When to rely on home herbalism and when to go to the professionals

As a young newspaper reporter, I was on the scent of oil sharks in the Amazon rainforest of Ecuador. The savvy taxi driver I’d hired pulled in at a newish gas station hunkered amid giant ferns. My photographer and I piled out and made a beeline for the tiny shop for water and snacks.

I misjudged and didn’t step high enough to clear a metal grate set up to scrape the thick rain forest mud off of the boots of customers. Being financially broke and an utter Gringo, I was also wearing flimsy open-toed sandals. The grate sliced into the side of my foot in a deep, red gash.

The lady at the counter shrieked. The wound was bleeding profusely and I noted with mild alarm that it barely hurt at all, which I vaguely thought was supposed to indicate a serious cut.

I sat down on the floor of the gas-station shop and pressed on the wound in an attempt to slow the bleeding. The woman behind the counter ran to the shelves, tore open a box of instant coffee, pried my fingers away while prattling in rapid-fire Spanish and dumped the contents of the box on my foot.

Image by Arie Farnam

“It’s okay,” the soft-spoken Ecuadoran photographer who doubled as interpreter consoled me. “She says it will stop the bleeding.”

The taxi driver came in and the woman seemed to be giving him firm orders. He and the photographer nodded and replied in short bursts. The photographer made to lift me up over his shoulder but I struggled to my feet, demonstrating that I could still walk.

“He’ll take you to the hospital,” the photographer explained.

“But I...” I protested.

“You should get stitches,” he insisted.

So, I got in the car. I’d had a lot of minor injuries in a pretty active, very visually impaired life, but I had never had stitches. In the US in a family with not a lot of means, emergency room visits were reserved only for the gravest emergencies. But I figured I could probably afford it here or I’d have to.

We pulled up in front of a mud-spattered wall around a tiny, run-down compound painted in dark green. The taxi driver hopped out to go see what the clinic could offer and I gingerly opened my door and tested my good foot on the ground. Only then could I see that there were piles of used toilet paper, syringes, general trash and worse scattered on the ground and drifted against the wall of the clinic. The stench was palpable and my internal alarm bells clanged violently.

I’m an herbalist today. At the time, I was no more than a dabbler with a first-aid course under my belt. But I was pretty solid on germ theory. This did not look like a place I wanted to be with an open wound.

The taxi driver came back with an invitation to enter and wait, But I laid down the law. Both of them protested. I insisted, “Take me back to my hotel! I have a medical kit there.”

Finally, they reluctantly agreed and a half an hour later I was in my room, pouring copious amounts of disinfectant on the cut and bandaging it with the gauze and surgical tape that always come in such kits, even though you don’t really expect to use them.

“Wow!” I was startled by the photographers low whistle. “You’re tough. I don’t know a lot of… “ he paused for a long time, “women who could bandage such a wound.”

I wondered what he had not said. Probably some local equivalent of “Gringos.” It’s a deserved stereotype mostly, though off-the-track travelers tend to be a bit more handy with a first-aid kit than the average.

I wasn’t in fact that worried about the initial stemming of the blood or the bandaging. The wound wasn’t actually that deep, just profuse. And while some doctors might have stitched it, I was sure it would heal fine under normal circumstances. But of course, these weren’t normal circumstances, for me at least.

I was supposed to spend the next two weeks in rugged conditions in the Amazon rain forest. Keeping a foot wound free of infection in this context would definitely challenge my tiny medical skills. I had read about the virulence of the local microbes and it was concerning.

i did manage to avoid infection through regular application of disinfectant and herbs that time. And I stand by my decision, on that occasion, to opt for self-medicating over the professionals at hand. i’m sure there are dedicated and excellent doctors in some of the most remote places on earth and I could have been lucky, if I had gone into that clinic.

But the bottom line is that intuition told me to run, in no uncertain terms. And I stand by that. Sometimes you have to make that call.

A more recent experience I had during COVID-19 lockdown shows the need to make the opposite choice at other times.

It started with an odd twinge in my right elbow. I had been working really hard physically for weeks. It’s planting season and I put in a huge garden by myself. I’m also taking care of two high-needs kids, cooking for my family all day, cleaning and getting around on foot and by bike. So, a few aches and pains are to be expected… or so I thought.

But over three days the mild pain escalated to severe pain. And then stiffness set in. I just turned forty-four and I make cracks about feeling my age, but this was out of control. I needed my other hand to bend or straighten my elbow. And I am very right-handed.

I caught it early and even the first day that it hurt I put ointments on the elbow that should soak in and fight infection. I could tell the elbow was inflamed and whether it started as a minor injury or as an infection, it clearly was infected now, under the skin.

But it wasn’t swollen and I wasn’t feverish, so there was time. And this is COVID-19 national lockdown. I now live in a country with a wonderful universal health care system, but the virus has me back to my childhood avoidance of doctor’s visits for all but dire emergencies. I wanted to avoid a trip to places where sickness is present, if at all possible.

But my ointments didn’t work. (I tried comfrey, onion and ginger poultice as well as some cayenne to sooth the pain and relax the tissue through heat.) So, I brought out my secret weapon, the oregano essential oil that I used to beat a persistent MRSA infection a few years back. Now I know how to dose it properly and I didn’t even end up with blisters this time.

But it still had only a sho0rt-term effect. My arm hurt worse and worse, day by day.

My husband had some pharmaceuticals left over from a joint infection he had had in his leg I tried some of those but also to no effect. In fact, it definitely seemed through trial and error that the diluted oregano oil was the best thing I had. It at least improved things temporarily.

Under normal circumstances, I wouldn’t have gone to the professionals at that point. No swelling. No fever. Some minor progress with a certain herb... I would have put the arm in a protective sling and babied it for a week before even testing it out and it is very likely that it would have been fine.

But another thing about COVID-19 lockdown that a lot of people might not realize is how much hard physical labor it entails for mothers. I am working physically a lot harder than I normally do and not using my right arm is just not an option. When you’re the Mama and you’re 5,000 miles from the nearest devoted grandmother or other major support, you just have to be the one giving the care. Being an invalid—as nice as it sounded—wasn’t in the cards.

So, that time I chose to call my local GP. She’s a wonderful, practical woman with a pleasant respect for my choice to mostly avoid pharmaceuticals. She also doesn’t want to physically see any more patients than necessary during quarantine. I gave her a run-down of my symptoms and she proscribed medication over the phone to reduce the inflammation and combat joint infection.

Within two days, I could use my arm again. The pharmaceuticals didn’t actually get rid of the problem entirely, but they set the infection back enough that I could nurse it slowly back to health with careful use of essential oils. So, this isn’t a story of either the superiority of herbs or the triumph of pharmaceuticals. In this case, it’s a tale of how they are often used together.

What these two incidents illustrate to me is the line that divides the situations that can and should be handled by home herbalism and first aid from those where professional medical help is needed.

There are plenty of situations where modern medicine is necessary AND herbs can also assist. The best medical professionals know this and are glad for the support. But there is still a line we need to be aware of, particularly on the herbalist side of the equation.

When writing about herbs I always include that disclaimer about how I’m not a medical professional and you should always seek out professional advice. It just seems like a good legal and practical precaution. In the US, where I am a citizen after all, suing people for the fun of it, is kind of a national sport.

But also, I don’t want some naive person to read my blog stating that lemon balm fights strep throat and refuse to go to a doctor when they have a life-threatening illness. I want my herbalist experience and my writing to be helpful and for readers to understand that I don’t know everything and can’t possibly pass judgement on a particular case over the internet.

Medicine is—even for the professionals—still a very subjective and complex science. There are a few things doctors can say with absolute certainty, but not as many as you might think. And most of the rest of us must be even less certain.

Just about everything is a case by case decision. I have dealt with life threatening injuries and illness a few times without professional support, but there was no choice in those situations, either because health care was truly far beyond the assembled financial means or because it was geographically distant. There are times when you have to just do the best you can even in a serious situation But that does not mean you should choose to do without medical help when it is an option.

Professional health care should be considered a human right. And even though some serious problems can be handled by someone with good first-aid training and solid common sense—if you’re lucky—there are instances where even a very minor injury or illness needs professional appraisal. Are you diabetic? Or do you have other chronic conditions that create risk?

The bottom line is if you’re reading my posts or otherwise working with herbs and practicing home herbalism or first aid and you don’t have a medical degree, the most important knowledge you can have is an understanding of your limitations. Arguably that also applies even if you have a medical degree, but that’s another topic.

Be aware and question your assumptions. Don’t make herbalism and avoiding pharmaceuticals a religion. Yes, there are side effects to pharmaceuticals. There are with herbs too, if not usually as problematic. Yes, there is corruption and dishonesty in pharmaceutical manufacturing and marketing. There’s a ton of it in commercial herbalism as well, and even less regulation.

Growing and processing your own herbs gives you protection against some nasty stuff and it’s a worthy practice that I love. But one of the keys to a good practice is always having your eye on the limits and the phone numbers of some good medical professionals on hand.