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Legacy Appendix E - WHATEVER HAPPENED TO THOSE GOOD OLD SANITARIUMS?

LLUMC Legacy: Daring to Care

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Appendix E

WHATEVER HAPPENED TO THOSE GOOD OLD SANITARIUMS?

Today there are only a few Adventist sanitariums. These self-supporting (rather than church-operated) institutions continue the original sanitarium concept.

Today the patient who goes to a self-supporting Adventist sanitarium may not be acutely ill, but he may feel "under par," may want to lose weight or stop smoking or drinking, or may have some minor chronic ailment. Possibly he wishes to adopt a life-style that will put him in the best possible health.

In the sanitarium he is guided in a personalized program where he learns to eat a balanced diet; to get adequate amounts of exercise, sunshine, fresh air, pure drinking water, rest, and sleep; to abstain from that which harms health; to practice moderation in the use even of that which is harmless; and to trust in God--all remedies which the patient himself can apply to maintain health. In addition, there are natural remedies applied by the sanitarium staff, such as fomentations and physical therapy to alleviate his particular ailment. There may also be some acute-care, lab, Xray, and surgical services available; still, the emphasis is on prevention, on teaching the patient how to regain and maintain optimum health. The costs would be high except that many of the personnel donate all or part of their services.

By the turn of the century the church had established 27 sanitariums and treatment rooms in the United States and abroad. At one time the Battle Creek Sanitarium was the largest institution of its kind in the world. In 1927 it had more than 1,500 beds. Then something happened. As medical knowledge increased, sophisticated new diagnostic and therapeutic techniques proliferated. The public demanded "miracles." Church members demanded "miracles." Though natural remedies worked, other methods worked faster.

As a result, over the years Seventh-day Adventist church-operated sanitariums have slowly become hospitals which provide care chiefly for the acutely ill. But some sincere church members are frustrated that Adventist sanitariums have become hospitals. Some are also disturbed by the fact that Adventist physicians and hospitals prescribe and administer so many drugs. Ellen White spoke out against drugs, favoring natural remedies of the type promoted by sanitariums. At first glance, there could seem to be a serious disregard for the counsel of Ellen White.

These two concerns are closely related. To understand these changes and to more fully appreciate Seventh-day Adventist medicine as it is practiced today, one must understand (1) Mrs. White's attitude toward drugs in particular and medical care in general, and (2) the dramatic difference between modern healthcare and that of Mrs. White's day.

Medicines and Surgery Not a Denial of Faith

Ellen White condemned "drugs that poison the blood and endanger life."1 She wrote in 1888, "Drug medication, as it is generally practiced, is a curse."2 On the other hand, in a letter to personnel at St. Helena Sanitarium, she said that drugs may not be as dangerous if "wisely administered."3

She recognized that there are times and circumstances when it is justifiable and indeed necessary to employ medications, even those known to be poisonous, although she condemned the indiscriminate, careless use of drugs. This is substantiated by a note from the compilers of Selected Messages, Book 2, commenting on Mrs. White's approval of surgery:

"Before major surgery, the entire body is saturated with a powerful and, in a sense, harmful drug [the anesthetic], to the point of complete unconsciousness and to complete insensibility. By the same token, after surgical procedures, the physician may find it necessary to administer [pain killers] that almost certainly include drugs to give relief and prevent the patient from lapsing, from sheer pain, into a state of surgical shock and, in some instances, possible death."4

Regarding surgery, Mrs. White wrote, "It is our privilege to use every God-appointed means in correspondence with our faith, and then trust in God,... If there is need of a surgical operation, and the physician is willing to undertake the case, it is not a denial of faith to have the operation performed."5

It is apparent from these statements that Mrs. White's attitude reflected a great deal of common sense. It would seem unreasonable to assume that her warnings against poisonous drugs could be an indictment against all drugs for all time. Most of the drugs in use during her time are recognized today as poisons: arsenic, strychnine, opium, heroin, calomel, prussic acid, lunar caustic, antimony, and mercury. She said of these drugs, "We can with safety discard the concoctions which man has used in the past."6 Commenting on this, the compilers of Selected Messages, Book 2, noted in 1958, "It is an interesting fact that as a result of twentieth century medical research, physicians have largely discarded most of the medications in common use at the time referred to in this statement."7 "Mrs. White nowhere states, in discussing such simple medications, that other and more effective medications might not later be found."8

"Do the Best We Can"

It is clear that Ellen White favored the use of all the means provided by God to heal the sick. When medications are beneficial and are appropriate, they may be used. When surgery is called for, it should be performed. She wrote in 1905: "It is not a denial of faith to use such remedies as God has provided to alleviate pain and to aid nature in her work of restoration.... God has put it in our power to obtain a knowledge of the laws of life. This knowledge has been placed within our reach for use. We should employ every facility for the restoration of health, taking every advantage possible, working in harmony with natural laws."9

Ellen White herself used tea as a medicine (though not as a beverage). She recognized that blood transfusions could save life. She had radiation therapy--23 X ray treatments at Loma Linda for a skin problem. She was vaccinated for smallpox and urged her helpers to be vaccinated also.10 She once advised a missionary to Australia that if quinine was the best thing available to fight malaria, it should be used. When the missionary asked, "Would I have sinned to give the boy quinine when I knew of no other way to check malaria and when the prospect was that he would die without it?" she replied, "No, we are expected to do the best we can.''11

Dramatic Changes in Medical Care

Ellen White once wrote, "The present cannot be judged by the past.''12 She recognized that times change and that the principles in her counsels would need to be applied to meet the needs of changing times. And times have changed, especially in the world of medical care.

If the axiom that medical knowledge doubles every ten years is true, then medical knowledge has increased more than 50,000 percent since the death of Ellen White in 1915. It is difficult to determine whether it has doubled every ten years since as early as 1915; however, some say that in recent years medical knowledge has been doubling much faster than every decade.

In 1964 about 50,000 babies were affected by German measles: 30,000 deformed, 20,000 born dead. German measles once appeared in epidemic proportions about once every seven years. Because of vaccines developed by pharmaceutical companies, a major epidemic anticipated for 1971 failed to materialize.

Modern drug therapy and medical treatment have saved countless lives. In the United States we rarely hear of polio, scarlet fever, typhoid fever, yellow fever, cholera, plague, diphtheria, tetanus, scurvy, leprosy, or malaria. Pneumonia is not the killer it was just a few years ago. The treatment of epilepsy is so advanced that most Americans have never seen an epileptiform seizure.

Chemotherapy has greatly benefited patients with acute lymphoblastic leukemia, a form of cancer of the blood mostly affecting patients less than ten years of age. A combination of drugs induces remission in 80 to 90 percent of the children who have the disease.13

Most of the medicines used today were developed after Ellen White's death: antibiotics, antihistamines, anticoagulants, anticancer therapeutic agents, hormones, steroids, scientific diagnostic aids, insulin, bronchodilators and mucolytic agents (both used in respiratory therapy), anti-venom, and modern diuretics. Likewise, intensive care units and most of today's surgical techniques and medical procedures simply did not exist: open heart surgery, respiratory therapy, artificial kidney machine dialysis, microsurgery, fetal monitoring, vascular surgery, neurosurgery, dental pain control, coronary care, organ transplantation, hypothermia surgery, cryosurgery, total-joint replacement, proton therapy, and pallidotomy for Parkinson's disease.

It is only within the last five decades that such sophisticated diagnostic procedures have been developed as computer-assisted pulmonary function analysis, computer-assisted electrocardiogram analysis, chromosome analysis, electroencephalography, electromyography, amniocentesis, diagnostic ultrasound and echocardiography, computer-assisted radioimmunoassay, automated blood chemistry, radioactive isotope scans, selective coronary arteriography, computerized tomography (CT) scanners, magnetic resonance imaging (MRI) scanners and positron emission tomography (PET) scanners.

An Appropriate Response to Human Need

Surely the Great Physician wishes today's physician to do his best to help those with such problems as birth defects, arthritis, ulcers, strokes, cancer, burns, snake bites, lung disease, diabetes, spinal cord injuries, and brain injuries. Although not everyone can be helped by modern medicine, medical science today no longer feels it is futile to seek cures for once hopeless conditions. Men and women who would have died without today's advanced technology are being returned to useful and productive lives.

The author's assistant was hospitalized in 1976 with sub-acute bacterial endocarditis, an infection in the membrane lining the heart. It was complicated by a hole in the membrane that separates the chambers of the heart. According to her cardiologist, she could have died within three months without antibiotics. "Natural remedies"--exercise, proper diet, fresh air, hydrotherapy--could not have healed her rapidly enough to keep pace with the deadly advance of the infection. Before 1945 almost 100 percent of the patients with her problem died. Their bodies could not produce enough antibodies to fight off the infection. Who would have denied her the one million units of penicillin every four hours for three weeks--a "light dose" of six million units per day--which restored her to health?

This is not to reject "natural remedies" nor to reject Ellen White's statement that "the Lord has provided antidotes for disease in simple plants.''14 Indeed, many of today's so-called "drugs" are natural remedies. "It is to be observed that a large proportion of the prescriptions written by physicians today, [said in 1958] call for ingredients taken from the vegetable kingdom...."15

This is not to say that there are no problems with today's medical care. The miracle drugs are sometimes over-prescribed. There is drug abuse and overuse. There are incompetent or dishonest physicians. In a continuing effort to provide quality care, conscientious physicians have established programs to discipline negligent physicians.

Still, there is another problem. With all of the recent advances in medical science, many believe that it is an exact, infallible science with guaranteeable results. It is not. It is still a frontier science with much to be learned. With the knowledge explosion so much evident today, we cannot assume that medical knowledge will not also continue to advance with giant strides.

Meanwhile, medical and surgical decisions are sometimes difficult to make. The known benefits of the medication must outweigh the known harmful side effects. Risks may need to be taken. Alternatives must be considered and challenges met. But to neglect the use of medicines which have been proven to save lives when "natural remedies" cannot heal fast enough to prevent serious disability or death is to neglect God-appointed means of recovery and to expect divine miracles to replace the "miracle drugs" that are already in the physician's hands.

Ellen White wrote in 1905, "God does not heal the sick without the aid of the means of healing which lie within the reach of man.''16

As compared with 100 or even 50 years ago, today's drug medications are being prescribed with great discretion and health-promoting, life-prolonging effect. In a five-year study of 26,000 acutely ill hospitalized patients in seven countries, it was found that only 24 patients died of drug-related causes. Further, the treatment of these 24 patients (most of whom were severely or terminally ill with cancer, heart failure, or chronic alcoholism) represented a "last ditch life-saving effort, and death, when it came, was not altogether unexpected." Only three of these deaths were due to an unlooked-for "catastrophic outcome from drug administration."17

While curing acute disease through drug medication and surgery is a great boon to 21st-century man, modern medicine feels the need of emphasizing prevention rather than cure. Many diseases are caused by poor health habits and intemperate living--a result of the modern way of life. This needless suffering is being reduced through health education. A greater need for health education is underscored by the low level of health throughout the world and by the sky-rocketing costs of modern medical care. Today one of the national health priorities is "the promotion of activities for the prevention of disease...and the provision of preventive healthcare service.''18

Meanwhile, the physicians, chaplains, health educators, and other allied health professionals in acute-care Adventist hospitals are employing "every facility for the restoration of health and prevention of disease," using "the means of healing which lie within the reach of man."

In any condition of health or disease, the program must be appropriate. In every situation, whether in a sanitarium, a better living center, or an acute-care hospital, all health comes from God. And every method should be a means whereby the healing power of God can work through His laws.

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