Dr. Elliott Dachner hears a different-drummer. Though most of his colleagues haven't got the beat yet, it's been around since the first medicine man talked (or terrified) the first patient into being cured.
It's been a part of traditional medicine for better than half a century, but somehow -- with all the more explosive developments in medical technology -- its call was muffled.
Some might call it the rhythm of life.
A lot of people nowadays hear it with slight variations of tempo so it comes out in different ways -- as part of transcendental meditation, for example, or via purported self-help groups like est, or Lifespring. It's part of newly respectable fields like biofeedback and acupuncture and more controversial therapies like rolfing or faith healing and even astrology, as well as things even more, as author-editor Norman Cousins puts it, "out of the margins."
Sometimes it's religious; sometimes just spiritual. There are elements of it in Zen and yoga and Christian Science. It's what some doctors call "the placebo effect." It's what helped Cousins laugh his way out of his critical, paralyzing illness.
It's all lumped together, for better or for worse, as "holistic medicine." In some of its variations it is practiced by people who are not physicians. More and more, though, like Elliott Dacher, physicians are beginning to listen. And out of the margins or in, there are success stories that cannot be belied -- or explained in traditional terms.
What all the therapies have in common is the philosphy that each human being must take responsibility for his or her own life and health.
And this philosophy is based on the time-honored, but little heeded (by the establishment, anyway) premise that the human body contains within itself the ability and the mechanism not only to protect itself from disease, but to cure itself when the protections are breached.
The secret is activating this mechanism, and that is what holistic medicine is all about.
"There are a lot of different holistic therapies," Dacher was saying the other day. "I don't really care which. I don't hook into any of them. But I don't think the techniques are important. I think the philosophy is what is important. You have to choose. . . what you think is helpful and effective for you. . .people have to learn to trust their own bodies and their own intuition.
"The greatest healer is inside and I don't think our doctors know our bodies better than we know them ourselves. He probably doesn't even know his own body very well, much less somebody else's."
Elliott Dacher is the chief of the Georgetown University Community Health Plan in Reston, Va.
He has as traditional a medical background as anyone could ask: medical school in Buffalo, N.Y., internship at Michael Reese Hospital in Chicago, the (Vietnam ) war years in a Boston neighborhood health center (a break with tradition: He was a conscientious objector), then Harvard's Primary Care Program in Boston.
Still, he found he wasn't really practicing medicine the way he wanted. He was, he recalls, "just a pharmacist filling out prescriptions. The vast majority (of patients) were suffering from types of problems I really couldn't handle and which actually had no diagnosis at all -- they were mostly what doctors cal the 'worried well.'
"In the traditional diagnosis establishment you have the sick, the healthy and the worried well," he explains. "The sick have a sickness you can give a name to. The healthy have no disease -- going no further than that, just having no disease -- and the worried well are those where the doctors don't have a name for the disease, but they (the patients) think they have something and they're worried."
Although Dacher talks almost nonstop and is clearly excited and stimulated by his subject, he, before too long, has slipped off his penny loafers and is perched, sock-footed, on a sofa in the (more or less) classic lotus position.
His approach to his patients now is keyed to the belief that, indeed, there is something beyond merely the absence of disease. He and others are calling it "wellness," and, in essence, Dacher is asking his patients to decide if they can "believe that you participate in whether you have an illness or whether you have health. Do you participate in creating the illness? Do you want to acknowledge your part as a patient?
"If you do, i can work with you and show you some ways you can participate in being a well person.
"But if you choose to participate in being an ill person, i will take care of your symptoms when you have them, or someone else will."
One technique Dacher finds effective is the use of hypnosis as a teaching tool. He recalls that he had some ethical problems initially about "getting into somebody else's mind," but now he teaches self-hypnosis as a deep relaxation technique. It is similar to, but faster and easier than, the meditative state reached in TM.
"What most people call the base line (of relaxation) is a real stress state," he says, "and when i put someone through a relaxation technique and then wake them up and they're going just 1 mile an hour, they realize they never felt that way before and they say 'what an amazing experience.'
"It makes a major difference just to be relaxed: The muscles calm down, the mind slows down, things become clearer. You can even step back from there to look at what may be behind the whole thing . . . the issue of beliefs . . . "
Dacher has great respect for traditional medicine and is not about to turn his back on technological advances. And much of his advice about proper diet and exercise is traditional enough.
But, he says, "You're going to live and die the way you've chosen to live. And that's just the way it is. The diseases in our culture are those kinds of diseases.
"The major infectious diseases of the past didn't go away because of antibiotics. They went away because of increasing levels of affluence, better water supplies, better food supplies, better living conditions. It wasn't what medicine did, it was what happened within the whole context of people's lives."
Then later, " . . . The idea of curing cancer by trying to understand it on the submicroscopic level is . . . so misdirected i just can't believe it . . . it's the way we live. It's the disease of Western civilization. So is heart disease.
"People die from suicide, and look at the other problems: mental anguish, anxiety, depression, stress, alcoholism, obesity, high blood pressure . . . "
Some of Dacher's patients now are meeting in "wellness groups," created as support systems, and he has begun a newsletter for others to share experiences and techniques. (To get on the mailing list, write to The Wellness Network, P.O. Box 2531, Reston, Va.)
He also has helped initiate training sessions at Northern Virginia colleges and conferences in the area. A major one is planned for early next year in the District.
"It is," he says happily, "an idea whose time has come. I think it's going to fly over the next 15 or 20 years, because there isn't any hope in the present approach. Think how crazy it would have seemed 15 years ago if you'd told people they'd sit around for 20 minutes saying 'um' or whatever mantra to themselves . . . Now they do it in coronary care units!"
"Can you imagine a world where everybody knew how to relax?" he sighs.
"It's really earth-shattering."