Chair’s Column August 2011

Some reflections on the limitations of the conventional paradigm and a final tribute to David Servan-Schreiber M.D. Ph.D., a pioneer who helped to change it
By Ron Glick and James Lake

Conventional biomedicine—also called allopathic medicine—is based on an enormous body of research and is often very effective, however conventional biomedicine has failed to adequately address medical and psychiatric illnesses in the United States and the world at large. In the U.S. 15% of the GNP (approximately $1.6 trillion) is spent on healthcare, yet drug reactions, infections, surgical errors or other complications of conventional medical care are among the leading causes of death and morbidity. Broad economic issues interfere with the capacity of allopathic medicine, including the specialty branch called biomedical psychiatry, to meet the population’s health care needs. Some common issues include restrictions of treatments covered under managed care, Medicare, and private insurance contracts, growing dissatisfaction with the quality of conventional medical care because of concerns over efficacy and safety, and the increasing cost of care for the average consumer.
The shortcomings of conventional treatments suggest that biomedicine does not fully explain the causes of physical or mental illness; nor does it invite rigorous consideration of novel explanatory models of symptom formation or promote studies on promising non-conventional treatment modalities. Growing acceptance of non-allopathic healing traditions in Western culture is the result of both scientific advances and social trends. Conventional biomedicine is being influenced by the increasing openness of Western culture to non-Western healing traditions in the context of growing demands for more meaningful and more personal contact with medical practitioners—often difficult to find during brief appointments in managed care settings. These issues have led increasing numbers of individuals who see conventionally trained physicians to seek concurrent treatment from alternative practitioners, including Chinese medical practitioners, herbalists, homeopathic physicians, energy healers and others (Barnes 2008).
As I write this month’s column I am saddened by the recent passing of one of the true pioneers of integrative medicine. David Servan-Schreiber, MD, PhD, co-founder and former Medical Director of the Center for Integrative Medicine at UPMC Shadyside, passed away on July 24, 2011. On at least two occasions David and I (James) were slated to as speakers at the same conference but recurrences of the brain tumor that eventually took his life precluded our meeting. On both occasions as we learned of his progressing illness there was an audible outpouring of support and prayer for this pioneering researcher, teacher and author whose too-brief career was dedicated to the transformation of psychiatry into a more open-minded and more compassionate paradigm.
Perhaps David’s greatest contribution came in recent years after he gave up his research and clinical practice to devote himself to writing and speaking. His first book Instinct to Heal shared his knowledge and wisdom on the management of depression and anxiety disorders beyond the usual medication treatments and therapy approaches. In this book David was ahead of his time arguing for the relevance and necessity of rigorous inquiry into alternative and integrative approaches in mental health care. In Anticancer, his second book, he spoke of approaches that individuals can take, particularly in managing their diet and stress, to enhance their immune system. His books were translated in over two dozen languages and have sold over two million copies.
As a psychiatrist and cognitive neuroscientist, Dr. Servan-Schreiber was studying the effect of emotion on brain imaging and when a subject didn’t show for the scheduled lab time he went into the scanner instead. This led to the discovery of a brain tumor at age 31 and a twenty year struggle with cancer. Rather than slow him down, David approached each task with renewed energy. He excelled in multiple domains, providing warm and empathic care for his patients and their families and leading the Center for Integrative Medicine to be on solid footing programmatically, academically, and financially. After “retiring” from clinical practice, he maintained his connection with the Center and the University of Pittsburgh as a Clinical Professor of Psychiatry and continued to provide teaching and consultation.
After providing mission work in Iraq and other war-torn countries he helped co-found of the American chapter of Doctors Without Borders and later became one of the disciples of teaching of Eye Movement Desensitization and Reprocessing—an innovative psychotherapy for the treatment of post-traumatic stress disorders. The Pennsylvania Psychiatric Society presented him with the Presidential Award for Lifetime Achievement, which is only one of many honors bestowed upon him.
For those who knew David and those touched by his writing and speaking, he will be remembered for his love, caring, and understanding. David was a charismatic writer and speaker, able to express his ideas with clarity and in a way that resonated with his audience. He conveyed a sense of our innate resilience and ability to heal. David’s presence and empathic connection empowered people to make lifestyle and personal changes. He was a rare individual for whom being in the same room was a healing experience. Our deepest sympathies and kind wishes go out to his family.