After reading the chapter from Crazy Like Us on Schizophrenia in Zanzibar I was flooded with similar feelings and thoughts that I had encountered while studying indigenous medical practices in Chile. I had the unique opportunity of spending time with the machi or the Mapuche tribe’s “medicine man”, I was able to tour an indigenous hospital where traditional medicine is practiced, a pharmacy in which natural herbal medicines are distributed, and even follow a “medicine man” around an indigenous community to his various patients. As a “science person” (for lack of a better term) and a person culturally exposed to and invested in Western/occidental medicine, the idea that drinking herbal tea (that has no scientific basis for affecting any particular or relevant anatomical system) and sleeping with feet pointed toward the direction of the sunrise in order to cure an illness seems pretty ridiculous. Forget the fact that these people have been practicing such techniques for centuries, the take-home message for me was the power of the mind in the healing process.
As the Spanish invaded Chile the native Chileans suffered from the new illnesses introduced by the Spanish that their immune systems were not prepared to handle. In addition to imposing their rule over the native people they have also done their best to enforce their medical beliefs. To this day the indigenous people are still resiliently fighting for their land and for their own medical practices. Speaking and spending time with these people made me question my own beliefs regarding medical treatment. As neuro students we know that the mind and the brain are extremely powerful. I personally believe that they are extremely important in the healing process and, scientific evidence aside, can be powerful complements in treatment processes. Even if you wish to boil it down to something like, belief in and understanding of treatment can cause less stress and stress can have very negative effects on healing processes, it is undeniable that the brain and mind play a role in physical and mental well being. I believe this to be true in a variety of illnesses but given what we know about mental illness perhaps it is even more relevant.
The chapter “The Shifting Mask of Schizophrenia in Zanzibar” speaks to this idea in many ways but most powerfully in the idea that the varying manner in which Schizophrenic patients’ friends and family members treat them seems to have a great influence on the illness’ course and outcome. One of the greatest objectives of medicine is to improve quality of life. Just as the Zanzibarians might write phrases from the Koran on the inside of a tea cup in saffron paste to be dissolved, the Mapuche’s herbal medicines are only effective if the land has been properly thanked for providing them with the herbs. In more familiar contexts, when my little sister or brother would have a scrape or cut I would give them a smartie candy from an old pill bottle and they would say it made them feel better; similarly many clinical treatments must test for placebo effects in order to ensure scientific legitimacy. The beliefs that occupy the human mind are a strong force.
As much as I had come to accept (or rather respect) the practices of traditional medicine and the idea of natural and supernatural (spiritual) forces combining to cause illness and disease, everything changed when I was became very sick myself. My tonsils were grossly swollen and there were large white spots covering my sore throat. My family did not have water in the house, it was unsafe to drink out of the tap, and I was very dehydrated. Worse than the sore throat and dehydration was the fever. The fever was so high (over 104) I was hallucinating and it was painful. I felt freezing and was uncontrollably shivering but at the same time my body felt like it was going to explode because it was obviously overheating. My family took offense to food left over at meals so I finished meals but I was unable to hold down food. Often we had trouble breaking the fever and during the high fever (when I as not too uncomfortable to sleep) I would have vivid dreams and nightmares. One night I was dreaming about swimming in a lake and woke up actually soaking wet. The fever had broken. I stripped my sheets off and covered the bare mattress in towels. As I changed my wet clothes I noticed red spots on my arms. My mouth tasted funny and my lips were burning and dry. I went in the bathroom to look in the mirror and was horrified by the reflection. I was completely covered in a red rash. The rash was pronounced on my legs and chest. My mouth felt funny and I examined my tongue in the mirror. The red was peeling off and my tongue was almost entirely white. In the morning my Chilean family decided to seek help. I knew from the fever and the swelling that I had an infection and likely would need antibiotics. I was so ready to see a doctor and start a course of antibiotics. Instead, an Aymara (indigenous peoples of northern Chile, Peru, and Bolivia) medicine man showed up. Using his coca leaves (the leaves of the coca plant used to make cocaine…) he folded and unfolded a cloth filled with the leaves and then spread them on the table and touched my hand. He carefully touched the leaves with his fingers as if searching for something. He stopped at a particularly lightly colored leaf and looked up nodding. He then touched my throat and stomach pausing to close his eyes for each. He mumbled incomprehensible words under his breath before preparing an ill-tasting, neon-green colored tea. He told me a lot of things in Spanish that I did not understand and I nodded pathetically, too weak to try to frantically translate the mixture of Spanish and Aymara that he was muttering. After the tea, I felt just as sick and very frustrated. I hadn’t been allowed to shower for almost a week because my family believed the bad water would aggravate the illness. Finally I convinced them to take me to the doctor. Thankfully I was prescribed antibiotics and a small steroid dosage and was on my way to a speedy recovery. Leaving the familiar hospital, it was as if I immediately began to feel better.
Though it was difficult to extract a clinically relevant message from the chapter about Schizophrenia in Zanzibar, perhaps it is important realize the power of the mind in healing and the power of personal beliefs on the mind; and especially so in the treatment of diseases of the mind, or mental illnesses.