Sometimes it strikes me that the human body is more a witness to sense-of-humor design than to intelligent design.  Two beneficent nature cards I received on recent birthdays testified to that.  In one case the sentiment pointed to the fact that wrinkles develop about the same time as sight dims: the other made the same point about flatulence and hearing.  But neither of those prompted today's musings.  Rather, it is the design of the human knee.  The designer, knowing it would be required to carry near 300 pounders pounding up and down a basketball court, and shifting directions and speeds suddenly and unprepared, must have giggled uncontrollably.  But when (S)He looks at the human-designed health delivery system (H)(SH)e must let out with a cosmic guffaw loud enough to blow out Lucifer's candle.  Which brings me to my reminiscence about Dr. Härtling.

    Back in my mid thirties, I had the kind of knees one expected big galoot former basketball players to have.  They were cranky and fairly accurate weather predictors as I remember them.  There is a history of knee trouble in my family...more than one of nature's knees have been replaced by human invention (literally).  I expected to become bionic eventually, hopefully later than sooner.  One knee was quite a bit crankier than the other, and on my slow-to-move days I limped a mite.  Then came the summer when I met Dr. Härtling (henceforth Doctor H-I don't know if I can make the little dots over the a's on my blog).  My brother, shorter, but far more talented and handsome, was enjoying a career as an opera singer in Germany.  Dr. H was the official medico for the Opera House for everything which wasn't viral or bacterial, I think-certainly all the wear and tear things wound up in his Klinik. 

My brother recommended I pay him a visit, and explained something I didn't know was possible, and would probably be impossible if not excessively rare in the United States.  The good doctor was (a)an orthopedic surgeon, (b) a chiropractor, and ( c) a Dr. of Homeopathic Medicine wrapped up in one cheery bundle.  Oh yes, he was certified in acupuncture too, so if one needed his acu punctured, Dr. H. could do it.

I had never heard of such a thing-a practitioner who could choose the practice which his experience and expertise suggested would best heal the patient.  In the United States, back then the Medical Doctors were quite determined to quackify all the rest-I'm surprised they didn't complain because Dentists had the temerity to call themselves doctors.  Anyhow.  Dr. H put my left knee (the one about which I was grumbling) under his x-ray machine, and when the pictures came out, showed me things which I didn't understand (of course) and prescribed a treatment with Viscum Album and Fango.  Sounded jolly.  Then I found out that Viscum Album was mistletoe juice and Fango was mud.  Well, when in Bavaria do as the Bavarians do (very good advice to beer drinkers, but I digress).  So I lay on the table, Dr. H. took out a syringe with a short small needle attached, and proceeded to inject small amounts of a clear liquid at the edge of the kneecap: six little pricks around the top, and one underneath the knee.

    Then I found out what Fango was.  Hot mud, about the consistency of silly putty, in a sheet about 3/4 of an inch thick, wrapped around the knee.  I lay there, in my mud, for about a half hour.  Then off came the mud, on went the pants, and home to my brother's apartment I went. By the time I got home, I realized I had two bad knees, not the one I thought I had.  The one Dr. H. treated felt so good that I became aware of the pains in the other one.   I was on my way out of town back to the states, so I couldn't stay to have the other one treated.  

    The next year I returned to the picturesque town on the Donau, and with a month's vacation, decided to have the full treatment in both knees.  Two visits per week, for four weeks.  Dr. H. charged me just the co-pay my brother would have paid for treatment in the German system - 8 marks per knee per visit.  (I don't know if he fiddled his books, but I do know he liked opera singers enough to treat a brother like a king.) I'd like to report that after the treatments I could dance like a Bolshoi Boyar, but seeing as I couldn't do that before the treatment, I probably shouldn't have expected that particular miracle.  But I had two very good feeling knees...and they kept feeling good for two years, at which time I just repeated the treatment.

    All good things come to an end eventually, including this blog entry (is it a good thing?).  My brother returned to the United States to take up an academic career,   and while I love him enough to visit Iowa yearly as I visited Bavaria yearly, I have never been able to locate an American Dr. H.  

    Here's the little moral to my story...one of the ways to lower health costs in this country, mho, is to negotiate at least a truce, if not a reconciliation, between the various alternative medicines, and encourage cooperation among them-maybe even encourage the kind of training Dr. H. got.  THEN allow multiple practices to be covered by single-payer insurance. Were this to happen, appropriateness, rather than cultural and political muscle would determine "best practice".

Give some reputable scientific agency authority to determine which practices are beneficial for which conditions, if necessary, but don't let any let any one school of medicine be judge and jury on who quacks like a duck.  

    In the meantime, if anyone knows someone who's dispensing Viscum Album and Fango in the states these days, preferably in New England, please let me know.  We've had a wet, cold, miserable spring, and my knees, while reasonably well behaved, are making cranky mutters from time to time.

Amike (who finally got his grades turned in)