Knoxville joins the alternative health-care
revolution as scores of practitioners hang out their shingles
by Hillari Dowdle
Hal Ernest, 66, is a runner. A classic type-A personality, Ernest has for
years started his morning at dawn making the four-mile run from his front
door to the end of Cherokee Boulevard and back. An executive vice president
for prominent local advertising agency Lavidge and Associates, he leads a
life full of hard work, meetings, and deadline pressures. Running is his
escape, his meditation, his one nod to stress relief.
Imagine his dismay, then, when he was stopped cold in his tracks one beautiful
morning last spring by a searing pain in his buttocks. Regular runners like
Ernest are used to pains and strains, pulled muscles and shin splintsit's
just the price they pay for their sport. But this was no ordinary muscle
pullhe knew that right away.
A consultation with his physician led to a diagnosis of a muscle tear and
an appointment for a caudal block, a procedure in which numbing medication
is injected into the lower back to reduce the pain and relax the muscles
enough so that they can heal.
But for Ernest, the procedure didn't work. The caudal block did not touch
his pain, nor did it seem to initiate any sort of healing process. So he
was sent back for another...and another.
After the second and third caudal block failed to produce any significant
result, Ernest's physician revised the diagnosis. "He said he thought I had
sciatic nerve damage and that the only thing to cure it is surgery," Ernest
recounts. "He said I'd be laid up for awhile. And I said there is no wayI
have all these accounts, I have a lot of responsibilities, and there's nobody
out there to back me up."
Ernest began to cast about for an alternative way to heal himself, turning
to physician after physician and to a chiropractorall without result.
He found himself at the end of his rope, willing to try just about anything,
which is why when a nurse overseeing the round-the-clock care being provided
to his 97-year-old mother suggested acupuncture, Ernest was more than willing
to give it a shot. "I had heard nothing but good things about acupuncture,"
Ernest says. "I have always been the sort of person who believes the body
heals itself, which is interesting since my father owned a drug store [Ellis
and Ernest, a fixture on the UT campus from 1926 to 1967]. Since the alternative
was surgery, I thought I might as well give this a shot first."
So he began seeing local acupuncturist Susan Thompson, a master of Oriental
Medicine and diplomat of acupuncture with a degree from New Mexico's noted
International Institute of Chinese Medicine. After two-and-a-half months
of twice-weekly treatments, Ernest was pain-free and able to resume his morning
He's a believer now, along with scores of Knoxvillians who are seeking out
alternative health-care treatments, giving rise to a thriving local industry
that offersas a cursory glance at the bulletin boards inside Zephyr
or Nature's Pantry will informeverything from acupuncture to cranial
sacral manipulation to herbal therapy to Watsu, a newfangled form of massage
that is performed in a special heated pool. Three alternative medicine centers
have opened in the last year alone, and scores of alternative medical
practitioners have hung out their shingles. Even the local medical establishment
is jumping on the bandwagonthe Knoxville Academy of Medicine is planning
a special alternative health conference next spring that will be open not
only to the doctors it represents but to alternative practitioners and the
community at large.
But is alternative health good medicine? Even the newly converted can't offer
definitive testimony, it seems. "I don't know how to explain it," says Ernest
of his brush with acupuncture, "except to say that it simply worked."
The Big Picture
Alternative medicine, in case you haven't picked up a magazine or newspaper
or turned on the television over the last year or so, is big business these
days. A recent Journal of the American Medical Association reported
that one out of every three Americans has undergone or is undergoing some
form of alternative healing. And what studies exist show that these Americans
are well-educated and affluent. They'd have to befew insurance plans
in the country right now cover alternative care, so patients are paying
out-of-pocket for their treatments, which generally run anywhere from $40
to $200 per session.
The field is an amorphous oneencompassing everything from therapies
with thousands of years of history, like Ayurveda and Traditional Chinese
Medicine (TCM), to more controversial treatments like hydrogen peroxide infusions
and magnetic therapies. As such, it is difficult to say exactly how much
money is being spent by Americans on alternatives to traditional Western
(or allopathic) care, but estimates put it in the ballpark of $24 billion
per year. In fact, a 1993 New England Journal of Medicine study reported
that more Americans made trips to see "unconventional" practitioners (425
million visits) than to see conventional allopathic physicians (388 million
Dr. Jorg Winterer, director of emergency medicine at Morristown's Lakeway
Regional Hospital, thinks he knows why. Winterer, 56, is himself perhaps
the best allopathic medicine has to offerhe holds an M.D. from Harvard
University, a Ph.D. in nutrition from MIT, and a degree in public health
from Johns Hopkins. He is, like Ernest, an athlete who is prone to injury
in the normal course of things. And like Ernest, when he has tendonitis flare-ups
and muscle tears, he turns not to his peers but to Susan Thompson for relief.
"I don't take any Western drugs myselfthey're too strong and have too
many side effects," he explains. "I have unqualified endorsement for acupuncture
for musculoskeletal complaints. It's based on 3,000 years of experience,
and it's a pragmatic medicine that works.
"I think the narrow focus on high-tech and crisis intervention in Western
medicine doesn't serve the average person very well," he says. "And the whole
idea that you're being handed from specialist to specialistthat you're
just a disease to your doctor and nobody really understands all your problems.
People are looking for something more humane, more benign, and something
they can really get involved in themselves."
Dr. Leon Bogartz, director of medical affairs at St. Mary's Health System
and current president of the Knoxville Academy of Medicine, agrees. "People
are embracing alternative therapies like never before right now because of
their increasing visibility, availability, and the fact that you can access
alternative care without having to be directed by a primary care doctor or
insurance company," he says. "They can try it on their own, stop on their
own. They don't need permission from an HMO."
Bogartz admits that he knows little about alternative medicine himself and
says that few Knoxville physicians do. But he also notes that they should
be highly motivated to learn. "Number one, from the perspective of the payer
and provider, we know that people are spending millions of dollars on
complementary medicines and alternative things," he says. "So from a purely
financial point of view, we know we should be trying to bring these treatments
into the system so that they can be controlled."
This is, he explains, why St. Mary's and its parent corporation, Catholic
Health Partners, are taking the first steps toward exploring ways to pull
alternative therapies into their system. But there's more to it than just
the bottom line. "Most of what we know about alternative medicine is based
on anecdotal informationbut if there are enough people doing this,
there is bound to be value," he notes. "Plus, traditional medical therapies
fail in some areas, and we are desperate for solutions."
Newton v. Einstein
The failure of Western medicine is a topic that is intimately familiar to
Patty Silver, a clinical integrative hypnotherapist and proprietor of the
Shekhinah Center, one of the three new centers that opened last year. "A
few years ago, I had thyroid toxicosisI had a resting heart rate of
170, my legs were giving out from under me, I couldn't sleep," says Silver,
who is married to Dr. Steven Silver, a local gastroenterologist. "At the
time, the allopathic treatment was to burn out the thyroidthat's all
they knew to do. But that meant that I would spend the rest of my life on
thyroid medication, and I was not going to do that. So I traveled to Nashville
to do hypnotherapy, and Asheville to do acupuncture, and it took about six
months, but I brought the problem under control."
Silver's life-saving brush with alternative medicine led her to her current
field of practice (she'd previously been a medical technician working in
hospitals and in her husband's office). She founded the Shekhinah Center
in a restored farmhouse in West Knoxville as a sort of metaphysical clinic,
a place where she can practice her hypnotherapy and Reiki (an energy therapy
that Christian practice might call "the laying on of hands"), and other local
alternative practitioners, like Ayurvedic consultant and psychotherapist
Mary Roberson, can see clients and hold workshops.
Alternative practitioners like Silver take what they call a "holistic" approach
to health care. By holistic, they mean that they look at not only the symptoms
manifested by the physical body itself but at emotional, mental, and spiritual
needs as well. "I specialize in chronic and emotionally based illnesses,"
says Silver, whose clients tend to come in with problems like inflammatory
bowel disease, neck and back problems, and syndromes that throw the immune
system out of balance. "I believe that 80 to 90 percent of all the health
problems we have are emotionally based. It's like our bodies are a hall of
archives, storing every thought and every emotion we've ever had, and the
cells themselves are where we store those memories."
Silver believes that by hypnotizing her clients, she can allow them to access
those memories and thereby get to the actual root of the problem.
And it is this getting to the rootthe underlying causeof illness
that is the very raison d'être of alternative medicine.
Allopathic physicians tend to take a Newtonian view of the bodythat
is, they see it as a complex biomechanism made up of discrete pieces of matter.
As such, they treat the body much as a mechanic might treat a machine. Most
alternative practitioners take a more Einsteinian view. They see the body
as being made up of energy, the kind of quantum physics-based approach
popularized by Ayurvedic physician Deepak Chopra in his books Quantum
Healing and Perfect Health.
Corinne Rovetti, 44, is perhaps the elder stateswoman of Knoxville's alternative
medicine scene. She is a licensed nurse practitioner working at the Knoxville
Center for Reproductive Health. She is also a homeopath who's been in practice
in the Knoxville area since 1987. "Basically, homeopathy is a system of medicine
based on the law of similars," she explains, noting that the goal is to stimulate
the body to employ its own natural healing responses. "It uses natural substances
that can cause particular symptoms in a healthy person to treat a person
with those symptoms who is ill. For example, a bee sting will cause burning,
stinging, pain, heat, and redness. So a remedy created using the venom of
a bee might cause a healing response in an individual who has those symptoms."
Homeopathy is a highly complex form of treatment, one that offers 2,500 different
naturally occurring remedies the practitioner selects based on the most minute
of symptomologies. And it has been, since it was introduced in the U.S. in
1925, controversial. Critics claim that the remedies, which contain as little
as one part in one million of the treating substance, are simply too diluted
to have any effect at all. But Rovetti says they are missing the bigger picture.
"Every substance has a frequency to it, just as on a cellular level we are
all vibrating," she says. "In illness, as we know from cancer research, chaos
occurs. And so homeopathy is just another system that can help stimulate
the cells to vibrate and function at a normal levelto cause a shift
in the system. The remedies stimulate the body at the cellular level, producing
a shift in the internal state so that the body may no longer need to create
symptoms in its cry out for help."
Still, Rovetti is not ready to renounce allopathic medicine altogethereach
has their time and place, she says, and she enjoys keeping one foot in each
realm. But like Silver, she notes that allopathic medicine tends to overlook
the more etheric aspects: "It's a little like peeling layers off an onion.
We all have accumulated layers of illness and layers of emotional stuff.
Whatever is the outside layer is what will be presenting, but there will
always be an inside layer that needs to be treated as well."
Our Toxic Lifestyle
An emphasis on nutrition, too, is a common thread that ties most alternative
therapies together. What is required to cause and facilitate healing in most
people, they say, is not treatment with drugs and high-tech machines, but
an overall lifestyle change. And for most of us living in a fast-paced Western
society, this is a bitter pill to swallow.
Jennie Van Winkle, 42, found this out the hard way. Several years ago, while
working as an interior designer in Atlanta, she was stricken by a mysterious
and debilitating illness. "I had Epstein-Barr virus, fibromyalgia, and candida
yeast, and all of that wore my immune system down so that I became allergic
to the environment," she remembers. "It took me a year-and-a-half, but I
finally found an herbalist in Atlanta to help me, and this is how I got well:
by slowing down, taking herbs and vitamins, and changing my diet."
Like Silver, Van Winkle's efforts to heal herself led her to a new
careershe apprenticed herself to the herbalist who helped her and moved
to Knoxville to open The Herb Shop, where she practices iridology, looking
at the iris to see where the body has disease and inherited weaknesses. In
her estimation, poor health is generally due to the toxic lifestyles we all
"Most of us are walking around so malnourished it's awful," she says. "I
wish that our bodies were more sensitive, like a car. If you don't put the
right oil and gas in a car, you ain't going anywhere. But our bodies can
go, and go, and go on nothing. Plus, we drink water with chemicals, we eat
food with pesticides, and all these chemicals get into the body and react
with the chemicals that are already there and cause illness."
To remedy the situation, Van Winkle points to herbs, which are becoming more
and more accepted as Americans jump on the St. John's wort, saw palmetto,
gingko bilboa, and ginseng bandwagon. She makes recommendations based on
her iridologies, or on the case histories she extracts from the customers
who seek out her services. "Most people who come in here are curious, or
maybe they've taken this or that to no availthey haven't quite hit
the nail on the head," she says. "You have to realize that there are thousands
of herbs, and that every one isn't right for everybody. Every herb has its
own chemical makeup. One might be high in iodine, and if you're depleted
in iodine, that might be the herb for you. But it might not do a thing for
Gary O'Shaughnessy, 45, is a D.O.a doctor of osteopathy, a medical
discipline that combines allopathic medicine with manual healing, like that
practiced by chiropractors. Dr. O'Shaughnessy sees alternative healing therapies
as the future itself and this year opened the East Tennessee Holistic Medicine
Clinic in Farragut, where he combines Western approaches with herbalism,
Reiki, acupuncture, tai chi, magnetic therapy, psychotherapy, and, of course,
"My big emphasis is on nutritional therapy and on getting the patient involved
in his own careI try to do anything but drugs," he says, noting that
he much prefers to prescribe herbs, though they take longer to work. "Drugs
are a quick fix, and drugs a lot of times cover symptoms but don't go after
the underlying cause. But we're a quick-fix society. People are basically
saying, 'Doc, give me a pill and make me better today. I don't want to change
my lifestyle...I want to lay around, eat fast food, and smoke, but I want
to feel great and look like Raquel Welch.' That doesn't work."
Word to the Wise
Maybe so. But alternative medicinein all its formshas more than
its share of critics. After all, hard scientific data in America is largely
lacking. The National Institutes of Health, in response to what it discerned
as an overwhelming need in the country, formed the Office of Alternative
Medicine (OAM) in 1991 to remedy that situation.
Still, even that initiative has come under heavy scrutiny. The New York
Times last week ran a rather vitriolic editorial by Leon Jaroff (who
was identified as the author of The New Genetics, a book he penned
for Whittle Communications' Grand Rounds Press), which denounced the OAM
as an embarrassment and called for our legislators to slash its $12.5 million
annual budget. "The federal government has no business paying for bad science,"
it concluded. "Congress should cut its losses and shut down [the OAM]."
Compounding the problem is the fact that most alternative therapies and their
practitioners fall under very little federal or state regulation. Tennessee
licenses massage therapists and chiropractors, but that's about itno
herbalists, reflexologists, hypnotherapists, Ayurvedic consultants, or
acupuncturists. This means, basically, that anyone can call themselves a
healer so long as they do not claim to be an M.D. or make claims that natural
remedies have pharmaceutical benefits. There is, in Tennessee anyway, no
consumer protection whatsoever.
Acupuncturists, one of the better organized groups of alternative healers
in the state, bonded together last year to introduce a bill in state legislature
that would require that their profession be licensed. Though the bill never
made it out of committee, they plan to reintroduce it when the new session
begins this January.
"Right now, there is nothing to stop somebody from just ordering needles
and doing it [acupuncture]," says acupuncturist Thompson, who has a background
in biochemical research. "There's nothing that says you have to go to school
or pass exams. There's nobody to come in and take things away from you if
you're messing up. You do want those thingsfor the protection of the
patient and the protection of the profession."
Susan Weissfeld, 43, is a registered nurse who in January founded the Alternative
Medicine Center at Fort Sanders West, which offers acupuncture, therapeutic
massage, yoga instruction, and nutritional counseling. Her idea, she says,
was to address safety issues by pulling together several established
practitioners under one roof, where their credentials could be established
and checked and liability insurance provided.
"In some cases, it may be dangerous to see practitioners, especially when
they're practicing in their homes, because you really don't know who that
person is," she says. "When I hired my staff, they had to provide me with
their certifications, licenses, degrees, and references. And my medical
background helped me to know whether they knew what they were talking about.
But most people don't even know how to check and see if their M.D. is board
So how to tell if a practitioner is legit? Ask lots of questions, do your
homework, and listen to your gut is the conventional wisdom. The Tennessee
Medical Association does not keep tabs on alternative medical practitioners,
but it does offer some advice to those who call looking for guidance. "As
in [allopathic] medicine, you should always ask for a second opinion before
you undertake an expensive treatment," says Russ Miller, TMA's spokesperson.
"And know what you're getting into. Information is abundant, but most people
do more research on automobiles than they do on their own health care."
Another way to ensure safety, says Dr. Bogartz, is to make sure you've had
a good allopathic examination before you undertake any alternative therapy.
"The application of alternative care to true, developed symptoms should come
only after traditional evaluation," he says. "You need to know what you're
up against. If you're having heaviness in your chest that comes with exertion,
you need to know if you have coronary artery disease before you go hang garlic
around your neck."
Fishing for Complements
But despite the potential risk of running smack dab into a quack, Americans
are likely to keep seeking out alternatives. To Dr. Winterer, this is not
only natural but necessary. "We're being asked not to write prescriptions
for antibiotics every time someone comes in with a cough," he says. "Now
all the infectious disease guys who have been telling us to write antibiotic
prescriptions for 30 years are telling us not to, because we're seeing virulent
strains of germs that are resistant to antibiotics. And Knoxville happens
to be one of the cities with the highest rates of resistance of organisms
to antibiotics. Doctors are beginning to understand that they are going to
have to find other ways to treat illnesses.
"The alternative approach is to boost the immune system instead of try to
poison the organism," he says. "That's what alternative medicine tries to
do. It's a different philosophy."
Western medicine will always have its place, Winterer says. "Alternative
medicine is not for crisis management. It's more regular maintenance than
going in for a thrown rod."
A better way to look at it, he says, is a complementary medicine rather
than alternative medicine. And Thompson, his acupuncturist, agrees. "Where
Western medicine is strong, TCM is usually not so goodthat would be
surgery, emergencies, and physiological diagnoses," she says. "Where Western
medicine is weak, TCM is strongfor chronic illnesses, things for which
there is no symptomatic relief, and sub-clinical things doctors can't explain."
Hayat Ruh, 40, is the new acupuncturist on the block, having moved to Knoxville
to start her practice at the Alternative Medicine Center just last month.
Like so many alternative medicine practitioners, she too had an illness that
confounded allopathy. "I was born with a rare bone disease, and when I was
20, I developed arthritis so badly in my hip joint that I couldn't walk,"
she explains. "I went to an orthopedic surgeon and begged him to help me,
but he said he really couldn't do anything and told me to sit in a wheelchair.
I said bleep-bleep you and began to seek out other alternatives. Some of
the things I used were acupressure, acupuncture, nutritional therapy, homeopathy,
and lifestyle changes. And within a year, the situation had reversed."
Ruh, like Thompson, says allopathic medicine is necessary; she underwent
surgery earlier this year without which, she says, she'd have been right
back to the wheelchair scenario. Still, she faults Western medicine for its
inability to deal with the gray areas. "Doctors rely on their tests, on something
black and whitesomething they can see and say, yes, this is what you
have," she say. "If they can't find that, they cannot make a diagnosis.
"If you are told by a doctor that he can't do anything for you and your only
option is to continue to suffer from it, go out there and educate yourself
and find something else," she concludes. "Like I did."