Saturday, 17 January 2015

What's A Herbalist's Role?

Here's the spiel I give people who enquire about what I do, with minor variations:

"I interview people about their health problems, taking a full medical history and doing any physical examination which is necessary, then prescribe and dispense herbs and give lifestyle advice".  There are then follow-up consultations, usually, which are broken down in terms of the subjective (what the patient experiences), objective (what can be agreed to be experienced), action (what needs to be done now) and plan (what needs to be done in future).  This second bit is less structured than the first.

The training I have in terms of the interview and physical examination itself is comparable to the first three years of a medical degree.  This is starting to sound like a leaflet, isn't it?  Anyway, another way I describe the work is "like a doctor except that I use herbs instead of pure drugs".  I should point out that no-one who is not an officially qualified and registered doctor can legally claim to be one and everyone who is called a doctor is legally bound to correct that claim.  That means you incidentally, unless of course you're a doctor, in which case I should probably trust you or something.

However, is this really what a herbalist does or should do?  Is it what I do?  To an extent yes, if I get the opportunity to do it.  Here comes the complicated bit.

Nowadays, people often feel that they are qualified to know what herbal remedies they need because of the information available online, so they are quite likely to come to me and ask for those.  Whereas I do have two decades of experience as a herbalist, I also distrust the cult of the expert, so I often just give people what they want.  I assume they have already sussed out, for instance, whether they have high blood pressure, are allergic to something which suggests they will react badly to the remedy and so on.  I do usually ask them as well of course, but I believe the decision is theirs and don't want to disempower them or undermine their confidence, because ultimately a lot of professions, sadly, have to rely on talking people's confidence down so they will pay you to do what they could do instead.  This isn't a criticism, just a sad fact about the way the economy works.  We live in a system which thrives on lack of confidence and many of us have a stake in reducing other people's self-belief and making them reliant on us.  This is one reason that I dislike being a herbalist, although I have very little choice about it and it can be very positive, interesting and rewarding too.

Turning this round, patients often come bearing wisdom.  They have often found something which helps them or may have come across someone else who has found something helpful on an unrelated health problem of their own, frequently handed down through the generations.  When this happens, it's my turn to listen in a different way to my patient and to see myself more as a student than a teacher.  This brings to the fore another possible role of the herbalist, or for that matter many other healthcare professionals.  They can act as a go-between.  Someone comes to me with eczema but without asthma because she has found a breathing exercise which has resolved it.  Then someone else comes to me with asthma who hasn't heard of the exercise, so I tell her about it, and her asthma is resolved.  At the same time, she has no eczema because she's found an answer to that which I can pass on to the previous patient.  Hence being a herbalist is a bit like being an ethnobotanist. I collect information about the uses of plant remedies and pass them on.

One big influence, or perhaps quandary, I'm presented with as a herbalist who has also home edded is that I'm a great believer in autonomous education.  A medical consultation should be a process whereby the practitioner renders herself unnecessary to the patient, something which, of course, clashes with capitalism.  In the same way, parenting, also known as education, is a process whereby parents render themselves unnecessary to the child.  In fact children, depending on their character, tend not to need much input for them to learn.  Transferring this to the practitioner-patient relationship, there is of course often the problem that they have been schooled and therefore expect to need input, but at the same time there are some things which some people find harder to learn autonomously than others.  Therefore, the kind of hands-on experience which is needed to learn the aforesaid breathing exercise really involves being there with the practitioner in front of you, or in my case at an angle of about 135 degrees, showing you, of all things, how to breathe.

I would certainly say a herbalist is in the business of one-to-one education, but just as, for example, Afrikaans uses the single verb "leer" and non-standard English uses the verb "learn" instead of distinguishing between learning and teaching, so is the job of any teacher to learn from her students or pupils, or parents from their children, although this might be in various forms.  However, there is more.  Clearly it is important to care for a patient, and one of the best ways of caring is to be there with them.  Various processes are facilitated by physical presence, including communication, empathy and the simple feeling that someone cares about you and respects you for your suffering and wants to help.  As a result, being with a practitioner who has the time to assess your health in depth, which many GPs lack, and who can look at all your health issues and your status as a complete person, has in itself a placebo effect besides the efficacy of the herbs, and consequently is healing in itself.

To conclude therefore, the role of a herbalist is educational, learning from the patient as well as helping the patient to learn, caring and healing, and to act as a conduit of knowledge between patients who can thereby indirectly help each other.  It's also interesting to compare and contrast a herbalist's role with that of a doctor, and I'll be doing that in the next post.