Leslie Korn, M.P.H.'85, believes that healing is achieved from within, through the language of the body. In a traditional, open-air, thatched palm palapa house, she treats her patients--mostly indigenous residents of the coastal village Yelapa in the Comunidad Indigena de Chacala, Mexico--using acupuncture, polarity therapy, psychotherapy, traditional foods, and local herbal remedies. Yet even in rural western Mexico, where she has spent 27 years, "people have now been by and large conditioned to believe that healing comes from without, healing comes from a pill," she says, speaking from the Center for World Indigenous Studies, an independent, Indian-controlled, non-governmental organization in Olympia, Wash. There she is director of research and education and heads the Center for Traditional Medicine.

An indigenous Mexican may ask for a pill and a middle-class American may seek out alternatives to conventional medicine for the same simple reason. As one woman wrote in a letter to the New England Journal of Medicine explaining why she chose to use unconventional medicine along with conventional modern medicine: "Because I want to feel better. It is not any more complicated than that." Korn became a public health and traditional medicine practitioner through her own quest to feel better. When she first stepped into the jungle landscape of Mexico's west coast in 1973, she was a 20-year-old native of the upper-middle-class Boston suburb of Newton and a Washington University dropout searching for meaning in her life. She found typhoid, hepatitis, scorpion stings--"I got sick with everything there was to get sick with," she says, laughing. From the women of the village she learned to use medicinal plants, massage, and other traditional remedies to heal herself and others, and in return she introduced them to reproductive health concepts and basic sanitation.

Korn has taught at a number of universities, including Harvard Medical School, helping physicians and psychologists in the U.S. integrate therapeutic touch and mind- body medicine into their practices. "There's absolutely a growing acceptance of traditional medicine" in the U.S. today, she says, "and it's been consumer-driven and comes out of people's dissatisfaction with allopathic medicine"--the term Korn prefers for mainstream medicine as practiced in the industrialized west. She also differentiates between traditional medicine, which utilizes elements in nature and is most often passed on by empirical knowledge and traditions, and what is often referred to as complementary and alternative medicine (CAM), which adds the scientific method to these traditional components. In 1997 Americans spent a whopping $27 billion out of pocket on cam therapies, according to a study by researchers at the Beth Israel Deaconess Center for Alternative Medicine Research and Education--comparable to the amount spent out of pocket for all physician services in the same year. The B.I. Deaconess researchers also estimated that U.S. adults made a total of 629 million visits to alternative medicine practitioners in 1997, more than the total visits to all primary care physicians.

As consumers have shown their increasing hunger for CAM--and willingness to pay for it--and as more and more HMOs have begun covering alternative therapies, physicians have become less reluctant to offer or advise their use, despite ongoing debates over the efficacy of particular methods. A 1998 Kaiser Permanente study found that almost 90 percent of Kaiser primary care physicians had recommended or practiced alternative therapies on adult patients in the preceding year, and that 50 percent of Kaiser members had at some point tried alternative medicine (mainly chiropractic, acupuncture, massage therapy, and relaxation techniques). Consumer demand also influenced Congress's decision to expand the nih Office of Alternative Medicine (oam), creating the National Center for Complementary and Alternative Medicine in 1998. This year the center, which supports basic and applied research and training and disseminates information on CAM, has a budget of $68.4 million--small change in comparison with the National Cancer Institute's $3 billion plus, but an enormous increase over the $3 million budget oam started with in fiscal year 1993.

More funding for research on alternative therapies means more likelihood that consumers will receive safe, effective treatment. "Some alternative therapies, perhaps a small minority, probably do work, and it would be useful to sort out the useful from the ineffective," says Walter Willett, Fredrick John Stare Professor of Epidemiology and Nutrition and chair of the nutrition department, expressing the caution with which many practitioners of conventional medicine view the field of cam. "There is added reason to do research now because many people are using them, and some are probably ineffective and even toxic." For her part, though, Korn worries that the health industry is "co-opting naturopathic approaches and using them for purely economic purposes," and that by focusing on testing specific herbs for specific maladies "we've just transferred our reductionistic philosophy to what we call natural substances," rather than adopting a more holistic approach toward human health. She would also like to see the debate go beyond the question, Does traditional medicine work or not? "I'm not really as interested in that," she says, "because we know it works."

What does interest Korn is "how people can be in charge of their own health care" and the relationship between culture, illness, and the environment. She integrates mainstream medicine into her public health practice in rural Mexico with a caveat. "Vaccines and some antibiotics are very useful for prevention and treatment," says Korn. "However the vast majority of illnesses that indigenous peoples face in Mexico and many fourth world [indigenous] nations result from the destruction of their natural habitat and the resulting loss of good nutrition and sustainable ways of life that reinforce personal and community health." In these communities, where rates of alcoholism, depression, and malnutrition are soaring, a return to traditional diets and modes of healing can serve not just as a way to recover lost wisdom, Korn contends, but also as a step toward reversing the communal trauma and lack of self-worth that has been bred into generations of indigenous people by oppression and outside control.

And for the sufferer of borderline personality disorder born out of trauma or the Puerto Rican immigrant who experiences somatization disorder (severe chronic pain with no apparent bodily cause), the answer may be found within the body, rather than in a pill administered from without. Just as infants need to be held, Korn says, such patients need the healing power of touch. "There are particular ways of touching the muscles, of touching the energy points where the pain is," she explains. "Basically you're touching the pain of the body in specialized ways to elicit memory, feeling, sensation. It's a way of touching the body that gives voice to the pain of the body through the body."

Novelist Susan Sontag has critiqued the conventional Western metaphor of diseases as enemies to be fought and overcome, saying this attitude harms the ill. Similarly, Korn takes an approach to illness that is not categorically negative. Illness can be a wakeup call, she says, an instigator of change. She talks about healing as opposed to curing. "The purpose is not to get out of dying here, but it's to die a whole person," she says, dismissing "this idea that something external [such as a cancer drug] is going to affect us and beat our bodies into submission." Instead she asks, "Why do we have increased rates of breast cancer now on the west coast of Mexico?ÉI'm interested in helping people discover the link between their body and mind--and that it's not disconnected from the rest of their lives."

After all, Korn points out, the word "medicine" is derived from the Sanskrit root ma or me, meaning measure or balance; the roots of the word "culture" mean "worship of the earth." That is where traditional medicine comes in; it links medicine and culture to elicit well-being by creating a connection with the people and natural world around us and seeing "ourselves as human organisms, as pulsating, vibrating, energetic, chemical beings."

Eman Quotah