Tanaka also encounters in his practice. Namely, alternative treatments require an ability to bridge cultural differences--and this bridging demands more time and effort than many patients are willing to spend.

Acupuncture, for instance, relies on the Chinese concept of Qi. Chinese tradition teaches that Qi is a form of vital energy that flows through twelve meridians running up and down the body and connecting the organs. Illness occurs when the flow of Qi is blocked. The job of the acupuncturist is to restore its proper circulation.

Among his clients, most of whom are white, Tanaka finds few patients who care to hear about ideas like Qi, essential as they are. "Some people like to know how acupuncture works and about the history," Tanaka explains. "But in my experience most of the patients are just interested in if it's going to help them or not."

Marketing Difference

One of the persistent ironies of alternative medicine is that many exclusive clinics and spas now offer therapies originally developed by people of color. Many of the treatments called "alternative" in the United States have long been used as primary care in China, India, and elsewhere.

Profit motive has certainly played a role in the emergence of alternative therapies. The ethnic origins of some therapies have helped alternative practitioners to win over white, middle-class consumers. And predictably, new products have appeared to cash in on their interest.

In the 1990s, for instance, supermodel Christy Turlington released a line of facial creams that claimed to draw on Ayurveda, a traditional form of medicine in India. Turlington and her business partners called their brand Sundari, after the Sanskrit term for beautiful woman. One of the product's advertisements smoothly intones, "Today, Sundari is a collection of Ayurvedic-inspired luxury skin care products suited to meet the needs of contemporary women."

But there's much more to Ayurveda than skin care. Like acupuncture, Ayurvedic medicine is holistic: it seeks to treat maladies of the body, mind, and spirit through a complex system of herbs, exercise, diet, and special cleansings that even include enemas and purgatives (substances that cause vomiting).

In its simplification of Ayurveda, Sundari offers a classic example of what Edward Said calls "Orientalism"--the exoticizing of an Eastern culture. It relies on the notion that the East is fundamentally different than the West, just as (to follow the ads' logic) Sundari is fundamentally different from all other facial creams.

And where does such profiteering lead? Turlington's facial creams are her unique creations--but what of the generations of scholars, healers, patients, and historians who developed Ayurveda? Where should the line be drawn between fair use and exploitation? Sundari did not return calls seeking comment.

Harvey Ford did a lot of things right in his quest for healing. For one, he didn't give up on mainstream medicine.

"I see no reason why naturopathy and traditional medicine can't work very well hand-in-hand," Ford argues. "I've done a lot of reading, and I believe that with the right herbs the body can heal itself. If there were something that a naturopath could help me with, I would definitely go to another one. But by no means am I ruling out traditional treatment."

But Harvey Ford didn't wait on the mainstream either. He had too much living to do. He took control of his own health, and perhaps that's why he is still savoring it today.

Christopher Weber studies nonfiction writing at the University of Pittsburgh, where he also teaches. He is working on a book about alternative medicine.

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