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Modern Still Life

  • Alexander Pennekamp
Published/Copyright: January 1, 2016

Total hip arthroplasty is a surgical procedure that restores mobility and structure when other treatments for osteoarthritis of the hip fail. But, would the founder of osteopathic medicine, A.T. Still, MD, DO, have condemned or lauded an intervention capable of restoring structure and mobility at the cost of sawing the femur, reaming the acetabulum, and hammering in an implant? Does the body’s inherent capacity to repair itself1 supersede Still’s belief that, “[l]ike a machine, the body can function efficiently only when in proper adjustment…”?2 The answer to this question relies on the very advantage that osteopathic philosophy offers to the rapidly evolving field of medicine. Successful application of Still’s principles in modern medicine, in a way that offers competitive treatment options for patients, will decide the fate of the profession. Now more than ever, the teachings of Still and other leaders in the osteopathic medical profession hold the utmost importance.

Arguably the most difficult challenge on the horizon for the osteopathic medical profession is maintaining a unique identity. How can osteopathic physicians offer unique treatment and resist amalgamation to the mainstream to keep Still’s teachings alive? Modern Still Life attempts to underscore the solution that osteopathic medicine can grow and adjust, adapting to new technology and innovation, while still heeding its founding principles. Although Still was against radical pharmacologic intervention,3 he maintained that the goal of osteopathy was “to improve upon present systems of surgery… and treatment of general disease.”4(p168) In essence, Still embraced research and innovation and championed interventions that were safe for patients, above all else. Therefore, the goal is to see how osteopathic manipulative treatment and philosophy can serve as an adjunct to data-driven medical interventions in the modern age.

Arthroplasty—or any surgery for that matter—is not where osteopathic manipulative medicine ends. It is, in fact, another opportunity to employ Still’s beliefs. Still recognized that resorting to surgery was not an abandonment of osteopathic principles, but that “[t]he advocate of Osteopathy has the highest respect for the science of surgery, which has been recognized as a science in all ages.”4(p342) In considering the guiding osteopathic principles, what could be more personalized than a freshly machined, sized-to-fit poly and hip implant? What could be more comprehensive than addressing patient posture and breathing postoperatively? What could better support structural alignment than medicine’s best known method of orthopedic intervention?

Figure. 
        
          Commentary: I painted this portrait to capture the essence of how the osteopathic medical profession will recognize, address, and triumph over the challenges that it faces today. The tone is one of reassurance, as it allows this iconic image to evolve, underscoring the relevance of Still’s vantage point in modern medicine and surgery.
        
        
          Medium: Transparency sheet transfer, acrylics, and vine charcoal on canvas.
Figure.

Commentary: I painted this portrait to capture the essence of how the osteopathic medical profession will recognize, address, and triumph over the challenges that it faces today. The tone is one of reassurance, as it allows this iconic image to evolve, underscoring the relevance of Still’s vantage point in modern medicine and surgery.

Medium: Transparency sheet transfer, acrylics, and vine charcoal on canvas.

If Still were alive today, I believe he would fully embrace and encourage interventions such as arthroplasty. The clinical value of this perspective, and its significance for the profession, is that the osteopathic approach can provide unique and whole-patient care in the presence or absence of surgical intervention. Still maintained that “[o]steopathy is based on the perfection of Nature’s work. When all parts of the human body are in line we have health.”5(pVII) Still would urge us to consider a patient-centered holistic approach that sets osteopathic physicians apart and ensures that the profession remains an adjunct to data-driven care that shows patients and payers the value of practicing truly human osteopathic medicine.


From the Ohio University Heritage College of Osteopathic Medicine in Athens and Grandview Hospital in Dayton, Ohio.
This submission won the third-place prize of $500 in the 2015 AOA History Competition.

*Address correspondence to Alexander Pennekamp, OMS III 5028 Ralph Ave, Cincinnati, OH 45238-3804. E-mail:


References

1. Seffinger MA ,KingHH,WardRC,JonesJMIII,RogersFJ,PattersonMM. Osteopathic philosophy. In:WardRC, executive ed.Foundations for Osteopathic Medicine.2nd ed.Philadelphia, PA: Lippincott Williams & Wilkins; 2002:3-12.Search in Google Scholar

2. College of Osteopathic Physician and Surgeon documents, 1948. Located at: UC Irvine, Library Archives, Special Collections. Quoted by:SeffingerMA,KingHH,WardRC,JonesJMIII,RogersFJ,PattersonMM. Osteopathic philosophy. In:WardRC, executive ed.Foundations for Osteopathic Medicine.2nd ed.Philadelphia, PA: Lippincott Williams & Wilkins; 2003:9.Search in Google Scholar

3. Still AT. The Philosophy and Mechanical Principles of Osteopathy. Kansas City, MO: Hudson-Kimberly Pub Co; 1902:159.Search in Google Scholar

4. Still AT. Autobiography of Andrew T. Still with a History of the Discovery and Development of the Science of Osteopathy. Rev ed. Kirksville, MO: Published by the author; 1897.Search in Google Scholar

5. Still AT. Osteopathy Research and Practice. New ed. Originally published, Kirksville, MO: A.T. Still; 1910: VII.Search in Google Scholar

Accepted: 2015-10-13
Published Online: 2016-01-01
Published in Print: 2016-01-01

© 2016 American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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  12. Effective Patient-Physician Communication Based on Osteopathic Philosophy in Caring for Elderly Patients
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