Semira (Elena Shchepanovskaia)
Psychophilofical Items of the Oncological Challenge
an article for the conference «Human being between health and illness as philosophic, ethic and culture problem» at the State Saint-Petersburg University in 2017
The article deals with oncological challenge, when the treatment itself destroyed organism plunging a person into diseases. It is concerned also with the taboo of death, self and social isolation, and the sense of guilt, psychological assistance and rehabilitation during the treatment and attention to the individuality of a patient.
The ‘discourse of power’ in medicine (M. Foucault) and bureaucracy of health care aggravates the problems, produces disease as a product of it (A. Sekatskii), being focused mainly on the financial system (that leads to a shortage of doctors and queues, detrimental to the health). Humanistic orientation, as a possible way to exit from this critical situation, is the cooperation of the doctor and the patient.
The theme of oncology deserves philosophical attention, as the society still has some reluctance on dealing with the deep aspects of the challenge. This reluctance doesn’t disappear due to a taboo on death in the modern world. We have forgotten how to treat it. The sacred sense and respect for the processes of dying are almost lost. The Russian philosopher Boris Markov says, that «we have forgotten how to communicate with death, and it became wild’ [1, P.284]. Only in the East, in the countries predominant in Hinduism and Buddhism, death has a joyful and light attitude.
So a person diagnosed with cancer is disposed to be self and socially isolated. Because of the wild subconscious fear of death that now has become a social norm, this arouses in others a very special attitude that doesn't support health but is extremely harmful. Even the Russian usual term 'cancer sick' is not proper, as he himself usually feels quite healthy before diagnoses and treatment. Without the medical red tape that takes a lot of time and effort, and the lack of information on support means during periods of treatment, the 'sick' could have a healthy lifestyle. But in the modern medical system, one needs to fight for it. The notion of health can be understood as a life quality, which level depends on social consciousness.
Everyone is unique, and the word "cancer" today means a large complex of diseases of the growth of tissue caused by a variety of reasons. It is not surprising that in the absence of an individual approach to the treatment, nobody manages to find a universal cure from cancer. The ordinary medical model can be unhelpful as it is recognized by the doctors. That's why the patients must search for themselves. One should not blindly trust the official line. And one should try to communicate with doctors personally. It is extremely difficult, because of the bureaucratic system. But this communication is a very important perspective. And it's an important part of the first recommendation to the cancer patient that is to have close associations with people. That's what one has to learn from scratch. The main psychological problem here is self-isolation: the thought of death can make a person leave the world of living people before real death.
The oncological diagnosis throws a person out of this world in a vacuum of the peculiar isolated reality where everything has already come to end. The aforementioned insurmountable boundary in our minds between life and death gives rise to a patient's unconscious detachment from the world of healthy people, which prevents his recovery. The official medical discourse, ‘the discourse of power’, which Michel Foucault wrote about [2, 3 P. 47-97], makes a person find oneself sick or even insane, dependent and blindly following the medical procedures, about which he knows nothing, forever falling in the 'percent' risk of death and leaving a happy life with its usual prospects. And "sick" is easier to manage when one doesn't resist and doesn't ask questions.
Our usual medical treatment in Europe and USA is surgery and drugs that are inherited from the war-oriented medicine of a masculine-orientated society. One must understand that in the modern medical system operations are financially profitable. As well as the fact, that surgery and antibiotics in Europe are developed more than other methods of medicine because of the legacy of the war ages. Only in war situations, a habit of cutting off damaged organs could arise, instead of a holistic treatment of the organism having been developed in the Asiatic countries. This is the defectiveness of the European approach that makes medics consider superfluous even the symmetry of the organism. It is considered quite normal to live with one kidney or one lung. Well, why a 45-year old woman should have two ovaries, she's not going to give birth, is she? But there is nothing superfluous in the body, and the removal of whatsoever always bears imbalance in the endocrine system and a risk of cancer. So, only in the most extreme cases surgery is more useful than harmful.
We can find an alternative in Asiatic countries (India, China), that's a holistic approach, not destroying some parts of body when healing another. In European sources the idea is also developing, that we need to cure the whole person: «It is our central premise, that the illness is not purely a physical problem, but rather a problem of the whole person, that it includes not only body but mind and emotions» [4, p.10].
Advocating a holistic approach and attention to natural processes, R.G. Hamer urges not to hurry with secondary medical intervention, indicating that a phase of post-cancer recovering may show symptoms of inflammatory diseases (attack of the germs-shiners, which in fact is liberating the body from cancer cells, while toxins and drugs would become detrimental). As well as swelling in brain and in problem areas can be diagnosed as cancer, leading to unnecessary operations. Also the understanding arose that the modern method to cut as much as possible for the sake of insurance can provoke the problem: «The earlier maxim to cut deep into the healthy tissue to avoid metastasis is unfounded and absurd’ . This conclusion is confirmed by the theory that cancer is caused by bruises and inflammations. (In the 19th century the German physician R. Virchow conjectured that cancer is an erroneous mechanism of wound healing. Cancer exploits the process of tissue repair: inflammation that is intended to heal by creating a new tissue, but it can promote tumor growth [6, P.248].) From philosophical point of view, such understanding has a perspective (but in conveyor of German medical system, the ideas of Dr. Hamer caused hostility as alternative medicine which could prevent to the usual finance floods).
Developing the holistic approach, one can see a future perspective in healing by spiritual energy (shown in my story 'Twenty Days at an Ashram: Recovering by Spiritual Processes') . But such approach supposes that a physician should perceive the inner state of sickness (for example, diagnostic by pulse).
Today the doctors don’t want to go to the bodily depth of the patient, they want to preserve the independence of their medical positions – maybe because it is not very reliable? Patients wonder, why their doctors don't listen to them, don't hear them? Maybe it's because doctors are afraid to get in touch with their own bodily depth? They are not researchers as Paracelsus, Gehlen or Aristotle? Therefore, in modern medical discourses the patient's questions to his doctor are perceived as something indecent.
The doctor doesn’t trust the feelings of the patient. And the treatment usually begins when the illness becomes so extensive and clear, that it can’t be cured. The patient must first prove his right to be heard, he must insist that he is sick, to persuade the medic to take care of him. For this, one is forced not only to feel sick, but to establish himself in his disease, to prove its awfulness to himself and the doctor. The patient must convince the doctor that everything is bad, instead of the doctor assuring the patient that everything will be fine.
The issues were raised in an article by Alexander Sekatskii ‘Critique of medical discourse’: «One can ask, according to Aristotle: does healing provide health, or rather disease?» [8, P.339] The philosopher concludes that the contemporary medical system, along with medicines and physicians, produces «human suffering», «dark thoughts» – it makes a patient sick.
Philosophically, the disease has become in our minds a separate reality. It dominates upon health and takes more and more of living space. As Sekatskii notes, the human being became a subject to a new moral imperative, which can be formulated by analogy with the categorical imperative of Kant – even if you are healthy, act as if you are sick, because it is wiser: «Do as if health has always been the goal, not presence» [8, P.350]. We can formulate it in such a way: the patient must be ill – he has the rights of a patient (not to work), but as if he has no moral right to behave like a healthy person: to participate fully in life, to enjoy, to be strong, to live without pain, because the medicine does not provide the quality of life. To be healthy is an exorbitant claim. And from this point of view, for life itself you can hang the token of packages of medicines: «to apply for the appointment of a doctor».
The result is a reductio ad absurdum – and today, the average physician sees the treatment first of all as a factor in maintaining the financial system, without any belief that he can actually heal the patient. Therefore, doctors ceased to act as it’s necessary for the person coming to them. People need a doctor who, at least in part, within the framework of its recommendations, would take responsibility for their health. So it was in the earlier centuries, when there was less bureaucracy and juridical responsibility. But now doctors are often motivated by a desire to protect themselves from the consequences of their recommendations, which often comes to the fore.
It is socially legalized: starting with the fact that the patient signed the consent for surgery, and the rejection of it, in any case, taking full responsibility himself. Also medical commissions exclude the human factor completely. How can the doctors who saw the patient for first time and in two seconds looking at the pile of his papers, make a more appropriate decision than the one who had seen the patient for some time at least? For the doctor, the commission helps to finally get rid of responsibility. But whom do we have for doctors, if it is believed that they are unable to prescribe treatment alone? And if the medical system doesn’t give trust to the doctor, how will he learn to trust himself?
Ideally, the doctor has to discuss the treatment procedure with a patient: it would help the physician to get rid of doubts, so far as the patient is aware of his bodily processes. And it would also help the patient to get rid of a doubt, if the standard treatment of the medical conveyor is effective for him. After all, the belief, that the chosen method of treatment is the best, is very important in healing.
In USA, the patient can choose from cancer treatment variants, suggested to him – in Russia today there is no such legalized possibility. Though in a formal situation, where a doctor has no chance to go into detail of the situation of each patient, it’s really better if the patient is also involved in decision-making.
The cooperation between doctor and patient is a transition to a different discourse of their interaction. It’s a new, and perhaps long-forgotten model of equality, involved in the common process and tending to a common result.
Of course, the development of medicine radically transformed life – but what is the essence of its changes? According to the thought of Sekatskii, «first, the acute form of decay, in any occurance, translates into a chronic one, which now appears as life (but not the vita active – active life). Secondly, the moments of enduring, inherent to the healthy condition, is withdrawn into the disease <...> third, <...> health is something, that medicine can control, so it is reduced to the bodily functions. As a result of all changes, health shrinks like Shagren leather, and the area of sickness and pain, on the contrary, expands to the unprecedented limits» [8, P.352].
Medicine has become a business – the manufacture and maintenance of diseases and manufacture of its products, the disease, similar to other products. It's confirmed be\y mass media, overfilled by shows about health and advertisement of medicines from regular sicknesses of all age-groups of population, beginning with babies. The philosopher proposes to consider it as a special branch of power, following Michel Foucault (the sixth one, if we consider the media as the fourth and the security services as the fifth one).
As a discourse, medicine is forbidding and prescribing. So the refusal from the official treatment is considered the antisocial act. And most of the official doctors, of course, will blame the patient in a criminal attitude, if he does something independently or uses non-traditional methods to restore the body, even with no alternative, when conventional medicine cannot help him. The modern medical system «categorically refuses to concede the role of the intermediary monopolist in the field of health» [8, P.363].
Everything is done, not as it’s necessary for the patient, but as it’s convenient to the doctors and the system as a whole. The desire to keep the patient in ignorance, perhaps unconsciously, is the most powerful lever of authority. It is important, that it does not allow the patient to relax, unwind and restore. Today man has a right to know all information about his condition, and what treatment he will have, in what time frame. However, for some strange reason, we are returning to the situation when unspeaking and unknowing about their health the patients are given to the mercy of a doctor. Philosophy reasons that medicine has a separate sphere of relations, a model which is more conservative than modern relationships. It copies the outdated discourse of power of the past. But «power corrupts, and absolute power corrupts absolutely» [8, P.363].
Nowadays, almost every visit to medical institutions, with their bureaucracy, threatens to turn into stress. The official medicine consumes completely a person's free will and their own rhythm of life here is not respected. Maybe it's the legacy of a police state of Russia, as well as medical commissions – not so much for healing use, but supervision of medics. If you call a spade a spade, this is a humiliation of doctors that they automatically dump on patients. The purpose of their work cannot be achieved, as the medical system causes the absence and even the impossibility of rehabilitation needed for health. The sick people do not have time to rest and restore in the treatment process (that is necessary for cancer patients), spending all his forces on achieving results, albeit illusionary. They are only wheels of the medical conveyor, which must be in constant motion. So the financial system works. But human being... what human being? In the world, he is a passerby.
Sekatskii concludes that the medical discourse of «false, hypocritical and hidden cynical» [8, P.340]. The discourse of power makes medics to forget that the drop of humiliation and sorrow of one person makes bitter the whole social atmosphere, in which we live. That's why, no matter how utopian this may sound today, for the physician as for the sake of the patient, it is important to make a common deal, with equal involvement and with the utmost faith in the favorable outcome.
Then it’s necessary to highlight some psychophilosophical issues of the oncological challenge. The first one is the right to death. It is often assumed that cancer is a “mystical” disease, but the whole mystery around cancer is associated with fear of death. Without mysticism, the simplest hypothesis is noteworthy that cancer is the analogue of fungal diseases of different types. It is proven enough that it is caused by 1) stress (first description of stressor reactions was represented in the 1930s by Canadian physiologist H. Selye. And in the 1960s investigations of the German Dr. R. G. Hamer showed that in 50% of the studied cases of cancer, there was a correlation between the appearance of the tumor and some experienced tragedy [5; 9]); 2) hormonal imbalance, 3) bruises and inflammation, and 4) by lack of energy and immunity (now 20-years old patients aren't the exclusion, frequent cancer in pregnant and lactating women). The last challenge comes from an unnatural tensious lifestyle, oriented to surviving and not for living (now in Russia long working days in firms, exceeding the working time of the Soviet years; waking up in the darkness; late sleep, provoked by the media; superfluity of negative information in the mass media and the level of emotional aggression acceptable in a society, disrespect for the person, etc.).
Since disease is considered a social norm, here an ecological challenge arises: inattention to the needs of the human body. The mortal disease clearly manifests the bodily needs. It would be better to consider for the social norm a prevention of diseases, in particular, the elimination of the intense rhythm of life (that is, the legislative ban on excessively long working hours; the reduction of periods of getting up before dawn, namely the official shift of the work and school day in winter for pupils and students, as it is done for example in India; control the TV channels so that they wouldn't provoke late sleep, placing meaningful programs and movies in a earlier comfortable evening hours; also reducing permissible aggression and stressful tones in the media, etc.)
Despite all these obvious reasons for cancer problems, the fear of death makes reluctance from everything connected with the challenge as from something shameful and accompanied by a sense of guilt. Especially since Christianity lays painfully familiar feelings of guilt on any man – healthy or sick. Eastern religions do not blame the man if he dies. Maybe because of the concept of reincarnations but there is no problem in death. But according to Christianity, the person should live! After all, the man lives only once. If you die, giving up your relatives – how can you be forgiven? Nevertheless, the person is guiltless, if his frail body refuses to live in environmentally unfriendly conditions. There is a collective karma which the individual body may not cope with.
About the right to death it is written in the book 'Getting Well Again' of Carl and Stephanie Simonton [4; 10]. Arguing about human responsibility for their health, the book of Simonton suggests that guilt of self-destruction «in no way should refer to people whose physical illness has developed as a reaction to stress». Reactions of this kind are too deep to be considered today available for direct volitional control. But a person can help recovering by visualization desired effect of medical treatment [11, P.6-7].
The book of Simontons has advices on relaxation, overcoming pain, meditation and visualization - imagining how lymphocytes destroy cancer cells (the last must be represented soft and weak, but not as tenacious shellfish, and white blood cells as strong and intelligent - for example, in the form of sharp-toothed fish. According to the authors, the lack of aggressiveness is not good in such a case, it shows helplessness as one of the psychological causes of cancer, the inability or unwillingness to protect themselves, or lack of natural protection of the person and the body, which is converted to excessive defense. Another interesting image draws cancer as a block of ice, which is melted because of sunny lymphocytes, this is an image of release of energy earlier constrained). The principle on which radiotherapy is constructed is well explained: normal cells can repair the damage done to them, and cancer ones aren’t able as they are too weak.)
The mentioned book also says that a doctor shouldn’t be indifferent to the fate of the patient, because if he doesn’t observe a person, but only the disease, it puts difficulties to effective treatment. And if this is the case, the patient should try to change the situation. One shouldn't be afraid to include a doctor in one’s problem. If you help a medic to go back from bureaucracy to humanity, he will become internally grateful to you. Having overcome his helplessness in this and other aspects, he will open up new sources of energy, necessary to fight the disease.
This is confirmed by the experiment displayed in the book 'Anticancer' by Servan-Shreiber [12, P.257; 13]. If rats were subjected to electric shocks, which they could not control, they developed cancer twice as likely than the control group of rats, and three times more likely than those who could control it and learned to shy away from it. That means that the resistance of the last group has become noticeably higher than in the control group (for 20% - probably in the same amount our will usually can influence our body, but not more).
The book ends with the simple idea that the right relation of such a life event as cancer experience should increase the sense of health and energy, both in the oncological patient and those close to him, being the guarantee of the further life.
And to solve the problem of death, one needs to approximate the higher spiritual level, which can be expressed by words of Nietzsche (who could live and create in hard disease): «In your death your spirit and your virtue should still be burning, as the evening dawn burns – or you haven’t succeeded in your death» [14, p.75].
The second challenge is an objectionable idea, common among psychologists, that cancer arises when the person does not fulfill his destiny. (It may be a distortion of Hamer's idea that feeling of "futility" in cancer patients may provoke metastasis in bones .)– Here the consequence is taken for the reason that is typical for the ordinary (not philosophically developed) consciousness. Cancer patients are usually people of age, who lived strained lives, having made as much as they could. And the easiest way to understand the reason of cancer is such, that cancer, like any disease, occurs when a person is tired, exhausted from the tension of life. But to fulfill usual work and human purpose in the state of illness is really difficult.
The psychological help is complicated as the psychologist has rarely himself stood on the brink of life and death and endured feelings that cancer patients have in the hospital. So the cancer patient could consider naïve the usual recommendations of psychotherapists. And this is the third issue. First of all, one should explain the possible sequence of procedures and ways of compensation of the negative consequences of chemo- and radiotherapy, compensating usual silence of medics. And then, with benevolence and compassion (but without excessive tragic mood), one should simply listen to patient permitting him to open the causes of his problem himself, as he sees his situation and circumstances of his cancer much deeper than any other person.
It's necessary to note, that the psychologist generally seeks to draw man to himself. But the man, whom the abyss of untimely end is opened up before, is excessively self-absorbed. And first of all he need not to experience psychological problems, but to catch moments of lightness and easy being. As Nietzsche spoke: «Just don't be tired, never be tired! The spirit of gravity mustn’t rule over you» .
Psychological help often encourages people to cope with the circumstances themselves. But in the treatment of cancer this is not the case. This is a situation, when a person needs to get help from the others, overcoming the deep bodily resentment to the whole world, caused by operation and suffering from radiotherapy and the poisonous medicine of chemotherapy. One can restore his faith in people and their future opportunities. Typically, the goal of psychology is to prove that the experience of a person is not casual, it is woven into the treasury of the human experience. But for a cancer patient it is important to know that his treatment is a temporary and accidental experience, it is a mistake of humanity and it will be overcome. Just believing it, knowing it in practice, you can continue to live normally and not to fold the wings.
This understanding of the situation is well resonated with a book written by a psychotherapist and a doctor of medical sciences Andrei Gnezdilov, a founder of the first cancer hospice in Russia, who worked for many years with cancer patients, using also methods of fairy-tales and soundtherapy. In this book, there is an access to the truth of the situation that cancer patients are immersed in. The therapist writes: «It sounds paradoxical, but our patients often sustain us and our faith more, than we them <...> The special status of the people with whom we communicate, creates an atmosphere in which there is no place for lies, hypocrisy, adults games <...> and probably the most valuable thing is that we stand here all together in the face of Eternity hand in hand, and our goal really supports everyone» [15, P.10-11].
The fourth important thing is attention to one's own individuality, when it is compromised by a public formalism. Of course, the protection of the individuality is necessary first of all in youth, during its formation. But long disease is also a liminary situation, and no matter how mature and wise the person is, one needs self-defense and assertion of his view of life in relation to bureaucracy.
It's necessary to have one’s own space. For the person with oncology to get better or to die honorably, it is important to live in one’s own rhythm. Contact bridges must be built from him and according to his needs, as psychotherapist Andrei Gnezdilov writes about: «Our task is to listen and to fulfill the desires of the patient. He is an architect and an engineer [of his new, better world, that would replace the old one] and the psychotherapist is only a contractor» [15, P.94-95].
The psychologist here plays the role of an alter ego: a mirror that helps to see one’s own reflection. Here the Socratic method is actual: «I know that I do not know anything» -- which frees one from the ontologization of evil and fears. And by realizing this method inside, a psychotherapist can find a position, from which the natural entrance into the world of the soul of a patient is possible. For a psychologist, the highest task is to bring a person closer to himself, to connect him with a positive attitude toward the world, showing the place where effort can be done to change the attitude towards what is happening. For patients, the problem of lack of love for oneself is typical, and therefore the realization of the ancient 'care of psyche' is actual. The path of purification from the inner coercion of the will, rooted in the past, must be traversed («'It will be' – so it is called liberator and messenger of joy <...> 'It was' – so it is called grinding of the teeth and the secret grief of the will» [14, p.147].)
C. and S. Simonton consider that positively illness forces us to pay attention to the unmet needs that are not visible to the person: «You need pay more attention to the unconscious I and not to what you are expected by surroundings" . Psychoanalytically, to communicate with the resources of the unconscious, it is possible to work with dreams and with the inner mentor like a fabulous wise old man of C.G. Jung.
The role of positive emotions has been proven. The limbic system sends positive moods to hypothalamus, and that activates the immune system to cope with atypical cells. The negativity of fear and hopelessness (including these coming from relatives) depresses the immune system, and it ceases to resist. Positive emotions are the indicators of vitality.
Psychological assistance is the most relevant, when the diagnosis is set (to remove the shock), after treatment (to answer the question, how to live further) and before the first chemotherapy (to remove fears). And here clearing information on all issues has the main psychotherapeutic effect. Operation and radiotherapy causes fewer fears than poisons, since the consequences from them are more predictable. In my autobiographic work , I compare chemotherapy with the dead water of fairy-tales, which must be followed by the life (animating) one.
This requires a delicate work of discrimination, as well as the formulation of the specifics of the situation. Usually the mental imbalance is connected with the fact that the problem grows in the dimension that does not correspond to it. Unconscious blocks and clamps are associated with a lack of clear, reasonable interpretation.
In the case of oncology, the need for psychological help is permanent. In Russia, for a long time, it is mostly spontaneous, since there is no specialized network for psychological support for cancer patients. Moreover, in the cultured midst of Saint-Petersburg, elderly people are embarrassed to talk about their problems. But since people tend to communicate "heart to heart", we are each others spontaneous psychotherapists, and first aid is usually provided by neighbors in the ward.
In fact, psychological consultations in the hospital are necessary for all cancer patients entering there for the first time, and it would be appropriate to conduct them in the presence of relatives, who initially perceive the situation even more tragically than the patient himself. The neighbors in the ward aren’t able to render them psychological help, because they themselves are already perceived in the discharge of the tenants of the other world.
Then the roles change: with the success of the treatment, the relatives calm down, if it is unsuccessful - they get used to it, but the patient gets worse and worse, in any case, because of the accumulation of consequences that always takes place, one becomes more and more "sick". The patient is experiencing a constantly stressful state, also because a sudden change in the composition of the blood causes a feeling of "something wrong" - mostly unconscious and even more harmful for the organism, which can’t calm down and relax, without any visible reasons. And relatives need to understand that during the whole treatment, he needs support: first of all, as a help in visiting medical institutions, because he has more and more lack of physical strength to "break the wall with his forehead", that is always necessary inside the medical bureaucracy to achieve a real result. But one also needs contact on a burning topic, understanding of its weakness, lack of previous requirements, avoiding negative emotions, and confirming the correctness of what he does with his last efforts. This is often not evident, and a psychotherapist should explain to relatives the situation of a patient, to become his advocate before them and himself.
And the sixth challenge is in fact that psychologically, chemotherapy has some consequences alike to drug addiction. It doesn't give pleasure, but the payoff is the same: vascular sclerosis, impaired coordination, memory loss, increased nervous irritability, fear of pain, childish sentimentality, apathy. Sudden strange conditions when it’s difficult to recognize familiar places, so deep dips in the sleep that when awaking up, it’s necessary to make an effort to remember what happened yesterday and what needs to be done today. Ups and downs from depressions to night euphoria from the adrenaline of the compensating drugs in the hospital, cause insomnia. The body has been weaned from normal conditions, when it’s easy to live, the brakes weakened, and with the destruction of habits to health, it can cause, such a ascent that it can became a springboard to a different reality.
This is evidenced by statistics that the prevalence of cognitive impairment with a decrease in the function of 10-12% for 2 months to 3-10 years in comparison with the control group is 25 to 33%. This state was collectively designated as "chemotherapy brain" or "chemotherapy fog" [17, P.11]. The rehabilitation could reduce the statistics, but this task doesn’t even exist.
Here we meet also a problem of pain and its consequences. In a small amount, pain awakens the desire for life and the suffering can mobilize, but only for a short time. For months – it deprives the will to live: both the person himself and his loved ones. This is the reality connected with the laws of the body. Our medical system does not take it into account: it is designed for suffering for months. It does not take the mission of fighting pain, as well as of improving the poor state of the patient: neither after surgery (lack of any recommendations) nor in reoccuring cancer, in metastases (there is a significant shortage of drugs that would actually relieve pain), nor with lighter challenges (adult people must endure).
The person who has endured the long-period pain and heavy suffering (that nowadays medical conveyor and treatment suppose) often can't live after it like other people. This prevents healing and can give some isolation from society, as well as a need for more striking experience in order to return to normal life. The most radical is spiritual experience. That's why one can consider the normal rehabilitation of cancer patients to go in for religious and other spiritual activities. A spiritual approach suggests that the personality won’t experience anything in the destiny that one has no inclination to. That’s why one needs to satisfy one’s interest in the deep processes of body and soul, so that they do not lead to pathology, and that's the philosophical task.
According to Dr. R. G. Hamer, metastasis does not occur from the spread of the previous cancer cells to another organs (the investigations don't detect such cells), and the appearance of new tumors has nothing common with primary one, but due to the new shock conflicts [5, 9]. And if we accept this, quite logical, point of view, it’s the shock of the official medical system, its methods and their effects that becomes an unconscious obstacle to the cure of cancer, leading the patient to death. To cure a patient, we need to remove the cause of illness, even if it's background cause, that is first of all rescue him from stress. And usual methods of cancer treatment as surgery, chemotherapy and radiotherapy, on the contrary, have severe stressor influences. The stresses of exhausted cancer patients often transforms into abnormal reaction, aggravating the situation that provoked the cancer. Psychotherapy aims to break this vicious circle. Spiritual practice also can do it.
But can psychotherapy resists to the medical bureaucracy? Why medicine can today cause criticism from philosophers? Investigating spirit and will, a philosopher sees, how medical system can suppress it. Under Damoclus's sword of juridical and financial responsibility medics are afraid to do something in which they could be accused, preferring not to undertake any initiative. However indifference to patients doesn't refer to any responsibility. Juridical and financial factors (more and more penetrating our society through American mode of life) create virtual world of their own, replacing the reality of human life. The gist of concrete medical problem is being lost in bureaucracy. Medics turn to act in frames, in which they almost deprive of opportunity to help people personally, as they would like to act outside the system. Psychotherapy of cancer not even developed turns to be in juridical and financial grips, yet having been legally approved but already financially not profitable, it's not inserted in medical conveyor and necessary only for the patient, whose opinion is not paid attention to.
According to the recent statistics cited in the media, the Russian medical system takes the last place for the efficiency among developed countries. For example, in Israel, 95% of breast cancer is curable (five years of survival). And we in Russia have other official figures: during a year 50 thousand women come to doctor with this problem, and 22 thousands died! Although medications are the same and competence is not worse. Obviously, the reason for the extra 42% of deaths – in the standardized treatment (individual approach to the patient suggests deviation from medical schemes, and it is officially banned today). And in the absence of medical rehabilitation, in the lack of even general recommendations.
Formally, there is the so-called Individual Program of Rehabilitation (IPR) for the disabled in Oncology, but it does not include almost any real measures to help the person. No specialized medical care to restore blood vessels, liver, heart, lungs, bones, teeth and hair, injured from chemo and radiation. No physical fitness activities and sports (despite recommendations in the epicrisis of the standing pool, and therapeutic exercises from postoperative lymphostasis). No rest in health resorts, the need of which for cancer patients is discussed below. No socio-cultural rehabilitation – for what reason do cancer patients need to raise mood and to recover from depression on cultural events! This program is not even always including a compression sleeve and glove, which when lymphedema one must wear every day. They are prescribed only when severe edema, when it’s impossible to cure anything anymore.
The only available in our country effective rehabilitation, which is also recommended in the West, is travelling. For Western people its main reason is psychological discharge: to leave behind the diagnosis and excruciating treatment, to eradicate the horror of the situation by pleasant experiences and to forget harrowing experience as a bad dream. The task here is to rebuild unconscious habits that caused the cancer, not to take it back. This is the key point of rehabilitation, and this requires a fundamentally different social rhythm, an altered way of life. When travelling, the person is becoming a little different without losing oneselves, more cheerful and happy. Along with a new, pleasant, experience having expanded the horizons, one acquires willingness to live.
And for the Russian people there acts even more important, purely material factors – just to be in the area of more comfortable climate. And for a little while, one has to give a rest to the body. For the cancer patients this "vacation" from medicine is a necessity, it is more important for them than vacation for the day-to-day working people: in order to raise the immunity during and after treatment so that overstrains wouldn’t lead to metastases.
Returning to the subject of death, it should be noted that this is still a traumatic reality that requires the return to the ancient art of dying naturally, with dignity, easily and consciously. Echoes of that, one can find in the rituals of world religions. To deal with cancer challenges properly, the terrifying specter of death, now eclipsing the whole sky, must somehow be reduced in size, and become more accessible to people.
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 reduced to absurdity