What is Health? The Personal Journey of an Osteopath

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Sylvia Orozco Silberman DO, MS
May 1, 2023 / 3 mins read

Before med school, I studied complementary and alternative modalities, exploring different fields of medicine through Georgetown’s Complementary and Alternative Medicine program.

The experience allowed me to consider pursuing Traditional Chinese Medicine or even Naturopathic Medical School. I was searching for something beyond the treatment of disease. My passion became preventative care – promoting health, rather than treating disease.

Andrew Taylor Still, the founder of Osteopathic Medicine, wrote, “To find health should be the object of the doctor. Anyone can find disease.” What does that mean? What is health? What does it mean to “find health?” Curious, and finding something that resonated, I decided to pursue Osteopathic Medical School.

In med school, “health” was not something we found in anatomy lab dissecting tissue. Nor in my staged clinical encounters with actors pretending to be patients. Nor during my immunology and biochemistry lectures. The “health” – a founding principle of Osteopathic medicine – was conspicuous for its absence.

I spent most of my time in the labs standing over treatment tables – where osteopathy happens. I learned the difference between palpating skin versus bone, what acute injuries felt like when you touched different kinds of tissues. I felt heat, inflammation. I also felt restriction – as though the tissue could not move as it desired.

I observed upperclassmen while they treated colleagues. For a month, I was not allowed to touch the body – I observed. Once my mentor thought I was ready, I was taught with my mentor’s hands on top of my hands, and shown what all the different live tissues felt like on a patient. It was nothing like the tissue I felt in anatomy lab. Healthy, live tissue felt fluid – like water. Bone felt soft. The body was responsive.

I practiced on my family members as much as I could. I didn’t care whether they were laying on a couch or sitting in a chair. I wanted my hands to gather knowledge on as many different textures as possible. I returned to school in Tennessee and volunteered to treat at rural free health clinics with faculty. I discovered the anatomical irony that truck drivers – who move goods across the country all day – are nonetheless nearly motionless physiologically. Their bodies reflected that lack of motion – disconnected pieces that did not feel like they belonged to the same body. The tissues were not hot and inflamed – characteristic of an injury – as much as they were restricted, almost frozen.

I had begun a journey and would spend all day working toward my goal: to understand health. I purchased a treatment table of my own and didn’t go anywhere without it. My husband would complain that my little Chevy Cavalier was too small and we didn’t have room for the large treatment table to come with us – nonetheless, it always came with us.

I paid out of pocket to attend my first Introduction to Cranial Osteopathy course in Naples, Florida. My mother shared her hotel points with me and I was able to attend a 5-day long conference. Still, despite consuming voraciously – information, experience, and wisdom – I was barely in a place to understand “health” conceptually. In hindsight, I don’t remember ever hearing conference attendees present about or discuss “health.” Not because they didn’t, but more likely because I hadn’t yet arrived at a place to understand.

Throughout medical school and training, I spent all my time treating anyone who asked. I maintained a side schedule with my classmates and med school staff. I attended the OMM labs three times instead of once. Between the repeated hands-on labs, I would treat classmates on the sidelines. I started attending early morning group classes with faculty for those interested in more knowledge in OMM and took more advanced courses in Osteopathy. I talked to my husband about all the things I was learning and practiced on him all the time. I loved all of it.

My mentors treated me. Along the way, my dysfunctions and injuries peeled off layer by layer like an onion, allowing me to heal in a non-linear way from injuries I had endured in years past (including from childhood), that had remained embedded in the tissues. I saw that “health” could not be found piecemeal – fixing one muscle, bone, or structure at a time. Often, the body’s health is constrained by a key lesion, which, when found and treated, can help the entire body unwind.

In residency, I operated in a traditional allopathic paradigm – I was trained to find and treat disease. I was the only Family Med resident passionate about the integration of OMM within almost every patient visit in the clinic. The benefit was that I was allowed to do all the OMM I wanted. It was wonderful! Yet, the preventative care I learned about was all secondary prevention – meaning early detection rather than prevention of disease.

After completing residency, I wanted to open my own OMM practice. Now I am completely immersed in readings, study groups, and patient care, among a community of like-minded “health” practitioners. I treat all ages with all sorts of ailments. Now, more than 20 years after I first read A.T. Still’s “find heath” edict, I have begun to form my own understanding of its meaning.

My sense of health is personal, and I believe that, in itself, is central to the concept. I’ll share with readers what I share with my patients:

Health is a sailboat on a rich, blue open ocean. The boat floats freely on the currents of the wind and the swells of the sea. It is unimpeded and moves in symphony with the natural forces of the tide in which it coexists.

Perhaps this gives you a sense of my concept of “health,” as I’ve formed it today. More likely, your own sense will differ, and emerge over time, like a picture slowly coming into focus. My message is that health is not reductionist, nor, perhaps frustratingly, is it particularly concrete. Health itself is fluid, personal, and in constant, changing motion.

My exploration of health is only just beginning.