Grey’s Anatomy Episode – Energy Healing

Potential spoilers ahead for Season 4 Episode 11 that aired on 10 Jan 2008.

On the episode, a 49-year-old lady named Elizabeth Archer comes in with something (probably chest pain), was sent to the cardiac cath lab where she was diagnosed with dissection of the proximal 2/3rds of the left anterior descending (LAD) artery. That’s a major branch of the left main coronary artery and supplies the interventricular septum and a big chunk of the left ventricle. Important, important artery.

It turns out she’s a faith healer. Well, not quite. Energy healer. As she says, “I am a healer and I have faith, but I’m not sure the two are related.” In the show, she passes hands over a patient with persistent stable ventricular tachycardia (who’s on amiodarone, a drug with less predictable pharmacokinetics) as well as over a patient of Sloan’s with a “Staph infection” (speculated by J. to be Staphylococcus aureus cellulitis which any decent hospital would have covered with crystalline penicilline and cloxacillin) and the two recover.

It also turns out that she refuses surgery. This is peculiar and not-quite peculiar because the first-line therapy for coronary artery dissection is usually angioplasty and stenting of the dissection, usually performed in the cardiac cath lab at the time of angiography. Perhaps she had already been assessed and found to be unsuitable, in which case the next step would likely be a coronary artery bypass (hence the need for Dr Erica Hahn)

To restate the obvious, a coronary artery dissection, especially one involving the left anterior descending artery, is not good. There’s a very high chance that the patient will have an acute myocardial infarction (a.k.a. “heart attack”) with its risks of death from cardiac arrhythmia, heart failure and its longer term risks, etc. etc. Especially when the “most recent echo shows the dissection is expanding”.

Alright, background story over. The main point is that later on Bailey the chief resident of surgery and Webber the head of surgery are talking, with Bailey visibly distraught (you’ll have to watch to find out why) and Webber trying to sound sagely. The following is said:

Miranda Bailey: Don’t get me wrong, I have faith, I do. Faith isn’t medicine, faith can’t heal you.
Richard Webber: That may be so. But then again, it can’t hurt.

Wrong, wrong, wrong, wrong.

You have a patient with a potentially life-threatening condition that would be better served with definitive therapy and instead she’s chosen to check herself into a hospital and refuse surgery because she believes in her healing abilities. Because of this faith (accompanied by a fear of surgery), a belief in things for which there is no evidence, she has upped the risk of her having a myocardial infarction and very likely dying. And Dr Webber blithely says that faith “can’t hurt”?

Bullshit. There are numerous reports of people forgoing conventional therapy for alternative methods. People with breast cancers that would have an 90% 5-year survival with conventional therapy who were lost to follow-up to pursue “alternative therapies” and came back with fungating, metastatic breast cancer. People who’ve had faith that their deity would heal them until they died. Pointless deaths that could’ve been avoided.

And there’s enough on that for now.

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9 responses to this post.

  1. Posted by cheekysalsera on January 14, 2008 at 8:04 pm

    Does it matter if the death could be directly attributable to the choice they made to pursue alternative therapies? People are going to die anyway, regardless of the choices they make to secure life.

    Reply

  2. What? Does it matter? People are going to die anyway? I’m not sure whether you’re intentionally trying to sound callous or if it just comes off that way.

    Yes, yes it matters. It matters when a person gives up pointless a fantastic chance of cure, of potentially living a long fruitful life, to clutch blindly at false hopes.

    People are going to die anyway? No doubt. So? The fact that people are going to die anyway does not excuse murderers, drunk drivers, or quacks selling water as a cure for AIDS for causing deaths prematurely.

    If you’re wondering about my point of view. Think about this. Medicine is about prolonging life, maintaining quality of life, providing comfort in end of life care, and the active primary/secondary/tertiary prevention of things that would affect that aim.

    Here’s one type of question that’s always posed to us when we’re discussing best medical practices for patients:

    If your mother were diagnosed with Stage II breast cancer with a 75% 5-year-survival rate (5 years taken as the time after which recurrence is uncommon) but chose to forgo that for Reiki energy healing promoted by a “medium” (a completely unproven therapy that goes against all science as we know it, but one she believes in)… and then she dies, because the therapy has failed and the cancer has metastasised (no longer curable), does it matter?

    I believe we are fully justified in being outrage at the medium, and feeling anger at the gullibility of the patient, and pity for the senseless loss of a life.

    I believe that life is precious, that a life cut short is a terrible, terrible waste. From your statements, I’m not sure you view life in the same manner.

    Reply

  3. Posted by cheekysalsera on January 15, 2008 at 1:08 am

    No, it was not intentional. That is not how I view life, but you are probably right about me sounding callous, as I’m not particularly affected (or should I say indignant) about losing people to death. My perspective is that death comes to all man, whether through his own choices or other seemingly innocuous events, and if it came through the former, really, what else can we do if we have tried all we could yet failed to prevent a person from choosing that option?

    Is it your responsibility to save lives, or to do all the thinking, planning, and executing of actions required to the best of your ability to save lives? How far can you go against your patient’s free will to choose something for him/herself to make sure (s)/he takes the option to life even though (s)/he doesn’t want to pick that option? Would you do that?

    Reply

  4. I see. If I may ask, how far do you take that lack of regard? If a spree killer killed 25 people in cold blood in your neighbourhood, and there wasn’t much you could have done to prevent it… would it affect you at all?

    Do you care at all that ordinary impressionable youths are being brainwashed to become suicide bombers to kill others? Is there any indignity felt if a duo of conmen cheat a number of poorly educated, trusting women of their life savings?

    We could reasonably say, I suppose, that these people all made their own choices.

    You see alternative therapies marketing themselves as malaria cures, HIV cures, cancer cures to the gullible and the most vulnerable of people: the desperate to cheat them of their money. Does the Reiki energy practitioner tells the desperate cancer patient, “My therapy has never been shown to work. But I think it works! I will heal you despite all science and evidence saying otherwise!”?

    A doctor true to his professional ethics lays out the actual facts: the processes, the chances of success, the risks of side effects . Now imagine if a quack doctor said that, “I think, without evidence, that my operation has no side effects (actually 20% risk of stroke) and a 100% success rate (actually 60%).” to lure a patient from the actual doctor with actual rates of 80% success rate, 5% risk… I’m afraid that I, unlike you, cannot blithely say that well that’s the patient’s choice, you know.

    While a doctor, true to his professional ethics, cannot override patient autonomy to choose stupidity over proven medicine, it doesn’t mean that he has to be happy about it. Or that as a human being, he doesn’t feel sad that somebody has fallen prey to predators of human life.

    Do you understand that?

    “What else can we do?” “We have tried all we could yet failed” That’s what we should be thinking about. Better education. Better legislation. Better communication skills. Not to throw up our hands in surrender. My perspective is care not because you say “death comes to all man” belies an apathetic attitude that belittles the value of human life.

    Let me reiterate the policy of patient autonomy that guides healthcare today. A patient has every right to refuse treatment. A young 17 year-old devout Jehovah’s Witness can be bleeding like a stuck pig and refuse life-saving blood transfusion and there’s nothing doctors can do, period. They cannot forcibly transfuse him. That said, they have the right to be angry that a young, impressionable mind has been made to believe that dying is superior to taking blood products based on a couple of obscure passages in the Bible.

    Reply

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  8. Posted by Candis Rilley on November 12, 2012 at 12:22 am

    The cases of hiv infection is actually getting higher and higher instead of getting lower. too many careless people out there. ..

    Up to date write-up on our own blog
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