Her eyes sparkled. Her smile was radiant. It almost brought tears to my eyes when she told me how much better she felt, and that her migraine headaches were completely gone. She had suffered from intense migraines every single day of her life for the past twenty years. She had been to doctor after doctor, and had been placed on the usual litany of pills, none of which had given any significant relief. Instead of getting out my prescription pad and prescribing yet another pill in order to band aid her symptoms, I asked a simple question. It’s a powerful question you’ll often hear from a three year old, and yet it’s a question that you’ll rarely hear from your doctor. That powerful question is “why.” Why did she have migraines? Further history-taking revealed to me that her migraines were hormone related, as migraines often are. Appropriate lab tests confirmed my suspicion. Evidence based treatment was started with a balanced regimen of bioidentical hormones in order to correct her deficiencies. “Bioidentical” means that the hormones we use to treat her imbalances are exactly the same as the hormones already in her body. The results of this course of treatment were nothing less than miraculous. After twenty years of torture, her headaches, which had invaded every aspect of her life, stopped completely. For the first time in her adult life, free of the oppressive shackles of constant pain, she could be the wife, mother, and person she had always wanted to be.

We as physicians and healers have a lot to learn from three year olds who ask the question “why.” Our focus seems to be misplaced on labeling patients. Like a detective, our training instructs us to search for a suitable diagnosis (preferably something that’s codable and billable), and then to start the patient on a drug to relieve their symptoms. We rarely ask “why” they got the problem in the first place. Although, it is only by asking this simple and profound question that we can get at the root of the problem, and treat the underlying cause rather than putting a patch on the symptoms. Because if we don’t’ treat the cause, the disease will probably rear its ugly head again, and the patient will continue to suffer.

This search for the cause of disease represents a rapidly growing genre of medical practice called “Functional Medicine.” As described in “The Textbook of Functional Medicine” it is “a dynamic approach to assessing, preventing, and treating complex chronic disease.” At its core functional medicine is a search for, and treatment of, the cause of disease. The textbook further states that chronic disease is usually preceded by an extended period of declining function in one or more bodily systems. Such declining functions are caused by lifelong interactions with our environment (such as nutrition and toxins), and lifestyle (such as stress) superimposed upon our genetic predispositions.

Such a philosophy of medicine is also founded on the principle of “biochemical individuality.” Each patient is unique and complex in relation to the stage they have set for the development of disease or the maintenance of optimal health. Therefore a cookie-cutter, one size fits all, “here, take this pill” approach to health care frequently does not work for the individual, especially those with chronic and complex problems, like fatigue. Because of biochemical individuality, health care for these complex problems must be patient centered, not disease centered. Mrs. Jones and Mr. Smith may have the same diagnosis, but the physician may find that what works for Mrs. Jones does not work for Mr. Smith, and vice versa. The challenge of the healer and the patient is to find the healing modality that works for that particular patient, in order to treat disease and to optimize health.

Once we embark upon the journey of “why” we find that the patient’s dysfunction is often due to causes such as hormonal and neurotransmitter imbalances, inflammation, immune dysregulation, stress, poor sleep, trauma, emotional issues, toxins, allergies, occult infections, or problems with poor nutrition, digestion, or absorption. These are the common denominators of many symptoms and diseases. The search for these underlying causes may require a “leave no stone unturned” approach to the patient’s problem. However, by taking the time to identify and correct these underlying imbalances, we often find that the symptoms improve dramatically. As we have seen with our migraine patient above, such an approach can literally give the patient her life back. And nothing brings me greater joy as a healer than to relieve pain and suffering, and to start the patient on the path to optimal health and vibrant living.