It has been utterly frustrating for me to witness the constantly denigrating and sometimes tragic consequences of polarization from within and without complementary medicine.

Perhaps it is an inevitable facet of human nature that so many individuals and groups of people always seem to oppose colleagues and those of different persuasions, rather than attempt to allow the validity of differing views and somehow work for the common betterment, particularly as it relates to healthcare.

Polarization occurs at so many levels of medicine. At the widest level there is the huge gaping divide between complementary and orthodox medicine, so much so that certain elements from each camp regard the other as the enemy. This is reflected in the huge disdain sometimes voiced in the media and in the medical literature of alternative or complementary approaches being not only an utter waste of resources, but also extremely serious and dangerous to the health of the nation. Some of the research about the use of complementary medicine (CAM) by sufferers of various ailments which are highlighted in this issue was apparently motivated by such ideas of search and destroy. (See Richardson et al, 2000 and Bennett and Brown, 2000.)

Within the same polarization genre is the management technique of sidelining and ignoring developments within complementary medicine by the medical profession, so that the two camps remain as two solitudes. This is most evidenced by the total lack of any nutritional and herbal content within oncology programmes for cancer patients, who are being told that while nutrition may play a role in cancer prevention, that there is no evidence regarding its potential efficacy in cancer treatment. Every month Positive Health features at least one research update showing that a nutritional or herbal product has effects, at the molecular level, of either apoptosis (cell suicide) or cellular or chromosomal disruption within cancer cells. (See in this issue the research by Israel, Yu and Kline, 2000 and Karas et al, 2000.) And those in the media who are arguing for more resources for cancer services, such as John Humphreys (see The Sunday Times, 1 October 2000) never mention any approaches other than those conventional therapies of surgery, chemotherapy and radiotherapy. Surely, since nutritional and herbal elements can modify cancer genes, these approaches are worthy of being incorporated into cancer treatments?

Then there is the polarization within individuals and groups within complementary medicine. Over the years there have been slanging matches or court actions between various individuals from almost every therapy – including Bowen, Reiki, NLP, Healing, Homeopathy, not to mention the acrimonious disputes constantly ongoing between prominent leaders of various organizations. It is, in my opinion, justifiable to disagree about technical approaches to various therapies, classical versus complex homeopathy, aromatherapy versus aromatology, hands-on versus hands-off healing; however, it beggars belief to witness the wars which occur around different approaches to particular problems. The polarization between professionals regarding various dietary and detoxification approaches, regarding so-called miracle products including soy-derived phytoestrogens, food-state nutrients and the utter extreme camps which divide the complementary community regarding substances such as natural progesterone.

Why is it that as professionals we cannot agree to disagree, or to at least be agnostic, until the research is performed and the answers to questions provided? It is painful to read vitriolic columns by prominent members of the complementary community attacking those with an opposing view, just as it must be painful for those benefiting from animal research to be told such experiments are evil and must be stopped at all cost, or to children in the third world who might benefit from a genetically modified crop which could protect them against vitamin A deficiency, to be denied such crops because of the politics or economics of opponents in the so-called first world.

I recently heard the sad tale of a prominent complementary therapist who had been experiencing serious back pain over a fairly long period (18 months). This practitioner had been treated by a variety of techniques, including acupuncture, chiropractic and osteopathy, and indeed had been advised to have the nature of this pain investigated medically, a suggestion which was rejected, until after unrelenting pain, medical investigations revealed a large tumour on the spine, perhaps spreading into the abdomen. This therapist now faces a lengthy operation with an uncertain outcome; perhaps if looked at sooner, the situation would not have been so serious.

Polarized attitudes between orthodox and complementary medicine undoubtedly influenced this practitioner's reluctance to seek earlier medical attention; this is a tragic tale which brings home the human cost of this needless polarization, which only serves to diminish all of our lives.