OUR sanitariums are to be an instrumentality for reaching the people, an agency for showing them the evil of disregarding the laws of life and health, and for teaching them how to preserve the body in the best condition. Sanitariums . . . are to be centers from which a work of healing, restoring, and educating shall be carried on." --Counsels on Health, p. 207.
Medical care in the United States began with the bleeding of our founding fathers. Calomel was used as a cathartic, strychnine with iron and quinine was freely prescribed as a tonic. The early practice of medicine in this country may have hastened more deaths than it prevented. The quackery of the early 1800's, combined with the nationally advertised patent medicines, produced a crisis in health care.
It was against this backdrop that Ellen Could White (just a few weeks after the organization of the General Conference of Seventh-day Adventists in May, 1863) was given a vision that had far-reaching implications for the church. The broad field of health maintenance and preventive medicine was presented to her. The high points on the causes of disease were outlined.
On Christmas Day, 1865, Mrs. White came to the church with another message from God. We were to establish institutions to care for the sick and to teach individuals the principles of healthful living. In September, 1866, the Western Health Reform Institute, later known as Battle Creek Sanitarium and Hospital, was opened. In 1878 the Rural Health Retreat, later known as St. Helena Sanitarium and Hospital, opened its doors. At one or the other, or in some cases both of these institutions, health lecturers such as John Harvey Kellogg, Sylvester Graham, and Ellen White began to present a program of preventive medicine. A more healthful diet, a routine exercise schedule, sanitary health care, and natural rather than chemical treatments were encouraged.
The fear of hospital care brought the attention of thousands to these health reformers and Americans began to come to these institutions to learn and practice the principles of healthful living. These facilities seemed to stand like beacons of light in the dark ages of nineteenth-century medicine. To them came the rich and the famous and those who had been turned away by others as hopeless.
With the acceptance of the germ theory and the onset of the twentieth century came an era of pharmaceutical discoveries. Together with sanitary hospital care, these innovations changed the image and character of medicine in the minds of the public. Results from the treatment of disease be came more predictable and Americans began to depend less on the prevention of disease and more upon its treatment. The era of health reform was gradually over shadowed amid the developments of a new age of chemical therapy and still more recently of vital organ transplants.
These many changes have had a bearing on the operation of Seventh-day Adventist facilities. In many cases through the years we have changed our approach to the method of delivering medical services. Furthermore, cities have grown up around our institutions, and the length of time a patient stays in one of our facilities has been shortened from twenty-eight days to six or seven days. One by one, our sanitariums have been demolished or closed and merged into general hospitals to be used as space for new emergency rooms and new surgical units. A few sanitariums still strive to exist and operate primarily as senior citizens' resident facilities or extended-care operations.
The question is raised, Is the "sanitarium idea" relevant to day?
Today in our technologically developed society the diseases that are killing us are not the infectious diseases. These have largely been brought under control.
The majority of deaths and a substantial proportion of the disability are related to chronic degenerative diseases, particularly those associated with the cardiovascular and pulmonary systems. The cost to individuals, private industry, and government is estimated to be in excess of $30 billion annually. This is an economic disaster, and the human loss is unacceptable.
An increasing amount of persuasive evidence from medical research links certain habits of living and certain attributes of an individual to his chances of developing premature disease. These characteristics include:
1. Cigarette smoking
3. Sedentary patterns of living (physical inactivity)
4. Elevated blood pressure
5. Emotional and stress factors
6. Elevation of blood fats (cholesterol, triglycerides, lipo-proteins)
7. Nutritional factors
8. Electrocardiographic abnormalities at rest and during exercise.
These characteristics are called risk factors because they tend to shorten life if left uncorrected.
On the basis of the study of the Inter-Society Commission for Heart Disease Resources it was recommended, and most enlightened medical authorities now agree, that we should be dedicated to the early identification of high-risk people. These individuals should then be placed on a professionally supervised pro gram that is especially designed to modify the major risk factors.
The treatment in the United States of high-risk people, defined as having one or more of the risk factors mentioned, involves 20 to 30 million people. (If their families are taken into consideration, we are talking about 80 to 100 million people.)
A mass of information is avail able on the importance of reducing the risk factors that have just been outlined, and yet actual statistics demonstrate that most Americans are not taking advantage of this information. This is mainly because it has not been organized and presented as a pat tern, and because no full-time, understandable plan has been available to provide education and implementation in a practical setting.
Interest is growing today in the prevention of disease, and it is becoming increasingly clear that people and organizations are willing to pay for a program and take the necessary time if the instruction is professional, the setting is pleasant, and the participation is exciting and interesting.
To meet these needs, numerous conditioning centers (sanitariums) should be constructed and operated by the Seventh-day Adventist Church.
The basic hypothesis is that the incidence of disease can be significantly reduced by active education that considers the dietary habits, cigarette usage, sedentary living, and emotional stress and tension. Through the operation of a resident facility where each guest or patient is actively involved, the participant becomes much more susceptible and willing to accept change in his mode of life.
Many conditioning centers have already been established within the past twenty years in numerous European countries. Development of such centers in the United States has been much slower.
To many experts today it seems that the present health-care crisis facing us in the United States stems from the fact that our entire medical apparatus is oriented to meet the patient when he is already diseased. We need more emphasis on prevention of disease before the patient becomes critically ill and it takes a much greater outlay of money and personnel to diagnose and treat him. Often such treatment is too late to do much good. This too-much-too-late approach finds us making the least productive health investment possible both in manpower and in money.
Despite all of this, it was interesting to note that at the November, 1972, meetings of the American Public Health Association in Atlantic City, there was a growing debate among legislators and aggressive leaders in the health-care system over patterns of delivering medical care as well as over the mechanisms for financing this health care.
In some respects the European system of delivering medical services is being considered a model of things to come. In some countries, particularly Germany, it has been calculated that it is cheaper to send "healthy" individuals to a conditioning center (sanitarium) to prevent diseases rather than to treat them after the onset of illness.
Today, as much as at any time in this earth's history, men need to be educated in regard to healthful living. This is why the board and staff of St. Helena Hospital and Health Center did not reject this "sanitarium idea" when the opportunity presented itself in 1966-1967 at the time of the demise of the old sanitarium building. In stead, it was voted to construct a modern hotel-like facility where the unique objectives of the church's medical program, as outlined in the Spirit of Prophecy, could be promulgated.
The program at St. Helena had a modest beginning. The board, with encouragement from its chairman, Elder James Chase, and the hospital administrator, Charles Snyder, moved ahead in faith, accepting the possibility that several years might pass before the direct and indirect expenses of offering such a program would be covered from the income.
Through the initiative of the chap lain, Dieter Main, the first inpatient health education and stop-smoking class, with an enrollment of eight participants, was offered in April, 1969. Some fourteen per sons from the hospital staff were involved in some way in making this program a success. Through the summer and fall of 1969 one six-day class was offered each month, with an average attendance of six guests a month.
In the fall of 1969 Alan J. Rice, a trained health educator from the Loma Linda University School of Health, was added to the staff. Six programs were offered during the first six months of 1970, with a total enrollment of sixty-eight patients, or an average of eleven patients per month. The second six months of 1970 another six programs with 149 guests participating were offered.
During 1971 nearly two hundred patients participated in the nine teen programs conducted. In the first six months of 1972 eleven health-education courses were offered with an average attendance of twenty-five patients per month.
At no time prior to the second six-month period of 1972 was the income from the health-center programs sufficient to pay for even the direct expenses incurred in operating the health-education and physical-conditioning courses.
Because of the growing participation and interest in the weight-management aspects of the health-center programs, beginning in July, 1972, a separate weight-management program was instituted.
From July through December, 1972, health-center-program participants totaled 318. A total of eighteen programs were offered with an average attendance of fifty-three patients per month.
During the second half of the year 1972 the direct obvious expenses incurred in offering the physical-conditioning and health-education courses at St. Helena have been met. Unfortunately, due to the indirect expenses involved with operating a new building in conjunction with the hospital operation, the total program has been kept from being completely self-supporting. Thirty personnel are directly and in directly involved with keeping the conditioning programs running effectively.
Beginning in 1973 an additional adjustment in rates will be made and with the growing number of Bay area physician referrals the board and administration at St. Helena have faith that the total conditioning-center concept will be a self-supporting one. The work of the chaplain in such a program is invaluable. At St. Helena the chaplain's role is unmistakably clear and he participates in the program and becomes acquainted with the guests on a day-to-day basis through the tension management and will power dynamics classes, which he conducts.
Though St. Helena Sanitarium and Hospital has changed its name, our purpose remains the same. The program at the health center has been organized to guide and instruct men and women in modern times how to attain optimum health. It has been designed to meet the needs as expressed by many of the nation's health leaders. These are, interestingly, the same needs as outlined by Mrs. White more than one hundred years ago.
Whether the guest at St. Helena is participating in an inpatient stop-smoking program (designed especially for the heavy smoker who has not been successful in his efforts to stop smoking in less concentrated programs), a weight-management course, or a comprehensive executive health-care program, a day at St. Helena includes various medical evaluations to determine his health needs (e.g., tests to measure heart function, blood chemistry, and lung function), an exercise program, medical lectures and group discussions, physical therapy, nutritional programs, diet therapy, mental hygiene, films, and various outdoor activities. The total program is implemented away from the pressure of work, in an atmosphere of clean mountain air.
As the program continues to grow and more programs are added, we are encouraged to see people learn that it is not too late to turn the trend of the disease process in their own lives.
The sanitariums of yesterday and the conditioning centers of the future are unique in at least three respects.
1. Medically, they are places where the primary emphasis is placed on three therapeutic procedures: mental hygiene, physical medicine, and diet therapy.
2. Educationally, they are places where an earnest endeavor is made, not simply to cure the immediate malady but to instruct the patient in basic principles of health and, if possible, to generate in his mind enthusiasm to carry out these principles in his future living.
3. Spiritually, they are places where these health principles are presented in a religious setting, with the hope of furnishing the patient a spiritual incentive to live in harmony with physical laws, and to find release from the tensions of life through fellowship with God.
In a recent policy statement of the executive board of the World Health Organization, this statement was made:
Coronary heart disease has reached enormous proportions, striking more and more younger subjects. It will result in coming years in the greatest epidemic man kind has faced unless we are able to reverse the trend by concentrated research into its cause and prevention. "The Primary Prevention of Atherosclerotic Diseases," Circulation, Vol. XLII, December, 1970.
The board expressed a wish that countries most affected by cardiovascular diseases increase their efforts both to set up efficient services for control and to carry out more extensive research programs.
We live in a distraught world troubled with increasing cases of nervousness, tensions, and break downs; a world where bodily ailments now stand revealed as being too often attributable to dietary errors; a world that is doctoring itself with every kind of medication, most strikingly, sedatives. Such a world stands singularly in need of the help of institutions that specialize in mental hygiene, diet therapy, and physical medicine. Such institutions that seek to prevent disease will not lack patient business. If properly ad ministered, they will always have a waiting list.