OSTEOPATH & ETHICIST – Interview with Maria Clarke DO MA

I was recently given the opportunity to interview Maria Clarke DO(Doctor of Osteopathic Medicine) MA, Osteopath & Ethicist.  This candid discussion about Osteopathy and ancient medical practices, puts into context the Modern Industrial Medical industry, as well as the value of ancient medicines, which are so often these days relegated to the realms of semi-dismissive witchery.

MEL:  Tell us a bit about yourself and your background

MARIA:  My name is Maria Clarke. I left school without a sense of direction so I just worked, hoping that light would dawn in due course. I had various jobs in hotels and did the secretarial training to improve my work environment and my income potential. Then I developed a problem with my hip, and by good fortune was referred by a friend to an Osteopath, this was after I had spent a full year in pain with ever worsening symptoms. My Osteopath “fixed-it” and the rest, as they say, is history!!

I started college in 1984 and graduated in 1988 from the British School of Osteopathy. The basic training was 4 years of full-time education, with clinic time additionally. I continued my studies thereafter, getting to grips with the Cranial Techniques immediately after I graduated. I have done innovative work in collaboration with Dentists on the subject of tempero-mandibular joint dysfunction and how it relates to overall health. I spent a year working at the Osteopathic Centre for Children in a supervisory capacity. It is in London and is a fantastic facility offering amazing training for Osteopaths in Paediatrics, and giving a wonderful service to babies and children with all their particular needs.

I have been in practice since 1988, and along the way I also attained a Masters degree in the Ethics of Healthcare, from the University of Wales, Swansea. This gave me the opportunity to study the philosophy of health and disease in more detail. My dissertation was entitled: The Physician and the Patient, a fundamental relationship in healthcare.  My point was that as a physician it is vital to remember that you are dealing with an individual who is vulnerable and needs help, respect and understanding. The physician is a person too, and the healthcare system must be mindful to respect that, what matters is the healing relationship between the physician and the patient. The progress of the individual, particularly women, is a passion for me.

Osteopathy treats a vast variety of bodily injuries, ailments, pains and imbalances.

Osteopaths undergo a full training in all matters related to anatomy, physiology, pathology, diagnosis and treatment.

I was born in London in England, but my parents were Irish. I have lived in Ireland (briefly), London and the southeast of England, Scotland, France and now Portugal. I have been here in Portugal for about 15 years. I like it here, it reminds me a bit of Ireland, but the weather is so much better!! My children are grown up now and pursuing their own lives.

I have two dogs and lead a quiet life enjoying the lovely climate in the Algarve, and I continue to see patients on a part-time basis.  I have no intention of retiring, I am returning to studying and have started writing.

MEL:  What specifically does the discipline of Osteopathy deal with?

MARIA:  This is a misleading question, the short answer is – everything.

MEL:  What are the benefits of Osteopathy compared to similar disciplines like manual therapy, physiotherapy and others?

MARIA: This suggests that you think that osteopathy only deals with sports injuries.  All injuries and applicable therapies are different, so the short answer is – There is no comparison between them.

MEL:  How does spine and neck health affect internal organs and brain functioning?

MARIA:  The body is a unified whole and does not distinguish between this or that bit or system…. more later.

MEL:  What are the typical issues that people get resolved by having Osteopathic treatments?

MARIA: What they want to treat, what they have studied, their interests and extended training / reputation. Patients present with a whole range of problems, classically, of course, back pain. However (see later) we can treat practically anything depending on the situation / osteopath. In basic terms, people come to osteopaths for anything musculo-skeletal related, it varies from osteo to osteo as I said. You could have two osteos in practice side by side and one would see only sports injuries and the other only mothers and babies. What people think we do, if asked, is anything to do with pains in joints, especially back / neck pain. However, once they have seen an osteo they realise there is a lot more to it than that, and they come back with pretty much anything for an opinion, diagnosis, direction and usually treatment. Thus, one’s practice evolves and specialises quite naturally along the lines of your own skills and interests, supported by the growing years of experience.

MEL:  Is there a growing interest in Osteopathy and such like complementary therapies?

MARIA:  This question suggests that mainstream medicine is the dominant and original form of medicine. This is untrue and is very misleading. Natural based medicines are the majority of medicine world wide. The number of consultations that alternative Medical practitioners do in a typical year is very large indeed (I am sure google can help you with that). Mainstream medicine is western medicine and only really originated in the last century, until then what we in the west think of as going to the doctor and scientific medicine did not exist. In fact, before the second world war, very little of what you think of as medicine actually existed. Do not confuse surgery with western medicine and scientific medicine. Surgery is a practice that goes back thousands of years and is included in all Alternative systems of medicine. What most people think of as modern medicine, revolves around the hospital and pharmaceutical treatments. Surgery has benefited from some of the results of western medicine, but it was up and running long before that.  I personally loath the title “complementary” It makes it sound like what I do is largely meaningless and what all my colleagues on this side of the medical divide are essentially about as important as nail polish. Nail polish is nice and adds a little something but is not vital in any way and does not change anything.

2 minutes on the Great Medical Divide

There are two sides to medicine, two “camps” if you like. On one side is Modern Industrialised Medicine, famous for its surgery and vaccines. A new industrial model that originates in the so called scientific approach and really got going post world war II. On the other side are the much older forms of medicine, for example Ayurveda (in India) or Traditional Chinese Medicine etc. These have histories and success stories that go back thousands of years.

In the west we are most familiar with Modern Industrial Medicine. You visit the doctor who is the gatekeeper through to the treatment in that system. He will tell you what is wrong with you and then tell you how to deal with it. Using only the treatment within their own system. Modern Industrial Medicine is a business. Very large sums of money pass through the system, even within a national health system, you pay indirectly through your taxes. It is a commercial enterprise which uses all the usual tricks to protect its near monopoly. It disparages anything which is outside its model. There are many vested interests who see the patient more in terms of a customer than a suffering individual. With this background the focus is on disease and not health.

There are many good people within the system, and there are many useful aspects of Modern Industrial Medicine, such as surgery, emergency medicine and palliative care. Some of the pharmaceuticals are very useful, such as anaesthesia and analgesia. I find it interesting that patients often think I must be against it all as I am an Osteopath, that is not the case. I am objective about what is most useful for the individual patient in their particular circumstances.

This medicine is heavy on diagnostics, lots of machines and pictures and tests. Its treatment focus is on the disease entity. It is a relatively new invention and makes grandiose claims for its efficacy. Very very very large sums of money pass through it’s portals. All the usual rules of commerce apply.

On the other side of the medical divide are the so-called Alternative Medical practitioners. On this side all the disciplines and practices have a long history, they have a proven effect on a variety of disease states, there is no big money to be made, they are accessible.

The fundamental difference between the two sides is very simple. We on this side of the medical divide have Philosophy at the base of all our work, and they on that side, do not. Or to put it another way. We think about concepts of health, and how the health was lost, and they on the other side define their work by the disease state. We start and finish with the individual patient and are less dependent on the generality of test results, giving a more individualised approach based more on the clinical picture.

All of us – the Osteopaths (the newest), the Homeopaths, the Chinese medicine, Ayurveda, the Herbalists, we practice different techniques, but start from the same point. We work to change the patient’s state of health. We expect the patient to take an active role in this and to accept responsibility for getting in this mess in the first place. Most of our information comes directly from questioning and observing the patient. Thus building up a picture of the person in all their aspects and getting to the bottom of the problem. Well, that is the ideal. I am not saying we do it right all the time, or that it is taught correctly all the time. I am just saying that at least we have something to work from and aspire to.

In the western dominated world, our approach is marginalised and deemed “unscientific” and thus worthless. What I find so tragic about the divide in medicine is that if we combined forces we could help people more effectively. We could help them be well and stay well. Perhaps combined training courses will come one day, I hope so.

History Lesson

Andrew Taylor Still, MD (Doctor of Medicine), DO(Doctor of Osteopathic Medicine) (August 6, 1828 – December 12, 1917) was the founder of osteopathy and osteopathic medicine

Once upon a time there was a man named Andrew Taylor Still. He was a surgeon in Kansas in the US and it’s around 1870. He was a committed and ethical man, he was an abolitionist and his father was a methodist minister, he became dissatisfied with the way medicine was approaching health and disease and the results they were getting. He created a set of guiding ideas and concepts of health, which he then used as a basis for diagnosis and treatment of any given patient. They are largely technical for the use of Osteopaths in practice, but the basics are simple.

Osteopaths call these, Principles. They form the basis of our approach to health. The first of these and the most fundamental is: The body is a self-healing mechanism.

The Self Healing Mechanism.

This is simple and obvious if you stop and think about it for a minute. Any injury will provoke an immediate response from the body. Take for example a cut finger. The body immediately responds by stopping the blood flow and closing the wound, then the next stage is repair and finally replacing all the damaged tissue so it looks like new.

This is fundamental. It tells us a number of things about the body’s inner intelligence. The body knows it has been injured. It is aware of the injury and the extent of the damage. It knows what steps to take to avert a worsening scenario and to commence repairs and the return to normal structure and thus normal functioning.

So we can reasonably say that the body is an intelligent mechanism. This is an important point to grasp. Our bodies are not like machines. They are sentient and able to recognise changes and take action to stabilise and return to normal. This is what is called in physiology – maintaining homeostasis. All living creatures from little one celled plants and animals through to our own complicated structures do this. It is fundamental to the survival of life itself. The body actively promotes health.

This gives us the next important point. If this is the case, that the body is always “on the ball” watching and monitoring for any slippage, we can see that the drive within the body is always towards health. The body actively promotes health, always positive and pushing forward regardless of the circumstances.

The next point is that the body when it affects repairs or does any kind of routine maintenance work, always replaces like with like. It replaces old red blood cells with new red blood cells. It replaces stomach lining with stomach lining. It makes very specific repairs wherever possible. It will routinely maintain the structure of whichever organ or cell with exactly the right kind of replacement. This is because the body understands that Structure Governs Function.

Structure Governs Function

This is another of the fundamental Principles that Andrew Taylor Still worked out. The structure of something will dictate its function. Simple enough really, for example, a fork is not much use for eating soup!!

Having understood this, and knowing that the body’s Self Healing Mechanism knows what it is doing, we don’t have to try and second guess the process, we simply have to aid and abet. We just have to supply the body with all it needs to affect routine maintenance and perform repairs as necessary. The clever part is being done by the inner intelligence, the inner wisdom of the body. What we call the Self-Healing Mechanism or just The Mechanism for short.

There is one point that it is vital to get to grips with. The system, this Self-Healing Mechanism can be overwhelmed. Though it will always try to effect repairs even if the problem is too big, it may not be able to without outside help. In the most dramatic of cases, this might be a heart attack or a bad accident. In the less dramatic but no less dangerous cases, if you continuously cause damage by your lifestyle and do not even attempt to give the body a chance to catch up, you will eventually end up with a chronic inflammatory disease such as an immune system malfunction or failure. Thus it is vital to give your system all it needs to effect repairs and to treat it with respect knowing that you can by your action or inaction, overwhelm it.

What then are we to make of disease? Is disease something which comes on us from the outside, or is it really a cry for help by The Mechanism, which is becoming overwhelmed. Granted we have to be realistic, we know we will not live forever, but we can make the most of our time here by looking after The Mechanism. That is how you can support your health. If you are in a diseased state it is a request by The Mechanism for outside assistance. This may require surgery – in dramatic cases of badly broken limbs or appendicitis for example. Nonetheless, once the drama is over and you are beginning the process of restoration, the best thing you can do for yourself is to eat properly. This is one of the very best ways of providing the self-healing mechanism with the building blocks and raw materials it needs to effect repairs.

More history

So Still devised a series of techniques for the restoration of structure, and thus function would restore itself. Aiding and abetting the self healing mechanism, not dictating or taking over. He worked for some time and eventually took on students, started a school and so on.

The next name of interest was Sutherland – he was a student of Still’s and around 1910 he twigged to a very important structural truth. The Central Nervous System dictates to the rest of the body, thus if techniques could be divised to aid and abet the CNS, then much more therapeutic value could be had from treatment. He worked out the anatomy and physiology from observation and experiment and then created techniques to apply this knowledge, keeping Principles in mind at all times. He devised the first “Cranial” techniques. Osteopathy in the Cranial Field was his work and a natural extension of Osteopathic Philosophy and Technique.

Dr Rollin Becker was a student of Sutherland, and I was a student of Becker.

When I first saw an Osteopath in the early 80’s I had a problem with my hip (so I thought) I had had the x-rays and seen the “specialist”, I had had the physio and was not only no better, I was deteriorating. A friend at the time said I should see Susan, and the rest is history. Susan worked cranially, and “fixed” it. That is what I thought at the time. That things were fixed. In 1984 I went to college and this limited and superficial understanding was dispelled.

Dr. John E. Upledger has developed CranioSacral Therapy modality and is co-founder of Upledger Institute International, Inc.

The origins of the idea of Cranio-Sacral therapy go back to the 60’s and 70’s. Dr John E. Upledger essentially took the basic techniques of cranial work and separated them out, taught them to people without an osteopathic training, in short courses. Essentially divorcing technique from its underlying origins in thought and philosophy. A true Osteopath Thinks first and then applies technique as appropriate. Thus all medical techniques can be used if appropriate to the individual patient. That will include surgery and pharmaceuticals. True Osteopathy is about thinking in a certain way, and then solving the patient’s problem in the best way possible given all the individual circumstances.

So for example: a patient comes to me with hip pain and a set of x-rays. This patient is 65 years old. On examination I discover that the hip is – not to put too fine a point on it – knackered. In theory I could treat it, in theory it could be restored, but in practice the practical answer is a good surgeon. Get a replacement and get on with your life. The time for conservative intervention was several years ago before the joint was damaged beyond repair. Maintenance of health is the true forte of anyone who works on this side of the medical divide. For last ditch and drama when that has failed, you might need a paramedic to save you after a heart attack, or surgery for an emergency such as a burst appendix, or intensive care treatment after an accident.

MEL:  Can you give examples of success stories with your therapy?

It is extremely arrogant and counter to the principle of the self-healing mechanism and personal autonomy for me to brag about any patient whose life I might have changed. A patient may feel that I have made a particular intervention in their life that changed it, it is for them and not me to talk about that. I aid and abet the natural drive of the self healing mechanism which is always towards health. I work with the patient’s mechanism to support the restoration of their own health. I do not helicopter in and save the day. Actually no one does. The dramas that we associate with western medicine are also based on the self healing mechanism. The life support machine is a holding mechanism until the self healing mechanism kicks back in again and starts to restore normal service. If the mechanism does not kick back in, the patient dies. That is the case in all medicine.

To sum up…

Osteopathy is a complete system of diagnosis and treatment that uses manual techniques to restore structure and thus function in association with the patients inner drive towards health. We treat at many different levels, from sports injuries through anything structural dealing with the musculo-skeletal system, the typical back pains etc, to birth injuries and neurological conditions based on the ability to support the central and peripheral nervous systems. The musculo-skeletal problems vary in severity and respond to a range of techniques. The central nervous system techniques respond to the techniques of Osteopathy in the cranial field.  The health of the spine is important as it is the practical interface of the CNS , the peripheral nervous system and the workings of the body’s organ systems.

MEL:  What about babies and children?

Babies and children benefit enormously from treatment by a practitioner who has the experience and technical expertise. Dramatic changes can be made in the quality of life for all sorts of problems in babies and children. For more information contact – The Osteopathic Centre for Children in London.

Other apparently similar disciplines.

Please distinguish between the minor disciplines and the major disciplines first and foremost. Just because I use my hands does not mean I “just do massage”. Energy workers – the Reiki types etc, are not trained in medicine. Physiotherapy is a minor branch of mainstream medicine, not a complete system, it focuses on musculo- skeletal problems, rehabilitation after major surgery etc, it is always under the guidance of a mainstream doctor.

End Interview…

When Boss Media first expressed their interest in obtaining an interview with an Osteopath, I had no idea just how much insight I would gain, and I would like to thank Maria Clarke for her knowledge and candid disclosure and exploration of the traditional and modern medicine dichotomy.  This succinct and articulate portrayal of the health / healing / medicine status quo of our modern, industrialised era.   This  theme is echoed in many of our articles relating to health, as we explore that which benefits health.