David Schleich, PhD
When Napoleon and the Emperor of Russia met on horseback after a great battle just north of Moscow, the Emperor offered him a popular but bitter-tasting Russian ale as a gesture of goodwill during the temporary truce. In a matter of days Napoleon would be ensconced in the Kremlin, the city empty around him. In this moment, however, Napoleon returned the greeting and, aware of his tall adversary, stayed on his horse even after the Russian has dismounted. He fell silent for a time before speaking. Napoleon’s supply lines were dwindling and winter was settling in. Most of Russia’s cities had already been ravaged by his war-weary troops. These same French conquerors had grown nervous, accustomed as they were to lightning success with new technology and fierce ambition. In any case, now the great leaders of the two armies were face to face overlooking a fertile valley well above the blood and roar of the battle below.
The Russians were withdrawing to the Urals, leaving the French to occupy an empty city, gradually surrounding them with scorched earth, fouled water and poisoned food. Napoleon’s wars and his civil revolutions across Europe had changed the very fabric of that continent’s civilization. The Emperor of Russia knew and feared these waves from the West. Yet, that same Russian warlord also knew that Napoleon was at a crossroads. Napoleon finally spoke, “And now what shall we become this winter, you and I?” To which the Russian, uncomfortable having to look up at his proud adversary, said, “We can, neither of us, go home yet, Napoleon, for many men have yet to die on this frozen ground.”
“I know this to be true and it saddens the heart of France and the soul of Russia that it is so,” Napoleon replied. What happened in the next six weeks changed the course of history.
Crossroads of the Naturopathic Community
In terms of its medical education platforms and processes, the naturopathic profession has come to a crossroads, although decidedly less dramatic and lethal, but not entirely different. I know that my analogy is stretched, but we are not unlike those Russians, steeped in our traditions, comfortable in our safe distances from the rapidly encroaching transformations to the primary healthcare landscape of these past two decades, and most particularly since Eisenberg’s landmark 1990s studies (Eisenberg et al., 1993, 1998). But those transformations have made our enemies hungry, and they want to assail the walls of our city of natural health, adding the spoils to the empire they have carved, especially since the days when Johns Hopkins, Harvard, Pennsylvania and Michigan changed the paradigm of medical education in North America and, some years later, Flexner reported on how it all was going.
What has brought them to our city gates? We have been hearing about their coming, and we must decide how and if we shall drive them back. They are making it necessary that we ask fundamental questions for the future. Do we embrace the storms that accompany integration while at the same time preserving the very core of naturopathic medicine, philosophy and practice? Are we to fear these pretenders to the city of natural healthcare? The consortium of 40+ so-called “integrative medicine” faculties and institutions is an example of a very big foot in a very big door.
Lessons from Literature
Our deans and chairs could find some ideas in some of the great stories of transformation and leadership. Consider, for example, Kurosawa’s classic film, Ran, in which a historically powerful warlord named Ran attempts to pass on his wisdom and authority as he ages, exactly at a time when pretenders and new lords with gleaming weapons appear in the valley, eager to pillage its riches. Ran chooses a successor to “keep the battle red with the blood of our wisdom and knowledge” on the basis of what he feared rather than by seeing well past the confusion of the battle before him. Ran’s dilemma was that this battle was going to be fierce, like battles from long ago. Ran and Napoleon were both seeking a new strategy, a new paradigm for action in a very different world than they had heretofore known. Both realized too late that the old ways of victory would no longer work.
Western literature is replete with such examples involving the management of unpredictable events in worlds that are changing terribly fast. Ishmael, in Moby Dick, is consumed in his forlorn quest of an allegorical white whale. His task is to sort out the obsessive, consuming search of his leader, Captain Ahab. The forces in the once-familiar ocean are too strong and the ship breaks apart. As Ahab has to make sense, in that last fatal moment, of unpredictable events and new possibilities for co-existence and inner strength, he knows that had he acted sooner, with a greater understanding of what he was seeking and what the great fish was meant to teach him, neither he nor his men would have perished, and the vast sea and the Great While Whale who was at home in that cacophony would have been less enemy and more teacher.
Just as Hamlet was so contemplative, weighing one decision over another and still another over another and becoming frozen in incomplete action, so too the profession faces such a possibility unless it can galvanize its intuitive power, its accumulated wisdom. There is nothing new about the threat of assimilation. Since Flexner we have had a systematic threat to our philosophy, our well being, our very political survival in a culture whose bureaucracies and empiricists do not fully understand us. The Foundations of Naturopathic Medicine (FNM) senior editors have reminded us recently that we should delay no longer in incorporating, in a systematic rather than an anecdotal or sentimental fashion, the great knowledge of the elders of the profession alongside the abundantly, exponentially emerging new knowledge of that same profession into the current curriculum and pedagogy of our schools, into our evolving medicine, into our intentions, so that these truths are not lost but become part of the foundation of the walls that protect our city from the true barbarians outside. We need to take that accumulated wisdom and incorporate its savvy into a strategy that not only protects where the profession has come from, but makes us strong in the face of where it needs to go. When the emperors of allopathic and naturopathic medicine meet to consider what lies just ahead, it won’t matter that it’s winter, because we are comfortable and safe in our city. It is not our supply lines that will be stretched. We won’t be looking toward a long, deadly trek back to Paris in defeat.
We Will Prevail
We are about to move from being non-mainstream institutions into strong, post-secondary universities and colleges generating credentials for an emerging profession on this continent and abroad. Just as Henry V promised renewal for his troops at Agincourt, but not victory, since there is no war if we choose not to fight in that way, so too our colleges’ strategic plans need to be written and deployed to keep the walls of the city strong. Just as Henry V, in the process of engaging in a most important historical movement and moment, announced to his tiny, powerful band of supporters that whether the battle was won or lost, renewal and reconstitution of the English was assured, so too will our colleges bring the most powerful naturopathic medical education framework ever to the landscape of primary healthcare and profession medical education in Canada and the U.S. As we know, Henry prevailed in his great battle with fewer than a small percentage of the troops that the French monarchy was able to bring into the battle. The French felt the power of Henry’s political pioneers. So too shall the naturopathic profession prevail with its teachers and mentors. No question about it. But we’ve got to be smart and set aside old strategies, at least in this educational advance guard. In the coming months, let us review several of those strategies related to education to see how they stack up. For starters, what does the AANMC have to become? How can the schools support the voluntary medical associations like the AANP and the state associations in their evolution? How can we mount lots of residency opportunities going forward?
David Schleich, PhD is president and CEO of NCNM, former president of Truestar Health, and former CEO and president of CCNM, where he served from 1996 to 2003. Other previous posts have included appointments as vice president academic of Niagara College, and administrative and teaching positions at St. Lawrence College, Swinburne University (Australia) and the University of Alberta. His academic credentials have been earned from the University of Western Ontario (BA), the University of Alberta (MA), Queen’s University (BEd) and the University of Toronto (PhD).
References
Eisenberg D: Herbal and magical medicine: traditional healing today – a book review, The New England Journal of Medicine 328(3):215-216, 1993.
Eisenberg D: The invisible mainstream, Harvard Medical Alumni Bulletin 20-25, 1996.
Eisenberg D et al: Trends in alternative medicine use in the United States, 1990-1997, JAMA 280(18):1569-1575, 1998.
