Over the last two weeks, Donna Karan welcomed a diverse group of integrative physicians and practitioners into the Well-Being Forum at her late husband's studio. Her goal was to promote dialogue. And dialogue she got when the conventional and integrative faced off, and looked for commonalities in today's lively discussion, sparked by the presence of actor Michael J. Fox, a real trouper.
Speaking to the group, Michael J. Fox shares his health journey, "I was diagnosed in 1991 with Parkinson's Disease. You sit in a doctor's office and hear these words, and you put it into a package that you deal with later.
I was trained to think when you get a diagnosis, you go to a doctor -- like you go to a mechanic -- and get fixed. But you have to incorporate the losses into your life. As I sat with them I began to realize that there are no vacuums. My serenity grows in proportion to my acceptance, and in inverse to my expectations."
Seated alongside her famous patient is Fox' doctor, Dr. Susan B. Bressman, the Chairman of the Department of Neurology at Beth Israel Medical Center. She tells the gathering, "I'm here because I love what I do. Being a physician is both a privilege and a serious responsibility."
"Sue and I look at my illness as a part of life." Fox confides, "The question is: how are we going to make that journey better?"
Moderator, Daniel J. Stone of America Speaks poses a question to the panelists, "How does a doctor transition from being a mechanic to being a whole person, treating whole people?"
"In my medical training, I was never prepared to treat the chronic diseases from which most of my patients suffer," says Dr. Frank Lipman, an internist who directs the Eleven Eleven Wellness Center. "Studying Chinese medicine taught me that a symptom isn't something to eradicate, but a message about where we need more balance. Everything in nature, from bad foods to environmental toxins to global warming, affects us -- as do our beliefs, feelings, and thoughts."
Dr. James Gordon, director of Washington, D.C.'s Center for Mind-Body Medicine, targets medical education. "Currently, it's about mastering huge quantities of data. But in ancient healing traditions, you balanced mental knowledge with practices to create wisdom and personal authenticity."
"In music, most traditions don't put notes on paper. It's passed along," says Dr. Larry Norton, Deputy Physician-in-Chief at Memorial Sloan-Kettering Cancer Center. "We value what we learn through published evidence-based medicine. But that's not the only source of knowledge we should take into account."
"The problem is really managed care," Bressman offers. "That makes it impossible for doctors to see patients and provide good care."
"The average doctor visit is seven minutes," agrees Dr. Woodson Merrell, Director of Integrative Medicine at New York's Beth Israel Medical Center. "That's why primary care physicians don't recommend that their kids become doctors."
"Back in medical school, there was icy contempt for the local doctor," Gordon recalls. "Now everyone wants the old GP (general practitioner) at the center of health care. If family care docs made as much as neurosurgeons, more people would go into it."
"Patients need to have one captain of the ship," says Bressman, "And they look to us to provide that central support."
"How can conventional practitioners be captains of the ship when they don't know and value integrative therapies?" Lipman wonders.
Bressman offers. "Your methods are great, but no drug company will fund research on them. You'll need to look to foundations and lobby the NIH (National Institute of Health.)"
"The NIH has a thirty billion dollar budget," Gordon agrees.
"We need a fundamental shift in how that's allocated -- towards preventative approaches."
"Still we don't want to throw evidence-based medicine into the toilet," Bressman says. "Physicians should look at other approaches, but first we need clinical trials. And no one is going to pay for a yoga study."
"I think we need to redefine evidence-based research," suggests Merrell. "I personally consider two thousand years of using Chinese medicine as a reasonable clinical trial, plus now there are tens of thousands of studies."
"There's a difference between a doctor and a healer," says Gordon. "A healer is open to whatever is useful, not wedded to a particular methodology. A healer is present with the patient and the process."
Bressman agrees but she, along with most conventional physicians, defines presence, compassion, caring and the non-material interventions that promote them, as examples of the placebo effect, ie. healing responses based on patient belief. Studies have shown that placebos sometimes are more impactful than the medications or treatments being studied. "As physicians, we know that medicine is an art," acknowledges Bressman. "You can also heal through hope and belief."
"I view the placebo effect as stimulating the natural healing capacity," offers Lipman. "As the Dalai Lama said, it's all about the belief of the patient and the belief of the practitioner. And I'm satisfied so long as people get better."
"Medical students and doctors have to learn to become vulnerable if we want patient and healer to have a different kind of relationship and be there for each other," says Gordon.
"Remember your original intention as healers," urges Professor Robert Thurman of Columbia University. "Realize that you're there to help people. Love and compassion are your motivation."
"I read about a lady caught in a flood who gave birth to a baby up in a tree," recalls Michael J. Fox. "That shows that you must do whatever it takes to solve your problem. If there's flooding and you're about to give birth, you have an obligation to climb that tree."
"As someone who's dealt with serious illness, what's important is what you find within yourself, and from that you can learn to make the right health care choices," says Lynn Kohlman, a close friend of Donna Karan, who is a constant presence at the forum.
"In the South African bush, you see that animals always know what plants to eat when they're sick." Lipman recalls. "We're animals too, we've just forgotten what we need."
"Yes," agrees Michael J. Fox. "An animal knows and an animal can't be talked out of it."
Through May 29th, readers interested in commenting on the FDA's new guidelines on integrative care can go to wwww.citizens.org for a link to comment.