Healing Trust & Getting Closer to Clinical Reality
The Evolution of Therapeutic Injections to Relieve Pain
This article is from a talk I’m giving at the launch of the Healing Science Policy, a new health policy institute aimed at opening up discourse in today’s medicine. The launch is May 9th and 10th in Lafayette square, Washington D.C. Healing Science Policy Institute is a think tank that aims to sustain HHS and its restructuring. The hope is to truly organize all of the issues, including all of the weeds/details of science, research, regulations, and policies and to change the ACADEMIC-MEDICAL CULTURE
My earliest memories of visiting the pediatrician were always pleasant. I vividly recall Dr. Maloney, a tall figure with brown hair and a beard. He often sported shirts with cartoons and always surprised us with a toy on our visits. My mother prepared us well for the inevitable shot, whether for allergies or a vaccination, of which there were only a few in those days.
I would hold my breath or look away when the shots came, and the reason I could prevail over my fear of shots was this trust, instilled by my pediatrician. My brother, on the other hand, didn't fare so well. He cried every time he got a shot.
Based on my experiences, I wonder what it would take to help others gain strength or trust when a foreign object is about to enter their body. This is one part of my fascination with needles. Physiology is a brilliant way to think about medications, and here is how I think that patient-physician relationships and trust can be restored.
The easiest way of capturing the aspect of what I’m talking about is how I became interested in needles. Patients see my spirit and how I profoundly look at needles. People have an uncanny ability to trust, you know, at the exact moment when it’s most needed.
How do you turn that need into full-on trust?
Even one needlestick can paralyze a child for years and severely affect the ability to function or trust. I'm here today to tell you that NOT every child has the same experience same trust, and many children experience these things differently, just like my brother.
I'm a physician, and my childhood experiences shaped how I give shots nowadays. It highlights that even though I've been doing it all these years, I've never looked at it in this way until now. Patients have helped me realize the weight of the responsibility of being a healthcare provider, as the patient's trust is integral in their treatment. Dr. Maloney instilled a profound sense of trust in and around me. This spirit of trust is the cornerstone of our country, and the healthcare system, it’s what we all strive to uphold.
Human Evolution and Serpents
Over hundreds of thousands of years, we evolved this instinct of the innate fear of things puncturing our flesh, which still exists today. That innate fear of a hollow needle is the fangs from venomous snakes, lizards, or thorn bushes or knives. Our fear evolved around that skin puncture from a snake-like needle and observing what happens. This fear has biblical origins.
The Israelites, during their wilderness journey, speak against God and Moses, complaining about their conditions. In response, God sends "fiery serpents" (venomous snakes) that bite the people, causing many deaths. The people repent, and God instructs Moses:
“Make a fiery serpent and set it on a pole, and everyone who is bitten, when he sees it, shall live.” So, Moses made a bronze serpent and set it on a pole. And if a serpent bit anyone, he would look at the bronze serpent and live. (Numbers 21:8-9).
This is the connection pharmacotherapy or "small dose of poison cures."
The bronze serpent is a crafted image of the very creature causing harm (the snakes, whose venom is the "poison"). By looking at it, the afflicted are healed, suggesting a symbolic or divine mechanism. We’re confronting the source of the poison—through a representation. This aligns with the idea that a controlled exposure to something harmful can lead to healing.
History of Therapeutic Injections
The history of therapeutic injections is rich, dating back to ancient Chinese, Roman, and Indian medicine. Hippocrates (400 BC) used a local cactus application for shoulder pain, marking one of the earliest instances of this technique. Over 2,000 years ago, Chinese acupuncturists were already healing patients through injections.
The formal documentation of medical injections dates back to the 17th century. In a pioneering move, Sir Christopher Wren used a syringe made of animal bladder fixed to a goose quill to inject wine and opium into the veins of dogs. This historical context of therapeutic injections invokes a sense of respect for the evolution of medical practices. Following the invention of the hollow needle in the 19th century, the injection of substances became commonplace. Pain medicine, intravenous therapy, and vaccines were all born out of the invention of hypodermic needles.
Here are some historical examples of therapeutic injections
In 1865, subcutaneous injections and infusion was first described to treat dehydration in patients with cholera.
In 1870, doctors injected distilled water into the dermis during the Franco-Prussian War to relieve arthritic pain.
In 1884 Ophthalmologist Karl Koller injected cocaine for local pain management.
19th century French surgeon René Leriche injected procaine into inflamed tendons and the stellate ganglia, which is a cluster of nerves affecting pain in your face, head, and arms.
In 1885, American surgeon, William Halsted, injected sterile water for local anesthesia.
Medicine is the Art & Science of fostering Physical, Psychological, and Spiritual health.
The healthcare provider is interested in the biological manifestations of the pain and the energy needed to heal the lesion. Healing revolves around the interplay of body, mind and spirit. The first two are obvious and we can all engage in those discussions.
However, the spiritual discussion is virtually absent in allopathy due to the predominant materialist paradigm. Introducing these discussions, which are critical for our health, requires each of us in the healing arts to delve deeply into the spiritual realm which is neither acknowledged nor valued in allopathy. Now, in this realm, there is a high probability of being misconstrued. But humility allows us to acknowledge that we may be off track when cobbling together our own.
The Do No Harm Conundrum
The Hippocratic Oath doesn't explicitly say "do no harm," and is commonly misconstrued. The closest it comes is to the principle of non-maleficence, often summarized as "primum non nocera" (Latin for "first, do no harm"), which isn't in the original Greek text but is derived from later interpretations. The classical Hippocratic Oath, dating back to around the 5th century BC, includes specific prohibitions against providing abortions or euthanasia, reflecting the ethical stance of the time against facilitating death at life's beginning or end.
These clauses emphasize avoiding actions that directly end life, aligning with the broader intent to prioritize patient welfare without causing deliberate harm. However, the Oath also acknowledges the complexity of medicine, where some harm (e.g., surgery) may be necessary for greater benefit, making absolute "no harm" impractical. Modern versions of the Oath, like those used in medical schools, often soften or omit these specific prohibitions to reflect contemporary ethics and practices.
Allopathy Misses the Mark on Correct Diagnostic and Treatment rates
Patients are seldom satisfied with doing nothing and reveal everything if we listen. The doctor-patient relationship is a sacred bond, a meeting of confidence and conscience. This relationship is of utmost importance in patient care, making the audience realize the significance of their role in healthcare. Most never spend enough time with patients to ask questions to make an accurate diagnosis. When considering chronic diseases, an excellent physician only has about 35% accurate diagnosis rate, and a lesser physician is much worse. Certainly, this is more complex, but this percentage rings true with many physicians. Thus, more than 70% will not achieve healing, and the chance of harm is great. Why would any reasonable patient arrive at a position of trust? This crisis in trust may be a good thing. Would you trust a mechanic if he or she told you there was a 30% chance of repair?
The real problem is that allopathy claims to be the sole model of diagnosis and healing. We've been forced into believing this is the only evidence-based path forward. If we do not know how to help a patient heal, we should say so and make an "out of the box" referral. Maybe this means Eastern medicine, naturopath, acupuncture, energy healer, or the like.
Children are often forced to consent to things that they do not trust.
Children inherently trust their elders. They are incapable of knowing whether the healthcare systems fully understand the importance of loving relationships in the healing process or the extent to which some painful procedures, such as needle sticks, can cause suffering. Most children cannot trust a stranger and sometimes even a close relative.
When the only way to heal is by injecting people or, if you will, using the staff. Many situations happen forcibly to children. We subject them to our will and seldom ask permission or ask ourselves what's best for them. We often put children through fear and anxiety through some very hurtful situations for their "own good." Parents are good at defending children from the world's wickedness. But they can only do that if they are well-informed and well-educated. Even more often, many do not realize the wickedness of their cruelties.
Many healthcare providers see their duty in healthcare as minimizing the risks so as not to cause harm. Doing no harm is impactive, yet impossible. For many healthcare providers, it is problematic for bioethicists who justify medical actions and research as ethical if they reduce risks and are for the greater good. The standard for reducing risks is delaying death, which is seen as the greatest of all risks and, thus, the greatest of harms. Death separates a person from their physical vessel. The procedure often does more harm than the illness, despite the outcomes—for example, the terrifying scientific groupthink around the mRNA jabs for children.
What happens when pediatric healthcare providers justify coercing their patients to minimize their risks, as in the case of vaccines, chemotherapy, and diabetes? Many healthcare providers want the best for their patients, and not all believe using coercive tactics to ensure compliance with the care plan is in the patient's or family's best interest. However, even if one healthcare provider believes the treatment plan is necessary, the parent's permission can be coerced by other means, such as Child Protective Services (CPS), or overridden by court action. Even more, a favorable outcome is never guaranteed. And some children end up being injured by the very best treatment plans.
The Restoration of Trust between Patient and Provider.
I've studied pain and sought ways to eliminate and block pain; I wrote a book called "Stopping Pain."
I've written about ketamine and how it helps to treat pain; I wrote a book called "The Revolutionary Ketamine."
What does that trust look like? Imagine having a newborn, and after a couple of months, that baby is comfortable being held and healthy. You trust your mom or dad with your baby. When we hand our child over to our pediatricians or other healthcare providers, we all desire a world that approaches that same trust.
The loss of trust has been too far long in coming. But how that ethic, in terms of how it's done, matters. Because that's what you've seen. Because of that trust. And trust is the new currency, as we've seen—trust matters. Trust is the new currency. In America, trust has always been our currency.
So now, how do we, as medical professionals, restore medical trust? How do we restore trust in ourselves and our medical system? It's daunting, especially when many people have lost faith in our medical system. But it's not impossible. Building strong patient relationships and delivering high-quality care can rebuild trust and eliminate the rift between the medical system and the people it serves.
And what if you've noticed, the same thing I've noticed is that just about everyone is nervous about needles. We've read and seen trauma around this. Many don't trust physicians. The easiest way of capturing that aspect of this trust is by doing the right thing when people are most vulnerable. Trust changes immensely when someone is in need. The human spirit cares less about the needle at that exact moment when you're in need. So, how do you turn that need into full-on trust?
Well said Doc!!