In the late 1800s Andrew Taylor Still M.D. presented a unique and visionary form of medicine known today as Osteopathy. It is easy to underestimate the tremendous gift and insight Dr. Still brought to humanity. His gift was the result of profound suffering and grieving, having lost several children in succession to the likes of cholera and smallpox. For a physician to watch helplessly as his children died must have created unimaginable suffering, and disenchantment with medicine as it was practiced at the time.
“I love my patients, I see God in their faces and their form.”
A.T. Still, M.D.
Dr. Still was a deeply spiritual man – what arose through his grief, his suffering and a long period of deep contemplation is the art and science of osteopathic medicine. To truly appreciate the immensity of what osteopathy has to offer, it is important to realize that osteopathy was originally created and intended to give the physician the skills and tools necessary to meet the wide range of illness, pathology, suffering and human circumstance encountered in a general-practice setting, including surgery and obstetrics. To consider osteopathy to only be neuromuscular medicine is severely limiting; such perceptual boundaries will never allow us to experience the unimaginable beauty Dr. Still wanted his students and his patients to see and feel.
“In Osteopathy our hands are our primary tools for diagnosis and treatment.”
One of the most basic principles of osteopathy is the use of the physician’s hands for diagnosis and treatment. Well-trained osteopaths may spend most of their professional lives cultivating and nurturing perceptual and palpatory skills. At the most basic level, an osteopath is trained to feel physiology: first normal physiology, then as it presents in pathology; he is taught to discern sympathetic tone, barrier and non-barrier in tissue and fluid. The perceptual and palpatory skills of a well-trained osteopath defy reason and logic: blood sugars, electrolyte imbalances, psychological disorders, and many other nuances in the patient and the natural world can all potentially be felt both diagnostically and therapeutically by an osteopathic physician.
“Seek health; anyone can find disease.”
A.T. Still, M.D.
What was Dr. Still referring to when he encouraged his students to find the health? Was he speaking in metaphor? Osteopathy is based upon perceptual experience through our senses and our hands. We know through the oral teachings and the writings that when an osteopath puts a name to a phenomenon, he has felt it in his hands and his senses on repeated occasions, he has cultivated a relationship and the name has been given to him. This is consistent through out the writings of Dr. Sutherland and Dr. Still. We must therefore assume that Dr. Still had a perceptual experience and relationship with something he came to call health, that he was not speaking of theory or in metaphor. He was pointing us towards a direct perceptual experience with something much greater than our ordinary perceptions. He was pointing us towards one of the highest and essential principles of osteopathy.
“Health is the blueprint breathed into it by the Breath of Life; it is perfect.”
James S. Jealous, D.O.
“Health is the reference point for the healing process, our home base.”
James S. Jealous, D.O.
I have said that one of the most basic principles to osteopathy is the use of one’s hands to diagnose and treat. There is something even more basic that should be understood, embraced and lived in order to truly understand osteopathy. In order to follow Dr. Still and realize his vision and his gift to humanity, the osteopath must come to realize that osteopathy is first and foremost a service to humanity. To be an osteopath is to be of service. Service to another asks us to move outside of our own ideas about what our patient or our neighbor needs from us. We are asked to move into a larger fulcrum and into a midline that includes our community. From this place, our observer is free to be shifted from its self-limited view to a view that begins to approach something much greater and wiser than our own ideas. From this new place we can actually begin the long journey of learning how to be of service, and how to practice osteopathy.
We may find that what is asked of us when we come to a place of true service and a broader perspective is not so alluring. Human nature is such that we often like the idea of service so long as it gratifies the ego in some manner; however, true service will often require or even impose great humility.
I think if we are really honest with ourselves and look deeply, most of us could admit that we don’t truly understand what it means to be of service. Through no fault of our own, we are truly limited in our capacity to respond in the moment to another person’s need in such a way as to move him towards wholeness, while creating no perceptual tension in ourselves or the other. To help another move towards wholeness without creating perceptual tension would be a great service, a service that I imagine any one of us would be grateful to receive, and truly blessed to be able to offer.
The realization that our capacity to serve may not be fully developed should support us to take stock of our ability to understand osteopathy. Our capacity to understand Dr. Still, Dr. Sutherland, Dr. Becker, Dr. Jealous and Biodynamics is truly limited. If it is true that osteopathy at a basic level is about service to our fellow man, and yet we don’t fully understand what it means to be of service, then our capacity to truly understand osteopathy and Dr. Still is limited.
“You can’t just schedule surrender”
James S. Jealous, D.O.
The ability to serve in a way that is dictated by the moment and through the health of the patient comes not through our own will and idea of what is right, but through the practice of surrender. When my own will yields for a moment, there is the possibility of seeing and being moved by the health in my patient, and for a brief moment I may be of service. The difficulty here is I cannot simply decide to surrender. Deciding is an act of will – an act that prevents true relinquishment. Allowing this simple truth to sink deeply into our consciousness may be a first step towards our goal. This of course presumes a common goal of reaching a deeper understanding of osteopathy through a commitment to service to our patients and our neighbors. This also presumes that one wishes to have a deeper relationship with health and primary respiration.
“In Osteopathy the little things are the big things.”
William Sutherland, D.O.
Dr. Sutherland encouraged his students to be humble and to look for the little things in osteopathy, for the little things often prove to be the big things when it comes to our patients’ well-being. Interestingly, it is the little things that will teach us humility, surrender, service and – ultimately – osteopathy. If we truly desire to learn how to serve through the spirit of osteopathy, we will be given the lessons by looking for the smallest opportunities to be of service. We will be given little opportunities to help another often at very unexpected and inconvenient moments.
These little opportunities are available to everyone, every day. They are expressions of the health and they give us a tremendous opportunity. The smaller and more vexing the task, the greater is the potential to shift us towards a perceptual experience with our own health. By taking advantage of these opportunities and serving another with joy, our observer begins to be shifted. We are shifted by the health towards the health; we begin to surrender without effort to a deeper wisdom, and love. Our orientation begins to include a different kind of midline, and our perceptual fulcrum deepens well beyond the mid tide or the Long Tide. All of this occurs without the use of our own willpower. All that has been asked of us is to watch for the opportunities in the little places.
These opportunities to serve in a small but significant way have a particular quality to them. Making a study of the qualities inherent to these moments will help us to orientate our senses to an elusive osteopathic principle known as “the Health”, which is an indwelling natural part of us all. I really don’t think we can learn to see, sense and respond to the health in our patients by reading books or taking a series of weekend workshops in cranial sacral therapy. What is required is a reorientation of our senses; the difficulty is that the very effort of reorienting on our own part seems to further blind us. We must be reoriented by that which we hope to see. We must be moved by the health towards the health.
One of the greatest lessons osteopathy has to offer us is the nature of service. Osteopathy was conceived out of a deep desire to serve humanity. It is only natural that an orientation to service will facilitate the practice and understanding of osteopathic medicine: its many nuances, insights and gifts will all be better understood if we understand in ourselves what it means to be of service.
I offer this with deep gratitude and the hope that this little writing will inspire you to take joy in helping and serving your patients, clients and neighbors. I hope that through little moments of service, and by noticing the qualities of these moments, you will gain greater insight into what osteopathy has to offer us – a greater connection with our own health.
OLIXN ADAMS IS A CERTIFIED ADVANCED ROLFERTM AND CANDIDATE FOR THE DEGREE OF DOCTOR OF OSTEOPATHIC MEDICINE. HE WILL BEGIN RESIDENCY IN JUNE SPECIALIZING IN FAMILY MEDICINE AND HIGH-RISK OBSTETRICS. HE HOPES TO EVENTUALLY OPEN A FULL-SPECTRUM FAMILY MEDICINE CLINIC WITH AN EMPHASIS ON INTEGRATIVE MEDICINE AND HANDS-ON OSTEOPATHIC MEDICINE. THROUGHOUT MEDICAL SCHOOL HE HAS GREATLY ENJOYED BRINGING OSTEOPATHIC MEDICINE TO THE MEDICALLY UNDER-SERVED, AS WELL AS HOSPICE PATIENTS, AND ONCOLOGY AND PALLIATIVE CARE.