A Pill for Libido. Really?

As an internist who sees hundreds of women in the second half of life, I am all too familiar with women’s waning libidos.  Having gone through menopause myself, I have personally experienced the power that changing hormones have on many psychological and bodily functions that the younger me took for granted.  As an integrative physician, I am always searching for causes of symptoms and for natural and integrative ways to treat and heal them.  Our society sees a waning libido as a pathological symptom.  Viewing our aging bodies as pathological is where our problem truly lies.

Our collective maturity level in America can truly be seen as ‘adolescent’.  We are a society with many compulsions.  We seek fast ways to manipulate the body, to manage symptoms, and to regain youth. We want pills as substitutes for inner work, diets for rapid weight loss, and shots to stop menstruation considered inconvenient by many.  We are addicted to an ideology that has proven not to work over the past three decades.  Somehow, we are unable to make the shift to a more mature way of thinking.  Industries that support these compulsions make a lot of money.  The money itself becomes an incentive to keep the compulsions in place.

We have promoted the ‘anti-aging’ ideology for nearly 3 decades. We have yet to find a way to turn back the clock.  We are fearful of aging because we lack respect for process, and have not created a way to mark and consecrate our life stages from a place of reverence. Our society normalizes this. Mother Nature, in all of Her wisdom, marches on in time.  It is about time we find a way to gracefully honor the rhythms of the natural order of life and learn how not to resist aging due to our adolescent fear.

A woman’s libido has many facets that influence it – hormonal, psychological, emotional, and spiritual. Hormones have powerful effects on the biological nature of sexual desire.  When we are young and fertile, our hormone surges are aligned with the zeal to procreate.  In other words, the desire for sex is aligned with Nature. This is a powerful force that underlies our libidos when we are young.  As we age our hormones change, and we are less able to procreate - and Nature is less supportive of our libidos.  Women in their mid-40s complain about their waning libido, their changing body, and mostly their newly discovered need for balance.  They feel depleted after half a life of caring for others.  Energetic depletion, alongside changing biology creates less desire for sex. There is a greater desire for more intimacy, spiritual and emotional fulfillment, and the restoration of balance in both a woman’s body and life.

By our 50’s, most of us have experienced enough pain and difficulties to last us a lifetime.  These experiences are meant to serve as catalysts for inner growth and self-discovery. In midlife we must move out of the compulsion to ‘please the world’ and into an inner place of authentic connection.  We must learn how to be true to ourselves.  For us to find meaning and not feel victimized by our past requires hard work and a desire to seek.  The process of seeking itself deepens our ability to be intimate and fulfilled. In my medical practice, I find that women, who are committed to ‘seeking’ as they age, feel more fulfilled with intimacy, rather than the sex act alone. They are able to more readily accept their changing bodies. Sexual pleasure to them feels different, in some ways more fulfilling, even though their libidos may not be as heightened as in youth. The irony is that they are the ones who feel more sexual fulfillment than those who continue on the treadmill defined by the collective, with expectations of eternal youth.

Because our society has glorified youth and the sex act in favor of aging and intimacy, as we age, society expects us to perform both physically and sexually similar to when we were young, but with limited success.  Our aging bodies have different needs: the need for a pure diet, exercise, work/life balance, attention to inner process, and - one that we have not yet normalized in our society - a search for meaning. The spiritual aspects of ourselves call to us more powerfully and with greater zeal as we age.  Our physical bodies also require more attention.  Continuing the unhealthy diet of our younger years, does not nourish our changing bodies, and many of the lifestyle choices that have gained traction do not support our emotional or physical bodies.  This level of self-awareness needs to be paramount as we age if we desire to achieve a state of true health, which should no longer be defined by a ‘hard body’ or a ‘boundless sex life’.

For men, Viagra and Cialis do not fulfill these needs.  The ability to hold an erection for a longer time is not an adequate substitute for health, meaning, or intimacy.

Our society is struggling with the choices it has collectively made.  Frankly, our collective ideology is in contrast to the laws of Nature.  In other words, it goes against the laws of Nature.  Due to the decades of traction behind our unnatural ways of life, we continue to pump out pills as substitutes for what is missing at deeper levels of our being. The woman’s libido pill Addyi will not be able to offer what women consider as sexual fulfillment – namely:  intimacy, meaning, and a renewed relationship with themselves and their partners. The risk of life-threatening side effects alone is not worth taking a libido pill.

As we age and seek deeper levels of meaning, biology (not surprisingly) follows suit.  Not necessarily with the same intensity as it did during youth, but our aging physical bodies respond to emotional and spiritual depth differently than when we were young.  The zeal to live from depth is what Nature supports as we age, in favor of the zeal to procreate as in youth.

At this time we do not need yet another pill with more side effect casualties left at the altar of our flawed ideology.  We need to reframe our collective consciousness and normalize the necessity for healthy aging as defined by physical, emotional, and spiritual health.  This is a much more powerful way for us to live and will go much further in our level of fulfillment, both sexually and spiritually, than any pill can ever offer.

Why Are We Depressed?

• An 80 year old woman who just lost her husband to cancer

• A 55 year old man who just lost his job

• A 22 year old who just broke up with his girlfriend

• A 70 year old woman whose dog just died

• A 42 year old in the midst of a divorce

• A 51 year old man 2 weeks after his heart attack

• A 45 year old woman whose hormones are out of balance

In all of these examples, grief or depression would be a normal and healthy result of these losses. Would any of these examples fit the criteria of mental illness, requiring medication, or would their grief and sadness be seen as a normal response to what they had just experienced?

A few days after 9/11/2001, many patients came to see me when they realized they did not feel the emotions others did upon witnessing the devastation surrounding the Twin Towers. They felt numb from being medicated with anti-depressants previously prescribed by their physicians for circumstantial grief and depression that surfaced years ago after experiencing similar life events as those described in the list above. Although the situation that catalyzed their feelings had long passed, they had not received any support or help to process their emotions at that time, nor was it suggested that they wean off their anti-depressants. Their response to the 9/11 devastation made them realize they had unknowingly been emotionally numb for years due to the anti-depressants they were still taking.

This was a powerful sign for me to evaluate how we diagnose and treat depression. I also became acutely aware of the surprising amount of complacency that is normalized in the medical system when prescribing pharmaceuticals for symptoms of depression, anxiety, grief, or sadness. In fact, grief and sadness have been so pathologized in our society that people feel the need for medication if they experience either emotion. For many, feeling numb is preferred over experiencing intense emotions, which are actually a normal part of being human.

Our mental and emotional well-being is intrinsically related to how isolated and alone we feel during times of loss and transition, and whether or not we are a part of a larger community. People who feel their lives do not matter, are more vulnerable to depression and anxiety. People who are emotionally sensitive are vulnerable as well. Never before in the history of the human race have people felt so alone and isolated as they do today. Our connection with one another has been contaminated with technology and the mechanization of our systems. Before cell phones and computers were the norm, we actually spoke with one another. This has been replaced with texting and emailing, a method of communication that lacks heart or emotion. We have sacrificed our emotional and energetic connections with one another for convenience. Feelings of isolation, loneliness, and grief are the consequence of these choices.

When feelings of isolation, loneliness, or sadness arise, neurotransmitter levels (that regulate our moods) fall. Some important ones are serotonin, gamma-amino-butyric acid, L-Dopa, acetylcholine, and norepinephrine. Neurotransmitter levels are also directly affected by diet and exercise, our perceptions, and attitudes. It has also been well established that one of the most effective anti-depressants is regular exercise, as it affects neurotransmitter levels that regulate our mood. These levels are also affected by a sense of belonging. In fact, several studies have shown that women with breast cancer who were part of a support group lived twice as long as women who were not.

A diet high in Omega-3 and antioxidants and low in sugar and grains supports our nervous system and neurotransmitter levels. A diet high in refined sugar, processed food products, carbohydrates, chemical additives, and food colorings has a negative effect on neurotransmitter levels. When people use addictive substances such as recreational drugs and alcohol to ‘medicate’ their feelings, these can amplify depression and cause a rollercoaster of emotions. Unfortunately, this form of self-medication is normalized and present in epidemic proportions in our society today. In fact, it is a part of how we mark ‘the coming of age’ in our society.

An additional cause for mood disturbances is hormonal shifts in midlife. Between their late thirties and fifties, women experience a drop in levels of the hormone, progesterone, which causes their neurotransmitter levels to decline, intensifying feelings, and amplifying depression and anxiety. Both diet and exercise support the nervous system, as previously mentioned and, along with natural hormone balancing, are extremely effective in healing these symptoms.

Synthetic hormones, both prescribed and those present in non-organic food have the opposite effect, causing serotonin levels to fall, making everyone more vulnerable to depression and anxiety. A lack of sleep can also have this effect on mood and emotional health. Diet, exercise, and hormone balance are highly effective and restorative for sleep disturbance as well.

Processing our emotions and supporting each other during life’s transitions and losses (in addition to a healthy lifestyle) are the most powerful antidotes for depression and anxiety. Compensating for and normalizing our mood to appear unwavering (as expected by society) results in the denial of our very human experience of joy and sorrow. Having our feelings validated can do more for our sense of well-being than any anti-depressant ever can. If we require an anti-depressant for a brief period of time to help move through a window of difficulty, it is important to process our pain and wean off it, under a physician’s guidance, once we are stable enough to do so. When dealing with organic or familial depression or anxiety, prescription medication may be an important intervention. Normalizing the need to medicate our very human feelings is both dangerous and unfulfilling.

Traditional medical thinking is still archaic in its approach to our emotional and mental health. Physicians rarely make the correlations described above or take the time to understand why their patients feel what they do. They are quick to prescribe anti-depressants, the majority of which are unnecessary. It requires discernment to bring awareness to what is a normal emotion and what requires treatment. The medical system has still not normalized the impact that lifestyle can have on mood, despite the strong evidence showing a direct correlation. We must widen the context from which we understand mental and emotional health, and practice courage in exercising our choices for self-care that support it.

In the long run, nurturing, authentic relationships, acknowledging and accepting our emotional sensitivity, and living a lifestyle that optimally supports and optimizes our biology are some of the most effective ways to heal depression, anxiety, and other mood disorders that plague our society.

Ultimately, how we love and treat each other is the most powerful medicine of all.

This article was written in memory of Robin Williams, who brought joy and laughter to so many. He compensated for his depression with his gift of comedy. In death, he awakened us to the importance of honest, self-awareness of our emotional world.

May he find peace as he returns to the Light.

Can we Change the Course of Cancer by treating our Patients with Love?

I recently had a heart expanding moment.  In that moment, I felt a deep and wide sensation of energy radiating from the center of my chest.  I would call this a “vertical moment” one that feels powerful in its quantum nature.  Its memory has lingered and inspired me to reflect on the power that love can have on the course of an illness. As a physician, it made me wonder, “what if we engaged our love when we delivered a diagnosis?  What if we offered hope rather than fear? What if we loved our patients more?  What if we engaged wonder and mystery rather than statistical predictions?”

We were at a small café in Madison, WI for Saturday breakfast.  The middle aged couple at the table next to us was leaving as we arrived.  The wife clearly had cancer.  She had a makeshift turban over her bald head and her skin looked pale and flat, like the skin of many patients undergoing chemotherapy.

I watched their interactions as she fumbled to stand up after her meal.  Her husband’s kindness was palpable.  He offered her support with his strong arms and loving words. He knew she was too weak to stand up by herself.  His voice was filled with love and resounded like a melody through my heart.   It was one of those numinous moments where my heart melted and I wanted to laugh and cry at the same time.  I was reminded of the depth of loving kindness that people are capable of showing each other.  I surmised many theories about their life during this sacred moment – “he was in it with her for the long haul; he loved her unconditionally; she had learned to receive his love and support; she was weakened by her treatment; she was working extra hard to stay positive.”

Many people going through a cancer journey share similar challenges.  Traditional medicine fails them in its chosen ignorance of process.  Loved one’s who care for family members with cancer go unnoticed and unacknowledged by many in health care, especially physicians.  A cancer diagnosis also affects a patient’s larger community.  This is their lifeline that carries the task of empowering and caregiving over the long haul.  They are presented with the monumental task of transcending the fear that is mindlessly handed to the patient during the delivery of the cancer diagnosis.  This fear is the shadow companion that consumes vital energy during the cancer journey.

Fear is the often handed to the patient alongside a diagnosis of cancer. Is the “fear” part of the hand out really necessary? Or has our society just normalized it?  Why haven’t we normalized love, hope, reclamation, possibility or even opportunity?  I feel that it is finally time to reframe our perceptions of cancer or any illness, so those affected can be seen as the shamans that they are, bearers of deep and sacred wisdom.  They have faced the possibility of death and chosen to live.  They are powerful alchemists.  We must be open to learning from them as we also honor their process.

Of all diseases, cancer is one that can suddenly call us to transform.  It can be seen as a sudden wake up call, one that contains “awful grace”. It can force us to reevaluate our perceptions of the world, what we eat, how we behave, how we express feelings, and how we practice self-care.  I would call these reevaluations, a kind of “medicine” that cancer carries in its powerful and tight grip.  This medicine must be uncovered and released in order for one to truly achieve wholeness.  The causes of cancer are often hidden and only present at unconscious and unseen levels.  Wouldn’t it be meaningful to explore these levels, to make them conscious for clarity and healing, so we can be guided into becoming larger versions of ourselves than before the cancer occurred?

One would think this could and should be the normalized approach in cancer, from the moment of diagnosis through recovery.  If we only view cancer as the monster we need to attack, how can we learn what it is here to teach us?  How can we reclaim our life from what we feel may be its many causes?  These are the nuggets of learning that carry the capacity for us all to free ourselves from its threat and restore wholeness during our journey. How can we awaken the alchemist within us and transform every atom in our cells into luminosity and light?  As we seek its elusive and often hidden “medicine”, we may even learn to live in a way that makes us “bad hosts” for it, to prevent it from resurfacing.  This is the framework that must accompany the diagnosis of cancer to offer patients the best outcome.

When fear is handed to patients in the exam room, a cascade of events occurs.  First, they dissociate to enable them to actually “take in” the diagnosis.  A part of them becomes paralyzed as their limbic system engages for survival.  This is the part of the brain that is activated for fight-or-flight.  Trauma enters the emotional body, disrupting their electrical system, creating an unsettled, chaotic feeling of shock that remains present for months and sometimes years.  Many describe this as a feeling of “static in their field”.  Patients have a hard time feeling settled and empowered.  They find it difficult to engage their imagination where they can access solutions and become seekers.  This is where they can also gain access to their inner wisdom, instinct and insight and the healing power of Sophia, the Divine Feminine, whose power and capacity lays dormant, waiting for connection.  Cancer or any disease carries the potential for activating this.  The fear handed out subverts their connection with this intrinsic power which regulates their inner pharmacy, capable of more healing we can imagine, more than even the medical system can understand.  It subverts their access to the ‘stuff of soul’ where quantum healing awaits.

The physiology of the stress response and the impact of chronic stress on the body/mind is well known throughout the scientific literature.  Its impact on the endocrine system is erosive and thwarts the regenerative power of cells.  Cell to cell communication is impaired and growth hormone in the pituitary gland is suppressed.  Insulin receptors malfunction and the adrenals wear out.  The entire delicate web of hormonal and endocrine communication is harmed.  Under stress, the tapestry of these delicately woven systems unravels and its threads begin to fray and tear.  Under stress, the very molecules of the body degenerate denying access to the luminous.  We become uncreative and unimaginative.  We lose faith in possibility and our lens of perception turns negative.  We risk feeling like ‘victims, waiting to be rescued’.

Cancer has been normalized by society as a terminal disease, one that leaves little hope for recovery.  Recovery is termed ‘survivorship’ and the adopted identity of ‘cancer survivor’ becomes a badge that defines the end of the battle.  Meanwhile, the energy of cancer alongside fear hangs in the rafters, waiting.  Fear is intricately linked with ‘survivorship’.  It lies huddled in the background, surfacing with the slightest symptom.  Fear ultimately causes chronic stress.  The immune system feels its cold claws, as they scrape even lightly upon the psyche and imagination.

Creating a new framework to support patients with cancer has the potential to change its face and its course.  The negative thought forms where fear and death are kept at bay, can be transmuted into opportunities for seeking the growth and healing this diagnosis evokes.  Such an approach has the potential to change its course and significantly improve its outcomes. I believe this is truly possible but will take an effort on all our parts to reframe what we accept.  Our greatest effort will be to embody the awareness that is required to shift the traction from fear that has been normalized that ultimately predicts and defines the course of cancer or any illness.

Medicine is at a crossroads, a gateway, where it needs to transform into a system that offers more love, and hope, and where exploration and education are honored as core values.  As a practicing physician, I have carried this framework alongside my expertise and have learned to love deeply and widely along the way. I have felt my heart expand and my wisdom grow, but most of all, I have grown to honor the sacred contract with my patients and their loved ones, who have chosen me as their companion, and walk with them through sickness into health and often into a transformed life.  For this, I am profoundly humbled and deeply grateful.

And regarding the couple in the café, in that moment of witnessing their love, my heart leapt towards them with a loving and supportive embrace as they left to continue their courageous journey through the hills and valleys ahead.   Their very presence was a gift and an inspiration to me as a physician and a person who feels deeply. Even though they may never read this article or know how deeply they touched my heart, somewhere in the tapestry of the Universe that weaves us all together, I hope they do.  I want them to know that their love, kindness, and courage was witnessed, and deepened many around them in more ways than they could have imagined.

An EPIC Degree of Soul Loss

The practice of medicine has undergone yet another change. Over the past several years, it has gone electronic. Those of you who have experienced electronically recorded medicine have had to adapt to the profound change that this brought to the physician visit. Physicians, already stressed from adapting to the corporatization of medicine, now have to adapt to data entry during their time with their patients. I, for one, resisted this as long as I was able.  I intuitively knew what this would do to the sacred essence of the physician-patient encounter.  Last year, I was forced to succumb.  I was not really given a choice. Implementing the electronic medical record (EMR) in my practice was not only extremely expensive for a primary care physician in private practice, it was extremely stressful for one who practices “patient centered” medicine. For a physician who relishes spending time with my patients, listening for clues in their stories to help them problem solve and heal, this was deeply intrusive.

When I used paper charts to record patient encounters, I was able to look at my patients, be in their presence and receive their stories while using my technical and intuitive skills. Most importantly, I could hold sacred space for every patient who I promised to help and heal.

After the electronic medical record became a part of my practice, I grieved the presence of a machine in my exam room that interfered with this connection. Surprisingly, I found myself in constant heart ache struggling through the day to try and capture the sacred essence of my beloved patient encounter. I realized the “mill” medicine had now become was a data collecting one that no longer valued humanistic listening and caring.  I had to learn how to enter patient data quickly and efficiently in order to maintain connection with my patients, so vital for their healing.

Given the level of my grief, I was curious if other physicians felt like I did. I explored internet conversations and blogs about how others felt since this implementation. One physician accounted that the stress of implementing EMR caused him to suffer a heart attack.  Could this be symbolic of his heart break from not being able to engage with his patients like he used to, combined with the stress of learning this heartless system of data entry?  It is certainly a cause for wonder.

Our current corporate system of medicine has been in crisis for nearly two decades. Patients and physicians are disillusioned by what today’s health care system has become. It is obvious that it suffers from a great degree of “soul-loss.” Rather than finding ways to fix and heal it to improve patient care, I believe the implementation of the EMR has furthered its dis-ease.

We were told that this method of documentation would make health care seamless, more collaborative and save paper and time. It has done the opposite. Different health care systems are not able to access the records of shared patients; it has created more paper waste and has taken up more physician time. Physicians who are unable to balance the EMR with patient contact opt to complete their charting after work into the late hours of the night. This compromises their work-life balance, adding to their stress and rendering them vulnerable to mental and physical illness.  We have all heard of numerous

physicians who opted to retire before their intended time when EMR was implemented. They were unwilling to compromise the art of healing for data entry.

Many patients do not realize that physicians had no say in this decision to implement EMR. They were merely required to adapt to this mandate.

As a patient, when you visit your private practitioner who is now electronically linked, please have patience. And physicians, please know you are not alone in your frustration with yet another intrusion in the exam room, our sacred sanctum. We will have to adapt in a way that preserves the sanctity of our vocation, despite the stress this has created for us.

Our precious field of medicine cannot continue to lose its soul in the many ways it already has. At some point it will have to transform and reclaim its true purpose and restore the sacred contract between physician and patient.

Till then, as physicians, we must carry the flame of healing in our hearts for our patients with continued love for our craft, and patients must carry patience in their hearts for their beloved physicians who struggle to remain connected with their heart and feelings while trying to adjust to the presence of the EMR.

Chana Dal Curry Soup

For dinner tonight, I had an organic green salad with cucumbers and carrots, Chana dal (yellow lentils) and organic Jasmine rice.
Chana Dal is a lentil from India that has a low glycemic index and tastes incredible as a curry.


Chana Dal Curry Soup



1 cup of chana dal (available at any Indian grocery store - it probably won't be organic)
3 cups of water
1 whole finely chopped onion
2 cloves garlic minced
1/2 inch ginger root, minced
2 tsp of ghee or clarified butter
1 tsp of salt
1 tsp black mustard seeds
1 tsp cumin seeds
1/2 tsp of tumeric powder
1 tsp of coriander powder
1/2 tsp of cumin powder
1/4 tsp cayenne powder
1 tablespoon curry leaves
1/4 tsp asafoetida powder
1 tablespoon powdered coconut or 1 tablespoon of coconut milk
juice of half a lemon
cilantro leaves to garnish if desired

Heat ghee in a saucepan and add mustard seeds, cumin seeds, asafoetida, curry leaves, garlic and ginger till mustard seeds begin to pop and turn gray. Then add onion and fry for 2 to 3 minutes. You may need a bit more ghee to coat this onion/spice mixture. Add washed chana lentils, the coriander, cumin and cayenne powder, salt and water and boil till soft (about 20 minutes). Add powdered coconut. Garnish with chopped cilantro leaves and a squeeze of lemon juice. Serve with rice and enjoy!

A prepared cup of this exotic and delicious lentil soup with half a cup of rice makes a filling and nourishing meal especially when accompanied with stir fried chopped kale or collards. It has great cancer fighting and antioxidant properties as well.

Asafoetida is an anti-flatulant, digestive aid and anti-inflammatory. It is used in Indian curries and settles the stomach especially if the curries are spicy. It has a smoky flavor and can overpower a dish so only a pinch fried in oil is needed to flavor a dish.

Many of these ingredients are available at your neighborhood organic grocery store or an Indian grocery store.

A DEEPER KIND OF HEALTH CARE REFORM

Many of us are disheartened by the state of health care today.  The solutions being proposed to repair and reform it are not sustainable for physicians or patients.  Every system functions from operating principles that govern and direct its mission.  In order for us to understand why health care is dysfunctional, we need to analyze and understand its business model as it relates to is mission.

Nearly two decades ago, physicians delegated the business of health care to administrators and accounting experts to manage and run it.  Unfortunately, their mission was in conflict with that of the health care system. Theirs was profit centric rather than patient centric.  They believed that patient care interfered with generation of profit.  They began to see time spent with patients as a compromise of their mission.  They began to value numbers over people. Health care’s mission became disjointed when two contrasting missions were being served. Profit became the dominating mission for health care as business managers established control over physicians and regulated and limited their time with patients for maximal revenue.

When I worked in this system, I was unable to find meaning in my work.  I was also unable to sacrifice my mission as a physician for the mission of health care administrators.  I was told that my work in their health care system was a conflict of interest to their mission.  My patients were staying well and not generating enough hospital dollars.  I left traditional health care to create my own business model.  As a physician who remains devoted to my patients I wanted to create a model that generated value for both my patients and my business creatively.   I have never sacrificed mission for profit. I run my business with good business savvy, all the while devoted to my purpose as a physician.  A health care business model risks losing its way when it becomes profit centric.  For healthcare to be successful and sustainable, mission must never be compromised for profit. Our health care system has lost its way.

We have many examples of profit driven health care in our country today and especially in southeastern Wisconsin.  These systems purport to care about health, but on closer examination, we see otherwise – they rely on sick care.  Health care is a conflict of financial interest. Currently, the highest expense in health care are administrative costs.  Many layers deep, administrators manipulate and control physicians, nurses and employees  serve their mission of profit over health or care.  This has demoralized physicians and nurses and driven away patients. Moreover,  it has increased the incidence of medical errors, placing patients and physicians at risk. 

Author and president of Business Ethics Magazine, Marjorie Kelly, defines a business model that functions with this type of focus as ‘extractive.’  Its’ purpose is merely financial – maximization of profits.  Worth is extracted from workers to generate profit by layers of administrative hierarchy.  The extractive business model is prevalent in most corporations today.  Outsourcing work to Third World countries for cheap labor to increase profit-margin is extractive.  Extractive economics are bad for our country’s economy.  It displaces domestic workers and extracts as much work as it can from the remaining workforce to serve profit margin.  Extractive economics deplete meaning from work.  Employees find themselves working merely to pay the bills for survival.  They lose pride and meaning in their work. As a result their physical and mental health suffers.  We all pay the price for extractive economics.  The state of our country’s middle class is a result of extractive economics. 

The majority of health care systems function from this extractive model.  Health care employees are currently working merely to meet quarterly projections.  For health care to operate in this manner is unethical.  Health care’s mission is to serve and heal.  When the vulnerability of patients is used to generate profit, they are deeply harmed. The ‘care’ they receive is motivated by the drive to maximize testing and treatment.  Physicians are unable to diagnose and treat cost-effectively when working for an administrative system based on extractive economics.  They must follow the rules of the game to keep their jobs.  Patients are left with super-sized bills for mere symptom management.  Administrative bonuses depend on this.

A ‘generative’ business model provides services that generate value.  Health care based on generative economics focuses on health and healing rather than maximization of profit.  The focus shifts from one of greed to one of service. Patient care is not provided at the cost of profit, and there is a balance between both without compromising either.  A health care model based on generative economics operates from the principles of sustainability.  There is a fair exchange between doctor and patient. 

What this would look like in the health care system is already visible at The Ommani Center for Integrative Medicine.  Patient care as well as sound business principles are utilized to serve patients cost effectively.  In addition, the most cost-effective diagnostics available in the community are recommended to patients.  Small businesses in the community, such as organic grocers, complementary practitioners and businesses dedicated to health and sustainability that operate from a high standard-of-care, receive support and collaboration by practitioners through patient referrals.  Education and empowerment are of foremost value and achieving optimal health at all levels is served.  All retail profits are used to subsidize business overhead to keep health care visits affordable for patients.

Practitioners work collaboratively with patients to uncover the causes of illness and empower patient responsibility.  The mission of health care is served and all profits are reinvested to support the staff and employees of the Center.  The business is also dedicated to the health of the environment and recycles to reduce its carbon footprint. 

The Ommani Center is a generative business. 

Those who administer the business of traditional health care state that a mission centric model cannot succeed financially, that a generative business model is not profitable.  Nothing could be further from the truth.  Shifting the focus of a business from profit to mission, from extractive to generative can actually draw in more revenue in service of its patients.  In addition, in a model like this, patients are truly served by physicians practicing from heart without the demoralization they currently experience within an extractive model of health care.

This is health care reform at the level of its core mission.

I believe this is one of the key solution’s to healing our broken system of health care.  This can also restore the soul of our sacred vocation.  

The Intention Behind The Ommani Center

How does one adapt to being uprooted and unearthed?  The human spirit strives to survive, to continually move towards its destiny to carve out a course that reclaims ones sense of meaning.  My mother is a person who experienced this.  At the age of 10, her parents were killed in the India-Pakistan partition, leaving her orphaned and terrified.  As life presented her with gateways, she was able to walk through some, and not others, due to the fears resulting from the acts of violence she had experienced that had been imprinted upon her.  She engaged her courage as she grew large at the wounded places and carved a course for her life that offered her meaning and purpose.  Over the history of the human race, millions like her have been left with varying levels of paralysis in our world with little emotional context. The context with which the unknown was encountered for them was through the experience of terrifying loss.
We may think that our generation is protected from this level of loss, that it is from a more distant time, but this is far from the truth. Our world has been warring for decades, leaving casualties of violence and encounters with the terrifying unknown embedded in our collective psyches.  We are living in a virtual reality.  We have learned to cover up our feeling function and learned to deny our deep emotions with creature comforts, with superficial solutions, none of which endure.  Eventually we must stand naked before ourselves, confront our gateways and step into our largeness, reclaiming what was taken from us and redirect our course consciously into the unknown.  This is what midlife expects of us.  In the areas my mother was unable to choose, due to her circumstances, I must.  Where she could not reclaim, I must.  We, the children of the last generation, now in midlife, must find the courage to engage our consciousness in the areas where we become stuck, and live  from our superficial yet familiar cultural framework and believe in the potential of our souls.  To redefine health from this context is our sacred task.  This is how REAL Health Care can be accessed.
The Ommani Center for Integrative Medicine was born from my strong intention to create a context for health that is deeper than just the physical level.  Health is more than just symptom management through integrative methods.  As important and vital as this is, it does not access true health or healing.  Being conscious of how and where one lives and relates to life from may be the more important and deeper context that determines one’s state of true health.  This can and must be evoked.
If those that killed my grandparents and irrevocably changed the course of my mother’s life had this level of consciousness and asked the important and REAL questions, needless suffering could have been averted.  We cannot go back in time and change history.  We can, however grow strong at the places where we have been wounded.  We can use our wounds to acknowledge our humanness and engage our courage to grow in consciousness and health.  We must engage our wounds in order to offer ourselves a larger context for empowerment, reclamation and ultimately for healing.  This will uncover a deeper sense of meaning in our lives.
A Health Care System that can hold this level of space from a context such as this, inclusive of modern technological advances with high-standard –of –care, is what we all deserve.  It is a place where meaning is restored.  Cultivating and supporting a system like this is sacred work.  For me, it is a vocation.  Where my vocation aligned with my mother’s biography is where I found meaning and an opportunity to create a larger context in the form of The Ommani Center where true health and meaning could be accessed that was inclusive of my love of medicine and my devotion to high quality health care.
If we want a system that cares and offers us more than what our current system offers, this needs to be our collective work.  Together, we must  support and expect health care to be REAL for us so it can  address our REAL needs and ask the REAL questions of us, questions that we can live out in our destinies from a place of health and meaning.  I encourage all of you to expect this from our Health Care System.  Our expectations of what is REAL will truly change our world for the better.

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

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.

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

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.

Vulnerability

Being vulnerable is what makes us human.

 It makes us REAL.

It is also good medicine.

This is what our patients feel.

We must also feel it so we can stay connected through our hearts.

Connection is the only REAL experience we have on EARTH.

It contains within it the most powerful force for healing -

the most powerful Medicine there is.

We must all make an effort to connect in REAL ways every day so we remain in our hearts

and in LOVE.

The world needs more of this.

Imagine our world in LOVE.



http://www.ted.com/talks/brene_brown_on_vulnerability.html

What it Feels Like to BE with My Patients

Today I was thinking about the animating force in my body, in all our bodies, in life itself.  This animating force is SOUL.

Rumi says from the moment we are born, our soul is seeking union with Source.  This is the driving force of seekers.  I feel that the closest we can connect to Source in this life is through LOVE.  Music, poetry and art are all ways that come close to feeling the energy of Soul and connection with Source.  Another way to feel it is with people we love.  When I am with my patients, I always feel it.

I began feeling this sensation in my heart early on in my career.  It felt like the bliss of union, of connection and resonance.  It brought with it joy and lightness of being within me – a numinosity.  The moments I spent and still spend with my patients are indescribable, priceless and timeless.  These moments of soulful union are blessings in my life.

It feels something like this – “we are both here in this sacred space together, connected in a ‘soul contract’ to explore and seek a path to healing and wholeness.”

I can say that there is no other feeling quite like this one.  Maybe I can venture to say that it emerges from a portal in my heart that flows from my Life’s Work.  I don’t quite have the words to express what it feels like inside of me to be with my patients. Maybe BLISS is the best descriptor. Of course bliss is borne from LOVE.  Love flows from Soul as it seeks union with Source.  Being with my patients connects me to Source.

I am sure many other physicians feel this way; at least I hope they do.

Meaning and Medicine

Rachel Remen was my first mentor who inspired my life's work to create a medical clinic prototype whose core essence is to heal and explore causal issues underneath illness. The Ommani Center for Integrative Medicine, www.ommanicenter.com, is an integrative, high standard of care model which has preserved the soul of medicine without compromising expertise or scientific method. Both are possible and work more effectively than expertise at the cost of soul that is encouraged in corporate health care today.
Thank you for writing this article. It is enlightening and inspiring and very personal for me as an internist who cares about the meaning of my work.


http://opinionator.blogs.nytimes.com/2013/09/18/medicines-search-for-meaning/?smid=fb-share&_r=0

Poetry for Dementia Patients

As a poet myself, I have been changed by the poem as it comes through my heart onto the page.  It carries its own power and magic.  I am not surprised at the healing power of poetry for dementia.  Art is medicine.


http://www.pbs.org/newshour/bb/entertainment/july-dec13/poetry_09-12.html?utm_source=facebook&utm_medium=pbsofficial&utm_campaign=newshour

The Dark Side of Healthcare

Most people don’t realize what it is like to maintain a private practice in today’s health care climate.  I applaud and honor any physician who has the courage and audacity to do so.  As a private practitioner myself, I know and love the challenges of growing and maintaining a medical practice.  I know what it takes to swim upstream and settle for a fraction of what employed physicians get paid.  The trade-off they make is a large salary with little to no freedom to work from the soul.  They work for a system that is heartless and expects them to meet quarterly projections.  Many physicians feel trapped by the organizational limitations placed upon them, but have difficulty leaving to work independently.

It would be accurate to say that private practitioners belong to a sacred tribe, one that is preserving the heart and soul of Medicine.  I have experienced being an employed physician long enough to know that the heart and soul of medicine are absent in corporate health care.  After 6 years of practicing in that setting, I left that system and have never looked back.  I remember the immense initial adjustment this took. I had to rearrange my definition of success and put meaning in the forefront.  I remember feeling the tension between the financial freedom that being an employed physician offered versus the financial stresses of being in private practice. I also remembered the tension between what the ‘system’ expected of me –patient numbers- and my longing to be able to truly connect with my patients – a sense of meaning.  I opted for the latter, sacrificing the former.  The payoff was priceless.  15 years later, I can’t imagine working any other way.  My life is simple and sustainable.  My medical practice also operates from a model of sustainability.  Most importantly, I don’t work for the medical system’s financial projections.  I work to serve my patients, the vocation of medicine and the health of my community.

Two decades ago, our medical system embodied the scientific method, valued the doctor-patient relationship and practiced from soul.  Today, money and profit is what health care is serving.  Neither health nor care is its goal.  It is a ‘sick care’ system that manages symptoms in the ‘name of health care’.  The scientific method has fallen by the wayside.  Health care today has become a ‘closed system’ where even scientific evidence of harm is sidestepped in the name of profit.  Preventive medicine is a conflict of interest for this model.  Symptom management does not involve patient education, lifestyle change, patient responsibility or healing.  It involves using prescription drugs to manage symptoms.

Today’s health care consumer is waking up to the reality of this dark side of health care.  When people experience the lack of care from their physician who practices under pressure within a corporate health care system, they look elsewhere for a doctor who can take the time to problem solve with them.  Many people want more than what the current distortion of healthcare is offering. They want to learn what made them sick, how to heal, how to stay healthy and how to live consciously.  This is what patients, the consumers of health care, deserve.

One of the biggest crises in America today is the contamination of our food supply by the food industry.  We are all discovering that the large corporations running our food industry are no different than the pharmaceutical industry.  Our food supply is contaminated with hybridized plants, chemicals, pesticides and additives. If food is medicine, eating these foods is making us sick.  The incidence of food related illnesses in our country has skyrocketed.  The medical systems answer to this is pharmaceutical management.  Today’s medical paradigm still does not see the connection between food and health.  One broken system supports another.

The solution to this seemingly insurmountable problem is already underway.  A critical mass of people is formed and demanding change.  They are simplifying their diets.  They are eliminating chemicals and processed foods from their grocery lists.  They are eating clean, organic and local foods. They are living more in harmony with nature.  They are making choices to promote health.  They are discovering that many of their diseases are diseases of lifestyle; that the body is more resilient and regenerative than they have been led to believe.

Healing and transformation require work.  As adults, we must recognize that our choices will determine the kind of world in which our children will live.  We must do the good and hard work of creating a shift in our current societal paradigm.  Society and all of its systems are currently broken.  They have gotten so far off course that the lack of soul is palpable within them.  But I and many others, who refuse to compromise health and meaning in favor of money, are changing the organizational sickness by serving what is important and real.  I encourage all of you to see through the illusion of our health care system, demand the kind of care that you rightfully deserve and do the hard work required to restore the soul of our world by making personal choices for health and healing without compromise.  It is the only solution for correcting our collective course and restoring wholeness to our personal and collective lives.

As Margaret Meade said, “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.”

We are those people.  This is our time.

The Hippocratic Oath is NOT Served by the Corporate Healthcare System

This is the oath physicians honor when they graduate from medical school.
This is the oath that I have served since I graduated 30 years ago, that I hold sacred and expect the healthcare system to also serve.
I also expect all hospital administrators to remember that this is the oath that they serve, not the policies that are based on power and greed.
Employed physicians are unable to serve patients from this oath when administrators that control them have an agenda that is not in alignment with the Hippocratic oath.

THE HIPPOCRATIC OATH (modern version)

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University

http://opinionator.blogs.nytimes.com/2013/10/02/who-will-heal-the-doctors/

The Need to Transform the Existing System of Healthcare

There is a movement underfoot in our country that is provocative and exposing. Our shadow is up and it is unraveling itself in all of our institutions. When I left the medical system at age 36, I did so because the corporate intent that I was expected to enable – sick care, felt ‘unethical’ to me. Sick care was not what I was trained to serve. It was not what my heart and soul went into medicine for. But it was required of me by the medical system to generate profit. I was required to keep people sick in order to keep my job.

Deep inside, I knew I was a problem solver. This is what I loved about Internal Medicine. I wanted to uncover the causes of symptoms and ease suffering by working with people to figure out the causes for their illness and how to tap into it to find solutions with them. If our premise is that life is full of precision, then we should be able to figure out the purpose and meaning behind our symptoms and suffering. Our suffering can also help us become real. It has an alchemical effect on our ego that strips it from being ‘all knowing’ to becoming a student of life.

I love medicine. It excites me and it stimulates my thinking at many levels. As physicians, we need to use our knowledge from a context that serves the vocation of medicine.  We also need to use it responsibly and humanistically. This is what we have lost and must regain in health care today. We must open the currently closed system of medicine while maintaining a high standard-of-care. An open system grows and evolves.  A closed system stays stagnant and is based in fear.  Today’s health care system uses fear to keep patients coming.  Its revenue depends on this.

An open system will of medicine is cost effective and patient centered. Its context examines what is wrong but also “what is right about what is wrong”. When we explore symptoms and illness from this framework, we can heal our patients at causal levels. We can use the pathological model within the larger context of a healing model, seeing pathology as a symptom rather than an end.

This context is transforming medicine and evoking health at The Ommani Center for Integrative Medicine. This is a prototype of an ‘open system’.  This was a way I could make medicine REAL and restore and reclaim its SOUL. Becoming Real is the calling of our time. This is our collective path. This can transform our medical system and restore it to what it was originally intended to be.  This will involve physicians who are open to working from this context and patients who expect it.

Midlife as Alchemy

What is Midlife? What is Menopause? What is at stake?
What is our Conditioned-Self?  What is our Authentic-Self? How do they differ?
In my 22 year history as a physician who has worked with thousands of brave and courageous men and women with stories of wounding, suffering and healing, I can say that I have been able to identify the differences between these selves and the intrinsic power that emerges when one leaves the Conditioned for the Authentic Self.  The Conditioned-self is who you were told you SHOULD BE. The Authentic-Self is WHO YOU ARE.   For the first half of our lives, the Authentic-Self is buried beneath the Conditioned.  In the second half, we must re-emerge Authentic.
There is a powerful shift that occurs in midlife when our physiology and soul intersect at this gateway to make room for the REAL to emerge.  This creates a felt space between the Conditioned and Authentic selves.  The traction of the conditioned one pulls at us, urging us to behave from familiarity based in FEAR.  All the ‘shoulds’ fear us into staying stuck.  Fear is the feeling that adapts us in the first half of our lives.  We adapt to be accepted.  Adaptation conditions us. It creates a shell around our Authentic –self that waits patiently for us to awaken.  We learn to withhold our truth; we say ‘yes’ when we want to say ‘NO’. We over-ride our true feelings to be accepted and loved.  For decades we live this way.  We construct our lives from choices that emerge through our conditioning.  We become part of society’s ‘herd’.   We normalize this identity and close our eyes.
When we turn 40, something changes.  A soft whisper fleets through our body and mind, suddenly with no warning.  Sometimes we don’t really hear it, sometimes we try not to.  It beckons us to awaken, to bring LIGHT to our choices.  It says, ‘Who are you really?’  This frightens us.  If we don’t listen, it moves in deeper, rises stronger – as fire, as density -anxiety, depression –in our bellies, pulling us in.  We begin to sweat, to hot-flash; we awaken at 3 am with minds racing and fear coursing in this unknown place.  In the middle of the dark rises a whisper of comfort, the voice of our Soul pulling us in – to connect, to open, to awaken and deliver us finally to our Voice and our Truth.
If we do not listen, it may call to us as cancer, divorce, tragedy, devastation, that forces us inward to evaluate, deconstruct and  make ourselves new.
All this sorting and sifting, transforming and reinventing – THIS is midlife.
This is menopause.
This is not a sickness or a  deficiency. This is NOT a pathology.
This can NOT be medicated away.
This is HERE to stay and it will offer us the fire of alchemy into which we must step to make ourselves WHOLE.
The voice of the Authentic-Self will rise from ashes of the conditioned one as adaptations fall into the fire to be transformed.  If we willingly lean into this, our voice will emerge – FINALLY- the TRUE voice we will use to heal the world.
We will spread our wings and fly out from this fire into life again with wisdom and an inner eye that can never be closed.