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www.shamansociety.org 43 The winged caduceus of the Greek god Hermes came to supercede the staff of the healer Aesculapius with its single snake around a wingless staff as a representation of the North American medical profession less than a century ago appearing initially as a symbol of the American Medical Corps during World War I.1 Hermes and thus his staff was a sym- bol of wisdom eloquence and communica- tion vital elements in the physician-patient relationship. There has been some criticism of the caduceus as a medical symbol however because the mythological Hermes also leads the dead to the underworld is associated with wealth and commerce and happens to be the patron of thieves. But a deeper look at the symbology is in or- der. In nearly every culture throughout history staffs and serpents have had a general associa- tion with wisdom healing and transcendence whereby the underworld snake-consciousness passes through the medium of earthly reality to attain transcendence in its winged flight.2 The symbol historically has been reserved for powerful mythic figures humans of unusual distinction like shamans and mystics or for royalty.3 It seems to me the practice of medicine in the contemporary West is well represented by the caduceus in many of its symbolic meanings. As medicine has become big business the medical- industrial complex is ripe for thievery enhanced communica- tion technology and the electronic medical record challenge the privacy of patient records and in the time pressure of organized medicine doctor-patient communication suffers. The modern medical mandate to find it and fix it leaves out the possibility for true healing through the transcendence of illness when medical providers equate the souls response to illness as tampering with religion and therefore beyond their role. Symbolically the focus in modern healthcare is the staff and not the serpent or the wings. Healthcare providers in all the disciplines as well as the pa- tients they care for have felt the lack of soul in Western medicine. Over the past several decades there has been momentum to return the elan vital to our work as clinicians first as holistic medicine of the 1970s complementary and alternative medicine of the 1980s and 90s and more recently as integrated medicine in the 21st century. Into this confluence of Western and alternative therapies the spiritual methodology of shamanism has begun to emerge as a source of healing. Traditionally the purview of native peoples for over 30000 years a cross-cultural form of it more applicable to western culture was developed several decades ago by anthro- pologist Michael Harner who with his faculty has trained thousands of conventional medical practitioners. Shamanism seems particularly rel- evant to the practice of western medicine today inherently animistic it directly addresses the soul aspect of physical and emotional illness. Todays symbol of the caduceus with stiff wings and coiled snakes arrested in their movement is becoming invigorated. The traditional practice of shamanism over the millennia is a community event in which the patient is remembered into the larger frame- work of relationship to family and group life as well as to the family of spirit. Illness is seen as a need to rebalance and attend to the souls work in this lifetime and the process of recovery takes on a different and more profound meaning beyond only the re- lease of distressing physical or emotional symptoms. Shamanisms inherent work with the spirits can often provide answers to the existential questions of illness such as Why is this happening to me when illness seems unfair Who am I when illness takes away our roles Am I more than my physical body when we can no longer equate self with corpus and ultimately How do I learn to fully and bravely face my own death In January 2003 I conducted a survey of Western medical practitioners physicians nurses psychologists social workers pharmacists etc. who also had shamanic training to collectively understand how shamanic resources were being translated into more biotechnical healthcare settings. In addition to questions about allopathic training and shamanic training the survey asked if and how the practitioner was able to integrate shamanism into the work setting and if not able to integrate what the challenges were. I was surprised to find that many of the respondents especially those in primary care settings reported they did not use their sha- manic training at all. They cited a number of reasons for this in particular medico-legal and ethical concerns and the lack of a sense of how the form in which shamanism had been taught to essay The Flight of the Caduceus by Cecile Carson MD