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While still waiting to personally experience the intake visit of an "integrative medicine" center for the alternative medicine series, I began to worry about what article I would do for this issue. It occurred to me that terminology always presents us with problems.

Calling any medical system "alternative" is problematic. First, because most alternatives are not new to medicine in the worldly sense. We rather borrow from different systems and try to "integrate" different models into our own world view.

This integration raises problems. Many models don't mesh very well. Then, the basic essence or cultural aspect of any system might be changed for the worse as it is integrated into a new system. In other words, we might miss important things based on what we choose and choose not to "integrate."

More troublesome is an assumption that tends to prevail at any given point both in conventional and non-conventional medicine.

All medicine in this country still is intensely focused on interventional therapeutics — the treatment of a problem once developed — instead of the whole and complete forms of health care. This might seem like a radical statement since the term "wellness center" is basically advertising the stay-well, prevention philosophy of many alternative centers. As much as these centers promote staying well, say through exercise, diet, movement therapies, meditation and relaxation, the approach to illness still encompasses the disease model that assumes something specific is wrong with the person.

Regular medicine is the leader in this model. This model is excellent for broken bones, surgical correction of catastrophe and managing the life-threatening effects of incurable diseases. Furthermore, we now have high hopes for finding new magic bullets through the manipulation of our genetic structure. Correct a genetic deficit and replace a specific enzyme, for example, and all will be well. And indeed, we might cure formerly incurable diseases. Very occasionally, we actually do this.

None of our therapies to date, however, have ever alleviated human suffering to the degree that environmental improvement has done. Sanitation systems alone have wiped out more disease on a continuous basis than any of the many high-powered antibiotics in use.

Yet, in health care and health policy in general, we seem to have an almost relentless tendency to ignore environmental illness, either in terms of causes of disease or prevention. Our Environmental Protection Agency, for example, tends to regulate poisonous substances based on how poisonous they are and on what the acceptable potential damage to humans is. This might seem rational until you multiply the effects of one poison tens of thousands of times. As another example of the laissez-faire attitude to human health, indoor air quality has been labeled the most important health problem facing us, but regulatory proposals have sat in Congress for at least 20 years.

Medical folks tend to intellectually avoid the hidden field of "clinical ecology." This field tries to explain health problems in terms of environment. Why this work is avoided is apparent when you read what is written by clinical ecologists. For Pete's sake! Everything in our food, water, clothes, building materials and air is a potential cause of ill health. One might conclude that this is all simply a generalization of a definable problem — really poisonous stuff — into an easy fantasy and excuse for all those hypochondriacs who feel really lousy every day.

But, much more ominously, if we think hard about this, the untested use of poisons, synthetics, artificial ingredients, fake lighting, bad air environments, water additives and multiple forms of electromagnetic radiation, is at best, rampant and poorly controlled. The clinical ecologist, often labeled "unscientific and downright crazy" by colleagues, is of necessity a generalist.

The mentality supporting our ignorance takes many forms. Here's a real big one: If no one has proved it's bad, then it isn't. Or, even though the material has never been tested, we've used it for 100 years, so it's "generally regarded as safe." How scientific. Or, one of my in-law's favorites: Human beings will always demonstrate resistance and adaptation. Yes, but how many of us are dropping like flies while the marginally healthy survive?

Frankly and frighteningly, environmental toxicity is viewed by the majority of physicians, other professionals, politicians and business leaders as either a wimpy, worry-wart complaint or through the inability to face true and justified fear, something best not thought about. Quarterly profits are easy to understand. The ongoing rise of various diseases without "known" cause is harder to grasp and comprehend. In fact, a biochemical abnormality can actually be regarded as the cause of the disease, while the chemical not "proven" to cause that abnormality can be altogether, too easily, disregarded. This thinking is strong in our current health-care culture.

Looking at other cultures, I am forced to recall all of my reading about Native American Shamanism. It appears that various tribal rituals encompass the cultural, emotional and spiritual aspects of health that alternists complain is left out of mainstream medicine. Yet, the Native American population is severely afflicted with diseases such as diabetes and alcoholism. Although genetic explanations are in vogue, these epidemics apparently occurred from a disruption of culture, including diet and other environmental factors.

So, in "integrating" medicine, maybe we should consider this: Inattention to human relationships, ignorance of spiritual and emotional development and disregard for our specie's relationship to its own waste products and their effects on Mother Earth constitute the common attitudes that can undermine the benefits of any medical therapy.

Stated in a different way, the term "environment" encompasses therapeutics, food, air, water, the planet as a living ecosystem, the effects on our planet and its atmosphere from the surrounding universe, energy fields around us and on and on as these things are recapitulated in the human being.

A fishbowl not cleaned of waste will eventually kill all of the fish although you might see some mutants first. Here is our great responsibility. We put the fish in a bowl, and we have to clean it. So has nature in this century been assaulted more than any time in known history. Only mankind appears to have the potential to undermine the life-supporting efficacy of even the oceans.

The potential failure in incorporating "alternative" systems into ours is the loss of those systems' respect for the interrelated nature of human heath and our cosmos. In many systems, this cosmos includes a sense of a greater power, of universal forces and of the sanctity of nature and our place in it. The balance of forces is respected, as is our place in that balance, while the Western notion of us in control of greater and greater manmade machines is, well, viewed as totally crazy. In fact, many practitioners in alternative cultures view their role, more and more, as needed to counter this very mainstream, Western version of reality, which is considered insane.

A historical and a fictional example of such perceptual effects might help us understand the notion of this culturally specific, yet world-dominant insanity. In medieval times, the notion of strip mining for lead, or of digging lead out of the earth at all, would have been abhorrent to many, in that raping Mother Earth was abhorrent. Lead poisoning was not a widespread problem then as it is now. Since we can do without lead in activities that expose us to its toxic effects, our wisdom versus that of medieval times should logically be questioned.

In Kurt Vonnegut's Cat's Cradle, a weird, brilliant and vulgar scientist invents Ice 9. This is a form of water that freezes at somewhat below-body temperature. The problem is that it alters regular water to its own characteristics. Thus, most of the world and its life forms freeze. The main character freezes, giving the finger to the sky, presumably an insult to an uncaring divine force that would allow the abuse of such knowledge that could create Ice 9. The only satisfying thing about this story is that the scientist gets frozen first.

We have to then ask, are there people who will do things simply because they can be done, without much or any attention to consequences? Duh!! It isn't God who's the problem here. It's the abuse of free will and intellect through something that could be called arrogance. Even worse, as a lawyer friend pointed out, if things are done knowing they probably won't work or will have disastrous consequences, we are engaging in something called folly.

The creation of totally resistant bacteria through the injudicious use of antibiotics is an example of medical folly. We knew it could happen, that it probably would happen, and it has. Yet, we keep looking for the next generation of pills to correct our indiscretion.

We know we have significant environmental disease. Indoor, outdoor, internally and externally. Just one little example: In the early '80s, the National Scientific Committee on Diet and Cancer estimated that 30-to-70 percent of cancer causality could be related to what we ingest! This includes our water supplies. Add in all industrial toxins and all other human-made contamination. Is this 90 percent of causality? Are we making a 90 percent counter effort? Have all health practitioners banned together to fight a problem that could render any system useless? No, actually, we are collectively doing next to nothing. In fact, we continue to expand our conventional models with our detachment from nature and our preference for toxic ways. Folly, folly, folly.

At the same time we are expanding our integration of therapeutics, which can be categorized as follows:

· Modern Western medicine: Mainly deals with fixing things that are broken within the entire system, like replacing the stair railings in an old house, replacing furnace filters and updating the hardware that is worn out. Tends to focus on the physical and metabolic. Herbalism and megavitamin therapy are included here.

· Energetic medicine: Attempting to influence the human energy field, which is conceived to be on a physical, mental or emotional level. Acupuncture meridians are an example of the physical, but connected to wider energy. Mental and emotional influences such as healing touch or the Taoist inner smile and microcosmic orbit practices, are presumed to influence our physical expression of health. This is like working on the concept and possibilities of the house, until we have the best house in any given situation.

· Structural medicine, integrating the human form: This is like strengthening the foundation of the house. Of course, this might enable the concept and workings of the house to shine forth, enhancing metabolism and sense of well-being.

Without categorizing further, there are dozens — and dozens — of therapies fitting into these definitions. Visualizing how any system might affect an individual, however, as complicated as this seems, might be simple compared to creating a healthy planet with billions of us on it. Hundreds of therapeutics are destroyed each day as we destroy environments. Pick any one, but rain forests come to mind most often for modern Western medicine. Faced with thousands of potential healing forms of life — potential new drugs — we have opted for wood furniture and cheap beef patties on sesame seed buns.

We can integrate medicine all we want. But, we might eventually live on a diet of pills. Ninety percent of our activity might necessarily involve staying healthy, or trying to. After all, we can't make us healthy when nothing else healthy is left.

We can promote all the power of profit, expansion and technology, but it runs ahead of us and a deeper sense of who we are.

No matter what we think we can achieve, we are continually behind in integrating the results of our actions within ourselves.

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