Wednesday, October 9, 2013

The Ommani Center – A New Model for Healthcare


Rachel Remen M.D. is a physician and mentor who inspired me 23 years ago. An article about her current work, Medicine’s Search for Meaning was recently published in The New York Times. It made me reflect on where I started as a young physician, and where I have arrived today as a physician who holds a vision of a healed health care system in my heart. I was a fledgling 3rd year resident in Internal Medicine at Stanford when I attended the talk that Rachel gave on ‘patient-centered’ medicine. I sat on the steps in the auditorium, listened to her and wept. My heart has remained open wide since that day at Stanford and I have pursued a path of LOVE and DEVOTION for my patients and it has been my hope for health care ever since.

As stories of entrepreneurs go, mine has been lined with challenges as well as immense creativity. I weaved in and out of corporate medicine after residency and left it forever in 1998 when I was told that “wellness is a conflict of interest for health care” and “preventive medicine does not generate hospital dollars”.
I suddenly realized that the business model that corporate health care serves is exclusively a financial one. The dollar is what is served, not health, healing or patient care. Physicians are merely assembly line workers who generate money for the health care systems quarterly profits. My heart continually breaks for my colleagues who work in a corporate model that serves administrators and policies, not patients.

Let me tell you something about what a doctor’s heart is like. As I talk about mine, I can assure you that many doctors entered their profession with similar stories and experiences and were seeking the grace in their work that fulfilled their passion to heal.

When I was little, I remember the first inklings of how I knew I wanted to serve in this capacity. When I was around people, I felt a deep ache in my heart. I didn't understand what this was for a long time. I knew I was always searching for why people got sick and how they could get well. I think I came into the world this way in addition to being raised around the scientific inquiry of my parents who are brilliant scientists. Because I loved science so much, I voraciously read everything I could get my hands on to help guide my understanding. Nothing was as fulfilling for my soul as seeking answers to difficult questions. I knew I had to spend every day of my life in this numinous place. Going to medical school felt like a natural extension of my passion for learning within the healing model available in our society. To be immersed in it and to be able to feel the joy that accompanied complicated problem solving was nothing short of bliss. When I was on the wards during my clinical rotations, that old familiar ache in my heart from childhood resurfaced. I now recognized it as LOVE. This strong and deep feeling, this ache, this love that I discovered I had for my patients has never stopped flowing.

I feel privileged and honored every time I am with them, ever since the first patient I ever saw. She privileged me as a medical student, to study her condition and honored me with her patience during my very green inquiry. Since that very first day, my patients have made it possible for me to explore answers with them. The closest I came to this with colleagues was with nurses during night shifts on call. I watched their dedication and devotion – a Florence Nightingale energy that held their patients in their hearts embrace. I followed them on the wards to learn how to balance intellect with love and to this day, owe my deep learning to them. They
mentored me on how to hold space and how to stay real in times that were stressful, during life and death, illness and health.

When Rachel Remen spoke of patient-centered care in her talk at Stanford, I was just getting ready to graduate from residency and enter my medical destiny track. That day, was the beginning of the rest of my career. It was as if it all came together inside of me and I received an ‘initiation’ of sorts into practicing medicine to honor the soul of my sacred vocation.

After I completed my training, I worked in corporate health care. No such feeling was present in that system. The numinous was unreachable. In fact, if my patients needed time and attention, I was penalized. I soon realized that I was now a worker on the assembly line, towing the party line and making money for administration that served the dollar, not the soul of medicine. After 7 years of experiencing this heartless model, I left it forever. Without a degree in business or any experience in running a medical practice, I took a leap of faith and designed The Ommani Center for Integrative Medicine – a place where I could practice medicine from that same sacred place that unfolded my path through medical school and residency, initiating me in this sacred vocation of science and healing.

Today, my intention for creating this Center permeates its presence. Despite my lack of confidence in running a business, I discovered that in addition to loving it, I was also a fierce advocate for patients. The Ommani Center was born as an answer to what I felt is missing in health care- my love for my patients and for being able to practice with heart and meaning without compromising the scientific method or patient safety.
The Ommani Center is a unique health care model. I created it with a mindset for sustainability, both from a financial and environmental context. The architecture was designed to give the feeling of ‘flow’. The paint used on the walls, the water and teas served, cleaning products and even the soap we use to wash hands and cotton gowns are all environmentally friendly. We recycle everything we can and are fiscally responsible in how we manage overhead and even where we refer patients for lab and diagnostic tests. I believe that we all have a responsibility to keep health care costs down. It takes extra work, time and energy for all. On my end, I pay extra to have my medical assistants enter lab and diagnostic data (into electronic medical records) performed at labs that cost my patients significantly less compared to hospital based tests. I would rather pay the $6000 – 7000 per year for staff time to save hundreds of thousands in health care costs. We must all do our part to transform health care. We cannot underestimate the power of one.

As a physician, I knew I would be sacrificing financial security to do what felt ethically correct for me. My moral compass came at a financial price. As a response to this, I shifted from a profit mindset to a sustainability one. The Ommani Center's sustainable business model has proven to be solid for more than a decade. Since 2001, it has sat gently on the earth, served patients with heart and meaning and kept its carbon footprint light.

Meanwhile, my colleagues in corporate health care, struggle to adapt to endless policies that micromanage them and restrictions that make it nearly impossible for them to practice from heart. Corporate health care is an experiment gone awry. In my least optimistic moments, I gain solace in knowing that The Ommani Center, a sacred health care model that stands in the heart of Pewaukee,Wisconsin is poised to be replicated in communities across America where patients and physicians are hungry to access sustainable, cost and therapeutically effective health care. This is my contribution to restoring the soul of medicine and for bringing meaning back into physicians’ lives who have sacrificed so much to heal others and are less than able to in the corporate system today.

When I see them working under emotionally abusive conditions in the current system, I feel an unbearable pain in my heart. I want them to know that it is now possible to practice with heart and soul and to serve patients rather than policies and administrators. The Ommani Center is like a lighthouse for health care. As it grows and expands in the near future, it will become a haven for physicians looking to restore their souls and reclaim their hearts as they follow the golden thread of their purpose for choosing their sacred craft.
I have come a long way since that threshold day on the steps of the Stanford auditorium. The vision in my heart that was ignited there continues to burn bright and is brighter each day as my beloved patients add their light to it.

Let us create the new model for health care together. Let us all remain true to its sacred purpose and mission so we can finally gain access to health and healing.

http://opinionator.blogs.nytimes.com/2013/09/18/medicines-search-for-meaning/?smid=fb-share&_r=1

Saturday, October 5, 2013

The Gift of Our Wounds


A few nights ago, I had a dream that, my children, my ex-husband and I were driving down the road in our car (when I was still married to him).  My daughter was 12, my son 9 and I felt IT. You know, that feeling when you are a family, when you feel like you belong, when you are connected organically through blood, heart and SOUL; a feeling like no other on earth.  We got out of the car and I said to my daughter, “Did you feel it?” She said, “Mom, it’s not going to last.” Then I woke up.

This dream was actually my reality.  I did feel this organic connection inside when we were a family. Every now and then, when I'd close my eyes I'd feel IT - that magical sense of belonging, of being woven together like a beautiful tapestry.  My soul radiated out to my family with a love so deep, it took my breath away.  And she was right, it didn't last.

Eight years ago in early September, on a beautiful fall day, I discovered that my family had been shattered by adultery.  When I discovered this, I fell into a deep hole that seemed like it had no bottom.  My heart imploded like a bomb went off inside and vaporized it. Its million fragments scattered into space. All that I held sacred was desecrated and in shambles.  Even Ommani was defiled. This was a dirty wound. I feared I would never heal.

Fall has always been one of my favorite seasons.  As we move inward after harvest, we tap into the depths of our inner self.  As the days get dark and our journey inward spirals into the all-knowing Yin, we gain wisdom and connection with our roots.  We prepare for hibernation, for moving closer to the heart of the Earth Mother, to gain connection and nourishment before renewal in Spring. Fall is a sacred time – a time of transition, when the veil between Heaven and Earth is thin and we can access the Spirit world more freely for guidance.

For me, that fateful day in September marked an initiation into a deeper level of Soul. I fell into an abyss where I crawled around for years, asking questions of myself whose answers I am now living out.

For me, as magical and sacred as Fall is, the transition into it is often difficult. Memories imprint the heart. In the Fall, I am reminded of the cold, sharp shards of betrayal.  They were jagged.  They pierced my heart and startled my Soul.  My heart heaved and then contracted.  I tried hard to keep it open for years for fear that it might close down forever due to this pulsing and throbbing wound.  It took courage and grief to keep it open, a grief that was sometimes hard to bear.  At times, I felt it would never heal.  To my amazement, it grew stronger. It grew ‘proud flesh’ over the portal where betrayal had entered. Sometimes I imagine it heaved deeply,  like an exhale, releasing pain and the weight of the wounder’s shadow it could no longer carry.

What I discovered is that staying open heals us even when we feel that it won’t.  The pain of staying open is more intense, but a kind of Medicine flows through an open wound like a salve for the Soul.  The heart and Soul engage more deeply through an open wound. The Soul reshapes the heart around it so it can flow through it more freely. The wound marks the Soul and changes it forever. I now feel that my wound is encircled by a ring of light. This was how my Soul chose to shine its brilliance into the world from that day forward.

Our wounds often define us in amazing ways.  For example, people with cancer or a significant illness remember the day they were diagnosed.  It changes them forever. The wounding itself initiates. The wounded enter the sacred tribe of Warrior and Mentor.  They earn their role on Earth through the pain and Medicine of  initiation and then transformation.

In a tribe in South America, when a person suffers a deep wound, people in the tribe want to be near them. They say they feel closer to God through the pain of the wounded one.  They honor and revere the gifts of wounding.  They know they are in the presence of Soul alchemy. They hold sacred space for the one in pain.

People in our culture are afraid to be around pain.  If we have an incurable wound, many people avoid us. They deflect any talk of it and remain in superficial dialogue. They want us to ‘get over it’ and to focus on ‘the positive,’ to say we are ‘fine’ or ‘better off,’ as if this tactic will somehow erase the memory of the sacred wound in our Soul.  All that our pain needs is to be witnessed, to be held and honored by another when it is unbearable. This is what helps it change shape and form, and morph into Medicine through sacred alchemy.

There is grave danger in avoiding (denying) pain.  There is also danger in medicating or suppressing it. This interrupts the alchemical union between heart and Soul.  The energy of pain is here to transform us.  When we deny or suppress it, we get sick. We must reframe it so we can learn and grow in wisdom.  We must understand its alchemical purpose.  Pain ultimately helps us love more deeply.  It makes us trustworthy.  It gives us strength.

These are the gifts of our wounds.

Fall is a time when I re-member.  When I remember the pain I also connect with its power that shaped my Soul and healed me in ways that no other wound could.  I now feel an even deeper kind of LOVE, a fierce love, from where I can offer myself out into the world.  The ring of light around my wound keeps me humble and makes me REAL.

Now I am much stronger. The ‘proud flesh’ that grew from the broken place within has power and resilience.  It has the capacity to love like never before.   It can hold the pain of others who ask me to bear witness to what feels unbearable.  Proud flesh is good Medicine for the heart and the world.

And yet, the soft, tender center of my wound remains open.  It will never heal. It is the mark of my initiation. This is now where my LOVE flows through. Like a river that changed course, empathy, truth and beauty flows through it like never before. Sometimes it still bleeds and hurts, but mostly, it feels gratitude and loves deeply enough to want to heal the pain and sorrows of the world.

And my 12 year old with infinite wisdom is now a beautiful woman who like me and my son carries ‘proud flesh, and yes, she was right, it didn't last. But my love for them is a love like no other, woven now with golden thread between the tender places in our hearts.  We know the Medicine we carry and have become the family we once lost.

For that I am forever grateful.

Thursday, October 3, 2013

The Gift of My Near Death Experience

At 14, I had a near-death experience that left me re-calibrated and deeply sensitive.  It brought a dimension into my presence that was unknown to me before.  This dimension has never left me.

What I experienced is an otherworldly feeling of love and compassion that was multidimensional and utterly penetrating.  I could never have received the intensity of this in my 3-dimensional body.  Only my disembodied self was able to take this in.

The energy I was embraced in during those moments is always with me.  It has deepened my intuition and brought a depth of knowing that continues to move me to seek.  It is other-worldly.  It accompanies me where ever I go and with whoever I am. The compassion that I felt during this disembodiment was not understandable to my 14 year old psyche.  The depth of it can only be likened to the power and love of a mother giving birth.  This is the best description I can give of what I was immersed in.

For many people who have been near-death, the experience of the world is changed from that moment on. They are able see through the chaff and illusion and connect with a REAL sense of what being here is all about.  Their inner eye opens to a degree that brings clarity of purpose and a depth of soul vision that assists them in a knowing that only an initiation like this can offer.

In some ways, it is difficult to have this sight.  In other ways, it makes soul work more intense, ever pregnant with possibility and potential. It makes it easier in many ways to not get caught up in worldly illusions and develop a right relationship with oneself so the fleeting and superficial values of the world don't hook in.

The challenge sometimes is to be able to relate to this energy with the three dimensional body and one's humanness that can limit the felt experience.  It is also challenging to put it into words and describe it with an accuracy of feeling.

I was forever changed by this.  It initiated me into a sight with my patients that is deep and utterly sacred.

One of its greatest gifts for me is the depth to which I can feel what is REAL.

At this point in my life, I cannot settle for anything less.

For this, I am forever grateful.

Wednesday, October 2, 2013

The Power of Bearing Witness

I have been seeing a patient, who I will call Ann, for 10 years.  She is a therapist who is a gentle and sensitive soul.  I can only imagine the gentle yet powerful space she is able to hold for her clients.  As she bears witness to the many facets of their lives, they have a powerful witness to their process.  They have her love, guidance, expertise and strong arms that hold them through their journeys. They are fortunate to have her in their lives.  With the space she holds they know they are not alone.

I saw Ann the other day when she needed me to bear witness to her process.  She had to hold space for a mother who had lost her daughter.  She was not sure what to say to this mother to help her pain.  It rattled her to her core.

As I sat with her and held space for her, all I could do is bear witness to her process. I told her that the most powerful gift she could give the grieving mother was her presence.  Bearing witness is a gift we can offer each other at any time.  In a world that is moving at warp speed, it is easy to forget that we matter.  Since we don’t live in communities like we once did that marked our passages and witnessed our lives, it is common to spend our milestones alone.  Once they pass, people get occupied again with their busyness and forget that we are in process.  When a person experiences a loss, the process through grief takes time.  It is important for them to be supported through its different stages.

Bearing witness is a sacred act.  It even changes the one who bears witness.  It deepens and fortifies one's soul.  It makes one trustworthy.

As a person’s grief transforms and shifts through its various stages, one gains access to the inner endurance that lives within.  The vacuum that is left in one's life is somehow filled with memories and a deeper level of wisdom.  This is an alchemical process.  The pain of loss never goes away, but it changes  form and also changes the greiver in profound ways. Without bearing witness, one could never experience the power of  Soul in process.

Many of us feel alone in our process.  This is not good for our health. We feel isolated. We may feel that our process is a burden on others.  Isolation is one of the most profound stressors on Earth.  Being witnessed, on the other hand, makes us feel like we matter.  Mattering is good for our health.  It makes our life worth living.

Mattering is a form of LOVE.

As a physician, I feel that bearing witness is the most sacred part of what I do each day.  Holding space and bearing witness to sometimes unbearable suffering deepens my heart and fortifies my soul.  It makes my patients feel that they matter, that their pain and suffering matters.  To be asked to bear witness for another is a profound honor.  Life presents us with so many ways to bear witness to each other every day. We must embrace these opportunities for loving.

Like Ann who will be changed forever by her witnessing, we must hold our strong arms around each other with open hearts. As Ann bears witness to a grieving mother, I bear witness to Ann.  Somehow, I feel that my arms are around her and this mother, all at the same time.  My heart is open to holding space for all of this.  For me it is a great honor and a blessing.

Making another feel like they matter also makes my life matter.  Isn't this ultimately what we are on Earth to experience? For me, this is one of the greatest forms of LOVE.

Sunday, September 29, 2013

Modeling Healthy Eating for our Kids


When I ask my patients to change their diets to healthier, plant based ones, many tell me that they will be met with resistance from their children.  Isn't the role of a parent to raise their children with healthy imprinting?  Ultimately, it is our role as parents to teach our children what is best for their health, to model it for them and to provide our children with nourishment at all levels.

Children do not come equipped with accurate information in these areas.  They rely on us to guide them, which we must, despite their resistance.

When I was pregnant with my daughter 23 years ago, I realized that what I ate impacted her health, not just mine.  A 'light bulb' went off in my brain that was based in common sense. I stepped onto an organic path that was based on the premise of Food as Medicine. It made a lot of sense and since then, there is a monumental amount of scientific data that supports it.  I have never swayed from this path.  As a matter of fact, I have moved more deeply onto it. I am happy to say that both my children are imprinted with the premise that Food is Medicine!

Twenty three years ago, our food supply was not as contaminated and genetically modified foods were not commonplace.  They are today, and it takes more work and consciousness to make sure our family's are safe when it comes to what we feed them. This is one of the greatest acts of LOVE that we can show.  Its benefits will last our children a lifetime.

For parents who have young children, the link below has some superb recommendations.

http://www.takepart.com/photos/kitchen-chores-kids/elementary-school-kindergarten--2nd-grade?cmpid=foodinc-fb

How to Get a Good Night's Sleep

Sleep is essential for health.  The lack of sleep stresses the adrenals and reduces vitality. It causes an acceleration of the aging process.  The three most powerful ways to promote health and slow down aging are:
1. A plant based wholesome diet rich in antioxidants
2. 6 – 8 hours of sleep per night
3. Regular aerobic exercise (at least 20 minutes 5 to 6 times per week)

Studies show that 8 hours of sleep per night are needed to produce enough melatonin and healthy neurotrasmitters to maintain health. Hormonal changes in women in midlife, particularly a reduction in progesterone can disrupt the sleep cycle. The lack of sleep has become a chronic problem of our time.  The stress of our fast paced life and constant busyness, coupled with fast food, brain stimulation with computers, texting and television, all contribute to insomnia and disturbed sleep.  The brain has a hard time shutting off and resting at the end of the day with all the over-stimulation it experiences.  The brain needs energy to function and needs a good 8 hours of sleep to replenish its circuits before another day of activity begins.  Deep breathing and meditation help immensely but most people do not take the time to do this.  Doing 10 minutes of abdominal breathing every night, or alternate nostril breathing (Pranayama), relaxes the brain enough to allow for its rest and rejeuvination.
The regular intake of alcohol, inflammatory fast foods (nutrient poor), caffeine and regular tv or computer use have an additive effect in overstimulating the brain.  I advise my patients who have difficulty sleeping when they first come to see me, to eliminate or minimize alcohol and wheat,  increase their intake of whole, plant based foods, omega -3 and exercise.  With these changes, the vast majority begin sleeping better.  Not watching television or using the computer before bed also helps as the glare from the screens has deleterious effects on brain activity before bed.

Supplements:

1. Magnesium 250 mg before bed.

2. Lavender oil pills, Lavela, which have shown similar efficacy as prescription sleep aids (available at The Ommani Center)

3. Melatonin 5mg.  No more than 5mg should be used as a sleep aid, only on an as needed basis as melatonin is a hormone.  Any hormone taken by mouth regularly will suppress the production of the body’s natural hormone production.  It has been shown to help people that work night shift as melatonin production is reduced with lack of darkness during night hours (even a night light in the bedroom at night will reduce the brains production of melatonin).  A decrease in melatonin production by the body has been correlated with increase in the incidence of cancer. The data on melatonin supplementation is mixed and this should not be taken on a long term basis as a sleep aid until conclusive evidence demonstrates its safety.

4. Valerian is an herb that is commonly used for insomnia.  The data on its effectiveness and my experience of it with my patients remains mixed.

5. Omega-3 Fish oil. Omega 3 and the amino acid tryptophan together increase serotonin in the brain.  Seratonin is a precursor to melatonin which aids in sleep.  Salmon, sardines, oily cold water fish and eggs all increase serotonin in the brain.  Make sure your omega-3 supplement is of pharmaceutical grade, mercury free, micro-distilled and supplies at least 300 mg of DHA and 300 mg of EPA per capsule.  2 to 3 capsules per day are needed for a therapeutic effect.

6. Bio-identical progesterone is extremely effective to restore sleep in midlife women whose hormones are out of balance.  This must be done with the aid of a physician skilled in hormone balancing, who also monitors blood levels of hormones to ensure safety.


Foods:

Bananas, almonds, warm milk, cherries, decaf green tea, oatmeal, salmon, cold water fish and eggs are all recommended to enhance sleep.

I always tell my patients to try eliminating the unhealthy foods and behaviors they are engaged in for a few weeks and then resume them.  See what happens.  Experimenting in this way releases the pressure that they may feel of ‘being deprived.’  Instead, they approach this experiment with curiosity and take cues from their body instead of my directive.  The majority of patients who have approached it in this way have successfully resumed a healthy sleep pattern.

Complementary Medicine:

1. Acupuncture is a very successful modality in restoring sleep patterns.

2. Massage relaxes the muscles and produces serotonin in the brain and body.

It takes time to develop an unhealthy sleep pattern so it takes some time to develop a healthy one.  Food takes time to restructure the cells and re-calibrate the good chemicals in the brain and body that promote health.

Food is Medicine.  It is not a quick fix.  It is however a lasting one.  Supplements are just that – supplements to our diet and lifestyle, not substitutes for healthy food and exercise.

Nature has everything within it we need to support our health.  If we live a balanced life from its basic principles, we can minimize disease and maximize our body’s regenerative potential.  The good news is that we always have a choice to do this.  The fun of trying healthy behaviors and see how our body responds. This is the basic premise of any scientific study.  We can do our own study and learn from our body’s wisdom at any time.

The choice is always ours.

http://www.elephantjournal.com/2013/03/5-ways-to-get-old-fast/

http://www.yogajournal.com/practice/220

http://www.tatianasadak.com/userfiles/2607091/file/LavelaBrochureFull.pdf

http://www.ncbi.nlm.nih.gov/pubmed/16162447

http://www.cbn.com/health/naturalhealth/drsears_depression.aspx

http://www.ommanicenter.com/bookstore - Becoming Real by Rose Kumar M.D.

http://www.ommanicenter.com/womens-health

Thursday, September 26, 2013

Food As Medicine - Musings from a Foodie Physician

Over the years as a physician and a foodie, I have conducted my own scientific experiments on the effects of food on health.  Of course my primary subjects in this study have been my family and my pets!
I’m happy to say that all the experiments have been a glorious success, from healing my stepson’s asthma to curing sinus infections, colds and ophthalmic migraines to healing my dog Jazmine’s Lyme arthritis to a level where she can go for walks, spar with her buddy Boosie (a 2 year old Chiweiner who is full of energy).  I am happy to say that I can see the ‘puppy look’ in her eyes again at age 13.

Having been raised by two scientists (my parents) who are also foodies and amazing cooks, I grew up in a home where the smell of roasting spices and bubbling lentils were a common Sunday afternoon sensation.  If I scraped my knee, my mom would make a turmeric poultice to heal it, if I came down with a cold, fennel and ginger tea resolved it.  A cup of over-boiling chai was ever present as an afternoon elixir after a hard day at school – luxurious tea time during hot Indian afternoons that I cherished and a memory that will forever be held in my heart.  This was my original imprint – Food is Medicine.

It still is and will be as long as we are on Earth.

One of the only places that this is not a truth is in the traditional medical system.  Here we are in 2013 with hundreds of thousands of studies on the power of food to heal almost every ailment on Earth, but Corporate Medicine in its endless quest for pharmaceutical management has lost its common sense. For some reason, it is unable to wrap its brain around the concept of – Food is Medicine.

In this blog, I want to share what I love to do most (second to being a mom to my beautiful grown children and pets and spending glorious and cherished time with my family, friends and patients) – cook, smell, create, grow, experiment and live on the wild side with food – all kinds of food – herbs, spices, soups, stews, curry’s and concoctions that will heal colds to high cholesterol and heart disease.

I will share what I've learned from my ancestral roots and all the travels where I have explored different tastes and sensory pleasures with unique foods.  I have also witnessed my patients heal hundreds of ailments over two decades with foods that I will share as we explore the beautiful and medicinal qualities of food together.