 |
||||
| Book Review Book Review: Osteopathy Today. | ||||
| Osteopathic Medicine: Philosophy, Principles and Practice. Published by Blackwell Science, March 2001. |
||||
| The first thing I want to say about this book
is, read it. I feel it is appropriate for both students and practitioners alike, because it deals with issues at the very core of osteopathy. Having agreed to review it, I was obviously obliged to read it, but then when I had finished, I found myself reading it again. Most osteopathic books are really “how to do it” books; how to diagnose dysfunction, how to treat dysfunction. This book is different. McKone has taken a step back, by looking at questions that should come before how? Namely, why, and what? He starts by looking at the origins and development of osteopathy. More than a couple of anecdotes of Still’s life, there is a potted history of medicine, so we can understand the context in which osteopathy was created (or discovered?) Integrated thinking is a key theme throughout this book, and it starts by seeing the origin of osteopathy in the context of what had gone before, and the characteristics of the time that provided the impetus for Still’s discovery. This section of the book provides answers to why osteopathy, and why then? Now that osteopathy appears to be gaining greater acceptance, this is a good time to get clear on what it is that is being accepted. Osteopathic training (hopefully) immerses us in osteopathy, and we gain an unconscious grasp of it’s philosophy and principles by absorption. Yet this leaves many of us in great difficulty when asked to give a meaningful description of what is unique about osteopathy. McKone has set about bringing this intuitive understanding into conscious awareness. We need to look beyond how we treat, to find that which is unique about osteopathy. If osteopathy were no more than the how, then anyone who learned how to do dogs and lumbar rolls could justifiably claim to be practicing osteopathy. We need to look afresh at what osteopathy is, particularly now when there is increasing pressure is to conform to the methods of justification used by allopathic medicine. Without a clear idea of what is uniquely osteopathic, then all the potential benefits available from that uniqueness could be lost. As McKone quotes Irvin Korr, a physiologist remember, not an osteopath. “Conventional clinical research protocols for the assessment of the efficacy of most chemical and physical therapeutic agents are ill suited for the assessment of osteopathic medical care. . . . osteopathic medical care must be evaluated as it is practiced and not as a contrived unreal version.” It could fairly be said that McKone presents little that is new in this book; but much of what he presents, is non the less be new to us. He has gone back to find what was new about osteopathy at it’s origin. To do this he does not merely trot out the usual Still one-liners, but looks also at the thinking that fertilised the ground in which Still’s ideas germinated. Some of these early ideas make demanding reading, partly because of the style of writing of the period from which they came, and partly because they are attempting to express insights which were not derived from linear, cause / effect thinking, and which are therefore difficult to express in linear language. The effort is worth while however, as it gives an understanding of where McKone’s thinking comes from, and hints at the potential contained within osteopathy. As McKone illustrates, great thinkers throughout history have gained insights based on integrative thinking, which could not be expressed in analytical language. The language which they used is often poetic, not in a romanticised way, but in that it uses limiting words to present liberating ideas. We might assume that surely we know far more now, than Still did in his day. Certainly we have more information, the big question is do we have as much understanding. Still uncovered principles on which he based his osteopathy. He gained insight, and pointed us in a direction. We need not be limited by what he knew, but as osteopaths we need to keep an eye on where his finger was pointing. Very often we gloss over the philosophy and principles of osteopathy, in order to get to the “nitty gritty” of what you actually do. This is understandable, because techniques, difficult as some of them are, are still far more tangible than the concepts from which they were derived. This book makes us think again about what we are trying to do, and why we are doing it. There is more to developing our osteopathic identity than finding ways to market our practices. Osteopathy is a view of reality, a way of thinking, which gives rise to a method of practice. Start with the practice, and you have no roots from which to grow. Going back to the roots illustrates why osteopathy is not just a good treatment for back pain, nor “physical medicine,” but a healthcare system, based on an understanding of how nature functions. The chapter on Form and Function, again emphasises the importance of integration. “The whole is more than the sum of the parts,” so any study which dissects down to the parts, then tries to re-assemble the whole will miss the point. That’s why we all know that Frankenstein’s monster came to life only in a fairytale. McKone discusses the way of seeing that is required if you are to start with the whole, and see it expressed through it’s parts. He draws on the work of Still, Charlotte Weaver and other osteopaths, but also from others such, as seventeenth century German scientist Goethe. One of my favourite quotes from the book is from Ludwig von Bertalanffy: “This separation of pre-established structure and processes occurring in that structure do not apply to living organisms. . . What are called structures are slow patterns of long duration, functions are quick processes of short duration.” Seldom seen, but clinically relevant details on the form and function of the nervous system are included. This section is can be a bit heavy going, it would have benefited from being highly illustrated. However the costs involved would probably have scared off any publisher, considering the specialist nature of the book. Chapters also cover an osteopathic perspective on psychology, concepts of health and disease, osteopathic pathology, and finally, practice. The ideas that McKone brings together, filled me with excitement about osteopathy, at least as much as anything else I have ever read. The diversity of sources giving rise to such similar ideas, suggests to me the universality of their underlying principles. Undoubtedly you will find things in this book that you will disagree with (you are an osteopath after all) but that means you will have thought about them, and that can only be good. This is a deep book about a deep subject, which I expect to open many times. I encourage you to do the same. Andrew Pallas DO |
||||
|