We have a magic wand syndrome

It seems that as a society, from the medical field to the educational sphere, we want effortless solutions to complex problems. If hoping for any sustainable change, we need to keep developing integrative approaches digging for root causes through the art of asking questions.

We often want easy answers when there are none. As a registered nurse and a women’s health coach, women come to me in search of answers that our conventional medical system hasn’t been able to provide. They have anemia for which they have been prescribed iron but their hemoglobin and iron levels stay desperately low. They have acne and get prescribed the contraceptive pill to mask their symptoms, but when they decide to stop it years later, acne comes back with a revenge. They have hypothyroidism symptoms such as fatigue, feeling cold frequently, constipation, hair loss, difficulty losing weight - and yet their doctors say that their blood test results are fine.

Our medical system is based on experimental science that consists of knowing and explaining bio-pathological phenomena as generic processes in order to identify possible treatments. In other words, doctors are experts in diseases and symptomatic treatment; they are trained to recognize symptoms and to prescribe a pharmaceutical drug for those symptoms. Ideally, every action taken must have a visible effect.

Symptomatic treatments alone are no solution for chronic diseases

However, according to a 2018 analysis by «Mutualités Libres», chronic diseases represent 25% of the population and 70% of total health expenditure in Belgium. In only eight years (2010-2018), these expenses have increased by 17% (according to Mutualités Libres, Maladies chroniques en Belgique - Prévalence et coûts 2010-2018). And that was before Covid. I believe there is such a prevalence in chronic disease nowadays because we let underlying issues that have been at work for decades remain unaddressed, not asking ourselves the right questions.

What if our medical system keeps replacing flat tires, but the real problem is a nail in the driveway or the absence of asphalt on the road? More and more practitioners call for an approach that focuses on identifying and addressing the root cause(s) of diseases, called functional or integrative medicine (according to Lifestyle Medicine and Economics: A Proposal for Research Priorities Informed by a Case Series of Disease Reversal).

Besides, the Mutual Insurance Company recommends to investment more in preventive medicine and improvement of living conditions such as education, nutrition, promotion of physical activity and of healthy living spaces. But it seems to make everyone happy to suppress symptoms oin the short term rather than invest in prevention and work on deep underlying factors. Why?

On the one hand because most doctors are so squeezed that they can spend only fifteen to twenty minutes per patient (according to MadeForMed: La prévention fait-elle encore partie de la profession?). Yet, discussing subjects such as thyroid health or digestive symptoms takes longer than that. During my first consultation with a woman, I take more than an hour collecting precious information regarding her lifestyle; from the way that she eats and sleeps to where she lives and what her menstrual cycle looks like. This will allow me to research, make links, integrate informations and come up with individualized protocols.

On the other hand, patients want to get rid of their symptoms as quickly as possible, often shying away from actually listening to their body and taking an honest look at a health problem, ready to implement change.

Unsatisfactory diagnosis for children and their parents

Aside of my work with women, I also work with children from pre-school up to teenagers in highschool alongside a team of social workers, psychologists and other nurses. In the educational sphere, I witness the same dynamics as in the medical field. Teachers are referring more and more children to us who are struggling with learning difficulties. They reach out to us because everyone seems to be in a frenzy to test and diagnose possible learning disabilities: A  a diagnosis to put a name on their non-conformity, a diagnosis supposed to appease everyone. I believe it is because testing makes those teachers feel like they are doing something to solve the problem, the same way you would swallow a pill.

However, only about six to eight percent of those children actually need a specialized and specific assistance, but we treat 95% of the children having a difficulty that way. That's how we freeze label people into with a problem they didn’t have in the first place (according to Ligue des droits de l’enfant: Les troubles spécifiques des apprentissages ou «DYS»).

Most of the children that I see during appointments labelled as having trouble learning and causing teachers to wonder what is wrong with them, actually need psycho-affective support more than cognitive testing.

And even in the cases where a diagnosis has been made, it provides no easy answers, no magic-wand solutions. Teachers and parents therefore can get frustrated. This is where, as psycho-medico-social professionals, we defend tooth and nail a «global posture» that opens up the field of possibilities, that stops us from wanting to categorize everything in order to feel safe but to keep digging into the uncomfortable.

It requires to keep a «higher-up perspective» and not rush into a specific expertise. It requires to a look at a teenager's resources, his familial environment, his story, the way he processes emotions, what motivates him. And it takes time. Indeed, I believe sustainable change is only found in the complexity of a journey, not shying away from or by-passing the hard questions.

Questions for the journey

In my opinion, the Jewish culture has mastered the art of asking questions like no other culture. In Judaism, to be without questions is not a sign of faith, but of lack of depth. Faith is not opposed to questions, but it is opposed to the shallow certainty that what we understand is all there is. Even though the Torah, the first five books of the Bible, is full of commands and rules, there is no biblical word that means «obey». Instead the Torah uses the word «shema», meaning, «to hear, listen, reflect on, internalize and respond.», according to Rabbi Jonathan Sacks (Jewish Learning Institute : The art of asking questions).

Jewish culture teaches us that to ask is to believe that somewhere there is an answer. We ask, not because we doubt, but because we believe. So, when I ask myself why this woman suffers from this or this symptom, it is because I believe that her body is way smarter than I am and only needs to be given the right resources to function properly. When I ask myself how does a student processes information, it is because I believe that this student possesses in himself all that he needs to succeed in his life in a way that will be meaningful to him.

But in asking, I have to accept that there are limits to my understanding, that not everything is intelligible at any given moment. That’s why, for the Jewish mind, to ask questions is not only to seek an answer but to be energized to action. With the power to question comes the responsibility to act.

For example, instead of giving Lévothyrox® right away when hypothyroidism is detected in a blood test, I ask questions to discover as to why those symptoms have appeared in the first place. It doesn’t assure me that I will easily and clearly find a «culprit», but in the process of asking about the conversion of T4 (inactive thyroid hormone) to T3 (active thyroid hormone), iodine levels, eating and exercising habits and adrenal health, changes toward greater health can be initiated: Such as supporting the metabolism by eating every 3 to 4 hours, eating food rich in thyroid co-factors like iodine and selenium, stop exercising on a fasted state, reduce exposition to endocrine disruptors. In the tension of the question, we are moved to action.

Therefore, instead of being quick to find answers, let’s become good at asking questions, questions that compel us to look further, go deeper, act and change, live in the in-between and cultivate curiosity. Grow. As Elizabeth George, an American writer of detective novels say: «There are no easy answers, there’s only living through the questions.»