"Ta3a Ne7ke" with Ibsar # 2- "The Art of Healing; Western or Alternative Medicine?"

By Lojine Kamel

On Monday, November 29th, ibsar sponsored the second of a series “Ta3 Nehke” debates. Hosted in West Hall from 4 to 6 pm the debate, entitled The Art of Healing: Western or Alternative Medicine, featured a diverse panel of lectures, each of whom represented a western, alternative, or integrative medicine perspective. The event’s mediator was none other than Biology professor and Natural medicine and cancer researcher Dr. Hala Mohtaseb, who has been working with AUB for 17 years. The panel consisted of Mrs. Farida Abou Khizam, Dr. Fuad Ziyadeh, Dr. Jamal Hoballah, and Dr. Edmond Ibrahim.
Professor Mohtaseb began by introducing the speakers and the topic at hand. She described the differences between Western and Alternative medicine, or CAM (Complementary Alternative Medicine), the former being more surgery and drug oriented and the latter being more holistic. An intermediate between the two, called “integrative medicine” mixes both approaches, using both surgery and natural healing techniques. The panel was split between the two approaches, with Abou Khizam and Ibrahim favoring a more alternative/integrative proposal and Hobollah and Ziyadeh supporting western/integrative medicine.
First to speak was Mrs. Farida Abou Khizam, an Australian qualified pharmacist, Reiki master, and advocate of integrative and humanist medicine. Criticizing Western medicine for its symptomatic treatment of clients, Abou Khizam began her lecture with a quote by Plato, saying “Physicians separate the soul from the body.” Lamenting the fact that today’s doctors treat the patient as a symptom instead of a person Abou Khizam turned to Reiki, a biological medicine that uses energy circuits as a medicinal technique. Reiki allows for an electromagnetic field to trigger a greater cellular response for healing (amplification). Abou Khizam spoke of the benefits of Reiki, saying it provides for pain relief, detoxification, insomnia, wound healing, and cancer care, as well as being used in over 800 hospitals in the U.S. However, remarked Abou Khizam, “Unlike modern medicine, alternative approaches do not toxify the body with chemicals, but detoxify it. Reiki allows the mind, body, and soul to heal and express itself naturally in the true spirit of Plato.”

Following Abou Khizam was Dr. Fuad Ziyadeh, Nephrologist and Chairman of the department of Internal Medicine in AUB-MC and a specialist in the molecular biology of kidney diseases, of which he has authored more than 100 publications. Ziyadeh declared himself an avid supporter of Western medicine, remarking, “Death is inevitable. There is so much hype about alternative medicine but it is not scientifically sound, nor evidence based.” Ziyadeh backed up his claim with a study done on alternative treatments by the NSF in 2002, which experimentally determined that none of the treatments were proven effective, and were rather a “pseudoscience,” instead of a science. He cited the controversy behind some alternative treatments, mentioning the unproven efficacy of herbs like St. John’s Wart and ginkgo biloba, while simultaneously lamenting the lack of evidence and quality control in the industry. Ziyadeh also emphasized that sources of funding for many of the treatments remain unclear, saying “Many of these treatments are not only unproven, but disproven.” Several studies have pointed to significant amounts of mercury, lead, cadmium and arsenic in several treatments, causing more harm than initially was present. “It is a big fallacy to assume that what is natural is good,” said Ziyadeh, “natural can be toxic.”
Third up was Dr. Edmond Ibrahim, a special cist in Chinese medicine and acupuncture. Ibrahim studied in China for 10 years, and currently practices alternative medicine. Ibrahim discussed the benefits of holistic medicine, saying it studied a large variety of sciences, such as biology, physiology, and pathology, and incorporated each of them into its unique alternative medicine approach. To obtain a PhD in Chinese Medicine, a minimum of 11 years of study is required in the heart of China, to fully understand its techniques. However Ibrahim underlined that there were many similarities between the two approaches, asking “Do we have to study western medicine before Chinese? No, we can do both at the same time.” Advocating an intermediate integrative approach in order to best treat his patients, Ibrahim declared “Chinese medicine isn’t alternative. It’s 5,000 years of history.”
Last to speak was Dr. Jamal Hoballah, Vascular surgeon and Chairman of the department of surgery at AUB-MC. Hoballah delved directly into the main issue with his opening statement, clearly asserting his opinion: “I am not against CAM. I am against quackery and health fraud. Unfortunately most of the CAM practitioners fall in the quackery category.” He spoke about the principle rule of medicine; “do no harm,” which he believes is too often violated in CAM treatments. With serious surgeries and structural diseases, such as aneurisms and heart problems, CAM rather eliminates the chance of cure for, according to Hoballah.” Hoballah turned to scientific evidence, or in the case of CAM, lack thereof, saying “CAM just masks symptoms temporarily,” The lack of standardization makes alternative medicine more susceptible to fraud, and, said Hoballah, the ignorance of the patient even more so.
After the panel presented their opinions about the corresponding medical approaches, the audience was invited to share their own thoughts in a Q&A session. The first question of the night was from Medical Information Specialist, Aida Farha, who asked about the extent of which either practice had evidential superiority over the other. Said Ziyadeh, “No one has a monopoly over evidence. Modern medicine is evolving all the time, and it adopts new things proven to be beneficial to the patient.” From the alternative medicine corner, both Ibrahim and Abou Khizam replied that modern medicine has roots in alternative, with Abou Khizam remarking “modern medicine has evolved from alternative.” Another notable question came from Civil Engineer Youmna Nasser whose own experience with CAM stemmed from her disappointment in western medicine. Said Nasser, “Western Medicine only treats diseases, but it’s the human being that needs to be treated. I really look forward to a breed of healers that convey both western and alternative techniques that would address the human being. Western treats the consequences, never look at causes and reasons.” The panel responded from a moderately unanimous perspective, clarifying that there is pressure for doctors, pharmacists, and other medical professions to provide treatment in all cases, and medical short comings, in the form of poor interpersonal relations between the doctor and patient are too often present. Ziyadeh summed up this notion, stating “Medicine is an art as much as a science.” One of the last questions of the evening was from Gastroenterologist Dina Zeidun, who criticized the lack of scientific evidence and standardization behind CAM, as well as saying “Good medicine is not only western, it is international, yet scientific.” Her opinion tied directly with the responses of Ziyadeh and Hoballah, who attributed CAM effectiveness to placebo affects and chance occurrences. Abou Khizam agreed with standardizing CAM, but remarked “before you can regulate something you need to have acknowledged it.”
The final part of the debate consisted of closing remarks from each of the panel members, as well as the mediator. Said Abou Khizam, “We need to treat the whole person; psyche emotions, and the physical body. That is real treatment.” Ibrahim concurred with Abou Khizam’s statement, adding “Have evidence. Don’t just focus on U.S techniques, for medicine exists all over the world.” Hoballah and Ziyadeh took a different approach, stressing that evidence is the most important thing when it comes to medicine. Mohtaseb ended with her own comments, stressing that the point of the debate was not to choose one form of medicine over the other, but to make sure the medicine is evidence based, and contextual. Chronic and acute issues differ in their types of treatment, and the choice of approach should take context into account. Ziyadeh concluded his own segment with a quote by evolutionary biologist Richard Dawkins that comprised the debate quite nicely: “There is no alternative medicine. There is only medicine that works, and medicine that doesn’t work.”

Additional Comments from the Panelists:
Dr. Fuad Ziyadeh:
Dr. Ziyadeh argued that Alternative Medicine (AM) is popular because the public is always after a magic bullet. Unfortunately, there is little scientific evidence that AM is reliable, effective, efficacious, safe, or even cost-effective. The National Science Foundation, an independent federal agency in the USA, defined AM as ‘All treatments that have not been proven effective using scientific methods’, ie, AM is ‘a form of pseudoscience’. Many of the treatments of AM, especially botanicals, are not only unproven but also disproven by randomized clinical studies that were funded by the National Center for Complementary and Alternative Medicine (NCAAM) within the National Institutes of Health (NIH) in the USA. Also, what is natural is not necessarily good; natural can be toxic. Examples were presented of
harmful botanicals, contaminated concoctions, and instances where certain herbs can seriously interact with conventional prescription medications. The whole AM industry needs regulation and control including banning direct-to-consumer marketing in the media. The government needs to step in to protect the public, especially vulnerable populations such as the seriously sick or children, from unsafe and wasteful practices and products.
Dr. Jamal Hoballah:
The three points stressed in the debate were-
1. The need to focus on the patient as whole and not as an organ
2. The need for governmental regulation of CAM practitioners
3. The need for governmental regulation on non-pharmaceutical medicaments


As to the concept of implementing integrative medicine, I think we did not reach a consensus on that among the debators nor among the spectators. My reservation on that relates to what Dr Ziyadeh and I kept stressing on which
is we do not know what of the CAMs modalities available work and what does not. How can we implement teaching CAMs to health care providers when we still do not know what works? I may be willing to agree to say that for chronic conditions where traditional medicine has not been effective a trial of CAM may be appropriate as long as done by qualified individuals.
Dr. Edmond Ibrahim:
We cannot put the TCM (Traditional Chinese Medicine) within CAM and generalize. Chinese Medicine, as well as Chinese and modern pharmacology, have their own systems, basic theories, diagnoses, physiologies, and pathologies, along with treatments such as acupuncture, herbal medicine (which is recognized in all over the world, such as USA, Australia, Europe and all the far east,..), Tuina massage and others.
We also cannot say that TCM does not have an academic value while we are teaching it here in Lebanon in some medical faculties in Beirut as a DU (Diploma University).
In addition, TCM has too much scientific evidence and proof, and I think we need another debate or lecture in ibsar to mention this evidence.
According to what I mentioned before, TCM can treat both chronic and acute disease in some cases, but often times, we need the help of the Modern medicine for emergency and acute diseases, and even sometimes with chronic diseases.
So, I still support my idea, that we have to combine both medicines, Modern and TCM, and, in some cases, under the supervision of modern medicine.

Mrs. Farida Abou Abou Khizam:
Ms Abou Abou Khizam firmly agrees that modern medicine and medicinals have an important role in medical care. This is especially the case in diagnosis, referrals, necessary drug prescribing; testing; emergency care and surgery. She also suggested the need for regulation of CAM practitioners and the introduction of Integrative Medicine into Lebanese hospital practice. Indeed, many Western doctors, psychologists, nurses, physiotherapists etc., are embracing & learning CAM as part of their professional training. Wisely, they are not ignoring the growing worldwide trend towards disease prevention and treatment with CAM. They also know that “textbook doctors”- those who primarily focus treatment on the physical body- will become extinct medical dinosaurs of a foregone era. However, the main points the panelists agreed on was
1.The need to learn how to treat the whole person (mind, body and soul) by medical , nursing & 2.paramedical practitioners in Lebanon
3.The need for implementing Integrative Medicine into Lebanese hospitals and medical/paramedical practice
4.The need for governmental regulation of CAM practitioners
5.The need for governmental regulation on non-pharmaceutical medicaments