Lissa Rankin: Mind Over Medicine



everybody Jonathan fields from Good Life project so I'm really excited today my guest is listen Rankin Alissa has a pretty incredible personal story of transformation and also career evolution that's taken her through the medical profession and we're going to dive into exactly what that has been so let's just wait to be hanging out with ya we've known each other for a little while now and in the short window the couple of years that we've actually known each other is pretty astonishing change and almost everything that you're doing in the world but take me back a little bit about you were traditionally trained physician bring me back in time about how you were earning your living and what your path was expected to be well I was I was raised in hospitals my dad was a doctor you know it was called to medicine at the age of seven so that you think like you do the normal thing right you go to med school you get a residency I would train you're called to medicine at the age of seven I was you want to hear the story yeah okay so my parents were cleaning the chimney in her house and the chimney sweep found a little nest of baby squirrels they were so tiny they had no fur eyes were fused and my mom told me the whole story like you know the mom has probably left they've been abandoned they're probably going to die you know it's really nothing we can do we just let nature take its course and I was like uh uh had a none of that so we took the nest and I made them take me to the veterinarian and the veterinarian taught me how to use a little eyedropper with s black and dogs milk and like hand feed these little you know three-inch baby squirrels and keep them in an incubator and I had to like set my alarm at night every two hours to feed them and they had to make special arrangements at school because I had to bring the squirrels to school in a handbag with polyester fiberfill and you know have something to heat the milk and so everybody was on board for like Lissa and her project and every single one of them will end up dying Oh which is heartbreaking but and I've sort of got a reputation in the neighborhood as the girl that you know if anything happens to a baby squirrel you bring it to listen I was I was living in Florida at the time so a lot of baby squirrels that got injured or abandoned or whatever so by the time I was 22 I had raised 21 baby squirrels and had been written up in the paper multiple times as the squirrel girl oh that's amazing yeah so I'm Joe Witt so why not veterinary school because I knew all along that I wanted to do that for people but that I wasn't allowed to do that for people until I had been trained I mean I my dad was a physician so I I sort of veterinary medicine wasn't really on my mind plus I'm super allergic to cats so that's kind of problem that would be magic yeah exactly but that sense of being a healer was really ingrained in me early hmm so then the expression of it it seems was you know like okay I need to go heal people right so that's you know like I said at seven I was like okay I'm going to practice on animals until I'm old enough to practice on people so I scrubbed in on my first surgery when I was about 12 so it was an early thing I was you know a candy striper in the hospital and then I went to medical school became an ob/gyn at Northwestern and then thought well this is what you do right I was 30 when I finished I was 32 by the time I was a full partner in a practice but it became very evident to me very quickly that something about the way modern medicine has practice was out of alignment with what it meant to me to be a healer like I had learned from these squirrels what it takes you know it takes a love it takes time it takes nurturing care it takes learning what what the needs are and meeting those needs and I was being taught really to be a body technician you know and it was becoming increasingly reductionist like nobody was really looking at the whole picture and I don't even mean like the whole picture of the body I mean like the whole picture of life you know I mean where does that come from where does where does that approach to medicine come from I mean that's because I'm assuming that's is it the United States saying is it a global approach to medicine is it well it's really I think it's really very very modern like it's very new that reductionist approach to medicine I think I think it came along with the technological advances that really revolutionized medicine you know along with that we we had the best trauma care in the world you know we have antibiotics people don't die of pneumonia anymore hardly ever and yet somehow in that development of kind of gene technology and the ability to save premature infants and some of these great advances we became so sub specialized and so focused that we sort of forgot what it was the doctors used to do which was to go sit at the bedside and be with the family and assess the situation like what's going on maybe what's the root cause of this person's illness and it became impossible to even think that way when I started my medical practice I was my first day of work I was totally booked scheduled with 25 patients a day and by the time I left eight years into my practice I had 40 patients a day so I was double-booked in 15 minutes Lots which means essentially you have seven and a half minutes Wow so somebody comes in is that pretty normal for the medical tradition you know it depends on your specialty because I was doing a lot of prenatal care you know you they just booked the prenatal visits back to back to back and then in between you'll get a new patient or surgical consult that sort of thing so I think some of the primary care specialties have a little bit more time but in general if you if you ask around the average healthcare visit is about 12 minutes now Wow which is just not enough it's just like you can't even begin to ask an open-ended question like if you're my patient of course I'm a gynecologist so I don't do men but if you are my patient you know Jonathan tell me what's going on in your life right that's going to take 12 minutes right there just to even listen if I'm going to be present and and let you answer that question or what does your body need in order to heal so we're taught to ask those kinds of open-ended questions in medical school but when you're training you know we had like what I called be nice to patients class where they'd hire these actors to come in and you know listen to us give us feedback tell us whether or not they felt like we're being nice to them but we were given time during medical school to practice and then in the reality when you got out there you weren't given time so I started increasingly feeling like at the end of the day I had so much more to give than I was able to give that I started feeling like I was selling out my own integrity and this was increasingly happening so I started asking if I could see fewer patients like can I make less money and see fewer patients and have more time so we're in a larger practice with par I was in a group practice yeah with five other Pro other partners and our practice just wasn't set up to have any flexibility around that I really didn't have any power over that and I'd been asking to work part time because I'm also professional artists sorry at the time I had eight galleries representing my art so I'm trying to manage this full-time medical practice in this full-time art business and then things just weren't going well it was clear to me that something was going to have to change but I was scared I was scared to change anything you know so before we go they're also professional artists and full-time OBGYN how you know I'd always I'd always had that right left brain thing going on like when I was a Duke for undergrad I was pre-med so I was taking all my you know organic chemistry classes and whatever but I was an English major so I was majoring in writing and then and that worked well because you know I was able to like I hated my science classes sort of a means to an end it was how to become a healer right you got to jump through these hoops and I loved my writing classes but then when I went to medical school it was like 24/7 science you know I was in class from 8 a.m. to 6 p.m. every day just doing science classes so I signed up for art school at night everybody thought it was crazy like what your medical student you're going to go to art school do it so I was taking art classes at night and then every free minute I had which was hardly ever you know I was painting so I did that all through medical school and residency and then in 2001 I had my first art show which was at my medical office at the time so I sold out my first art show at my medical office and then I started working with galleries so I was you know I was doing this full-time medical practice and I'd come home and I'd paint until 11 o'clock at night so so what I mean it's all right most people say okay practice medicine alone is pretty all-consuming yeah a lot of artists who said that you know trying to actually build a career as an artist is pretty to me do you have a life at all outside of this addition to that family kids friends like your own body or like I kind of didn't I mean I I was married I'm twice divorced at this point so I'm not sure how well that was going but I was working a lot I mean I was I was really prioritizing medicine and art and an art felt necessary at the time it was I told people that medicine was my hemorrhage and art was my transfusion like I like I had to paint I had this like deep drive and it really was my meditation you know I realized that now at the time I it looked like ambition but in retrospect I realized that that was my healing like I was medicine was killing me and art was saving me so it wasn't it was really necessary for me at the time but no I didn't have any life balance I wasn't exercising regularly I wasn't taking good care of myself by this point by the time I was 33 I was on seven medications for a whole host of chronic illnesses I'd been diagnosed when I was 27 with high blood pressure that wasn't responding to three medications I was having heart palpitations I had severe allergies that I was on three medications for that weren't working it was you know one thing after the other the artist and the healer is in trouble it was in serious trouble yeah so tell me how this was what happens so then my perfect storm hit you know because of course I wasn't listening to the whispers of my body I wasn't listening to the signs from the universe and so I got flecked with a two-by-four and I was married to my third husband and pregnant with my daughter when my dad was diagnosed with a brain tumor that turned out to be metastatic melanoma and he was basically given three months to live so that in and of itself was like total life reframe like wow what if I found out I had three months to live here's my physician father he's only 60 you know and we I was living for retirement you know I was living for the day that I was 65 and I could finally stop practicing so I could start having life and I'd been talking for years about what normal people do you know like normal people take weekends off and normal people go to the gym and how I've been sort of craving what normal people do and and so I wound up kind of really looking at my life at that point and asking myself if I knew I had only three months to live would I still be doing what I'm doing and the answer was such a resounding like hell no so my dad I ended up giving birth to my daughter and then my 16 year old dog died and then my healthy young brother who had come out to be with my dad who would had come out to be with me because I had just had a c-section wound up in full-blown liver failure is the rare side effect of the antibiotics the through max that he was taking for a sinus infection and then my dad died and this all happened in two weeks so literally like we're trying to bury my dog my brothers in the ICU my father's and Hospice in this beach house that he rented so he could die with me because I couldn't travel because I had a newborn and a scar on my belly and it was just mass chaos I was just starting to like get back on my feet about eight months later and my husband who's this was the stay home dad for our newborn cut two fingers off his left hand where the table saw and couldn't take care of my daughter it was like all hell broke loose so I am you know at that point I was sort of looking back at all of my health issues and all of the things that were going on in my life and and I realized that you know when when your life falls apart you can either grow or you can grow a tumor you know and I just decided that it was time to grow so one thing led to another and it started this journey that's now then my daughter's will be 7 in January so almost seven years that that began with me quitting my job which was a massive risk my husband had never worked since I met him he was um you know unemployed and kind of managing my art business and doing his own art and writing a book and so we didn't have any financial support coming in from him and you know I had two mortgages and the boat and the fancy cars and the doctor lifestyle and a newborn so it was at plus I had to pay 120 thousand dollars for the privilege of quitting my job to pay for my medical malpractice tail to protect myself from all those lawyers out there you know so it was it was a huge decision super scary but it was it was you know it was one of those leaps of faith that you take because you can't not take it you know people ask me now like how do you know if it's time to take a leap of faith and I tell them when the pain of staying put exceeds the fear of the unknown it's time to time to leap you don't have a choice at that point and I really felt like I didn't have a choice talk to me about the conversation that goes on between you and your life partner come around this decision because it's big it was huge I mean there's so many people that would like fantasize about doing that right being granted maybe not for the same reasons and not without going through the same crucible but when you have other people in your life especially when you're largely the breadwinner family yeah this is a big conversation oh yeah it was it was a massive decision and bless his heart Matt was so incredibly supportive I had been asking him for years I'd come home from work and I'd say when can I quit my job and he'd say whenever you want when I come home the next day when can I quit my job and one day I came home it was something happened at work that was really the the ultimate like I can't do this anymore my integrity is in serious risk this is something you can share something that's well I by this point well essentially by that point I was being asked to prematurely deliver a twin pregnancy by c-section for no good reason and this had been put on my surgical schedule and I was you know when I looked at the chart I was like wait a minute why are we prematurely delivering this woman and the ICU was breathing down my neck like the pediatric ICU like why is this on the schedule and like I'd and I didn't put it on the schedule so I went to my I went to the person who had scheduled it and said why is this on my schedule and she was like don't ask questions just do as you're told and I was like I'm not doing this I'm canceling this surgery and she's like you cancel this surgery you're out I was like great amount so it was like ultimately at the end it was like I cannot stay so it's sort of I've been on the fence because you know was a good enough job I was making a difference in people's lives and the money was great you know it was meaningful work I enjoyed the people that I was working with but in the end it was just I had to choose you know I had to choose whether to fall in my heart and I remember right before that just a few days before that I had been up all night like doing a 72-hour call shift and I was I had just finished at the hospital and I was at the grocery store and I'm trying to buy my breakfast so that I can you know get home and finally go to sleep and the only thing between my bed and and you know where I was in the grocery store was this pimply teenage kid who's trying to swipe my yogurt and he couldn't figure it out and I remember this I'll never forget this I just looked him right in the eye and I said if I did my job the way you did your job there'd be dead people everywhere Oh God and I was like holy I've become that asshole like I've become that doctor you know I'd been trained by those doctors and I remember back when I was in residency I was a third-year resident there was one night where I had to deliver four dead babies in one night and it was the hardest night that I can remember from my medical years where I was still I would deliver a dead baby and I would hand this dead baby to the mom and crawl into bed with her and the two of us would sob together and like hold this baby and then I'd have to go that my pager would go off and I have to go like put on my happy face and deliver a live baby and go deliver the next death baby and it was just a heartbreaking night and by the end of the night after the fourth dead baby I was running down the hallway and I'm sobbing and my teacher my male teacher is running after me screaming Baca Rankin you got to get a thicker skin I ran into the women's locker room like fell on the floor of the locker room and I'm just crumpled on the floor sobbing and these two midwives came running in after me and my teacher by this point is like banging on the door like open the door get out here you've got a job to do and the two midwives are like cradling me on the ground and they're rocking me and I'm crying and one and said don't ever let them break you and I remember when I said that to that poor kid I was like oh they're about to break me and I can't do that you know I can't be that person so I didn't nearly answer your question what did my husband say you know I don't like ya just but I mean I mean powerful very confident for the story though yeah so he knew that like he knew I was becoming that person he could see it you know he'd been with me long enough at that point was that having an impact on your relationship you know he literally went like when I was on call we had a vacation home that was a couple hours away he would go to the vacation home because it was too hard to even be with me I was so unhappy when I was so tired and I remember just getting so depleted that you know I was giving and giving and giving to my patients but I was exhausted I was sick I you know and this is what you're trained to do as a doctor you're supposed to give until you're depleted and that's what makes you a noble doctor you know like in surgical specialties and surgical residences they say you know the worst thing about being on call every other night is you missed half the cases you know and you're supposed to have that mentality like you're supposed to be bummed that you had to go home and sleep and you missed half the cases so there's that there's that kind of a lot of machismo in this yeah there is and it's this there's a lot of ego in it and there's a lot of this the priority is learning as much as you can being as good as you can and serving as much as you can like never leaving your patients alone so the notion of self-care is just completely absent I mean I remember when I was a resident and one day I was so sick I couldn't hardly get out of bed but you can't call in sick when you're resident like you're supposed to be there at 4:00 in the morning and so I figured well I'll go in sick and I look so bad they're surely going to send me home so I go in and I do my rounds and I'm like on death's door and I'm puking my guts out and having diarrhea and I'm running to the bathroom every time and so then it's time to scrub into surgery and I'm thinking there's no way they're going to make me scrub in the surgery but they were like no problem they took me to the recovery room hooked me up to an IV put a liter of fluids and me pump me up with phenergan and put it depends on me so in case I had diarrhea and I scrubbed in the surgery so I then pass out in surgery like dropped the instruments in the patient's belly and pass out in surgery and they put me on a gurney and they take me back to the recovery room and they give me more drugs and then I'm supposed to scrap back in and I remember thinking like this is madness like this is madness and yet it's like if you ask any particularly any surgical specialty if you ask any doctor everyone of us has a story like that or ten so that notion of like caring for yourself is was just I was never taught that plus I was raised and like a family of givers like my family is full of doctors and missionaries so I mean which is so interesting in that you know if we know that you know one of the big things that we'll talk about this more but sort of like in modern well care is you know focus more on preventive and self-care because that will eliminate a lot of the need for you know like the time where you actually need the care but faculty if the very people that are supposed to be disseminating the message or the farthest ones from actually embodying it yeah there's a major disconnect our dad I was at a workshop with a group of Kaiser doctors and just even just looking around like there so they feel so hopeless at this point so the health care system is so broken and doctors have been indoctrinated into this for so long and they've it's been so I mean it's just ingrained in who we are that we give until we're depleted and that makes us Noble and I had to do a ton of work around this to get over this because that was my that was my mantra like I give until I'm depleted and that makes me a good person that's my value in the world and so when I ended up leaving medicine and getting into a different type of business I was way over giving in my online business and it was depleting me and I was getting pissed off and resentful and I remember feeling that way about my patients like standing outside of the door when I was about to go do a delivery and having to give myself a pep talk like don't be mad at this woman that she got you up in the middle of the night like this is the most important day of her life like show up be present like be the cheerleader because I was I'd get pissed I get pissed that I had to give up my needs and it just becomes your pattern no matter what you do yeah yeah exactly so it's really it's you know it's really a shocking state of affairs how things are and I was so depleted by that point and then you know by the time I'd made it through my perfect storm like I had nothing left but so um so where do you go from there after the perfect storm so I wound up you know this was the first time where I really started listening to like this little voice that I now call my inner pilot light and the little voice started telling me stuff and the first thing was you got to get out of the city so I was living in San Diego and you know you could pass eggs to your neighbor over the balcony and you wait in line behind 30 people to get your bagel and it's hard to park and you know LA it started expanded when I I grew up in San Diego but it was a small little Navy town then and it become you know SoCal so I wound up moving to the Monterey Peninsula the unincorporated County of Monterey and this big piece of land renting a house there and when we moved there and my plan was I'm just going to be a full-time artist and writer I had no idea how that was going to work or and this was right when the economy was crashing so I had been making good money with my art and all of a sudden like that completely dried up and so I started writing a book that never got published it's called it was called I don't do men confessions of an OBGYN and I wound up getting an agent who called it Eat Pray vagina so and I now call that time I spent two years in that house with my newborn and my husband and I pretty much didn't see anybody else for two years like I pretty much didn't leave the house except to go hiking or just did yoga and got in the hot tub and cried a lot and it was just a weird time I'd spent most of my time writing and painting and I now call it my waiting and becoming years because I felt really disconnected from my calling the one that that called me at seven I wanted have nothing to do with my at that point but I started I went and took a workshop a Tesla and Big Sur which is close to where I was living it was a writing workshop and at the end on the last day the women in the in the group were all sitting around and they had heard a rumor oh she's the doctor she used to be an OBGYN and so they wanted to ask me questions so we sat around in the circle and these women all started asking me medical questions and I just got that glimmer of like oh there's something here that I've been missing it had been nine months and it was sort of ironic that it had been nine months that I hadn't gestating something and there was something in that I didn't know what it was that was you know I'm now working a lot with Martha back and she talks a lot about finding your calling she talks about finding the hot track so that was a hot track back of okay there was something in that of being in community with women of talking about medicine but in a different way of not being constrained by the seven and a half minutes and the women we were talking as a group and then they started individually saying can I talk to you privately for a minute so I wound up going into the corner it was like I was Lucy that you know the doctors in five cents and and i sat there and i was just talking one on one with these people and there was no time limit and it was really awesome I was like that felt good that and I hadn't been doing that I hadn't seen a patient or really even seen anybody else in nine months so I started getting a sense like I want to do something that gets to integrate all these facets of who I am and all of my gifts and brings together my art my medical background and my experience working with women and one thing led to another and I wound up not getting a publisher for my book after a year of lots of editors loving it and lots of editors taking it to pub boards because the writing was good and every marketing department saying who is she we've never heard of here she doesn't have a platform you know so it got shut down time after time so my agent finally was like girlfriend you got to start a blog I was like blog what's a blog like I barely checked email and I you know like it's not enough that I'm a doctor artist writer now I've got to be a blogger but I did as I was told we had this painful release ceremony of like throwing the manuscript into the ocean like letting it go like okay bye-bye book but I never gave up on that hope that I would be a professional writer so I started blogging and three months after I started blogging an editor approached my agent one of the ones who had liked that first book and said I have a book idea I want your client to write it and it was funny because it's thinking back it's not a book I would have written on my own because it wasn't like the direction that I was the hot tracks I was following were following me away from gynecology because again that felt too reductionist it was that like I was much more interested when my patients were coming to me because they had PMS I was much more interested in what else is going on in their life that's resulting in this PMS you know or if their they were having sexual dysfunction like why are they having sexual dysfunctions not just about what's going on in their pelvis so but I ended up writing a book and so my first two books my first book was about painting with beeswax because that was the medium that I was working with in caustic and my second book was called what's up down there questions you'd only ask your gynecologist if she was your best friend and it was that was that was fun to write but again not it was a little a little bit of a sidetrack so where I ultimately wound up going I mean while you're building this blog in the background so in the meantime I started blogging at owning pink calm was my blog and it started out as just me and within three months I had 30 guest bloggers and I really my intention from the beginning was I was going to blog about everything I was going to blog about health and relationships and sexuality and creativity and spirituality and the environment and I had consulted a business coach and she was like you can't do that you got a pick like you got to pick your knee char you going to be about business are you going to be about health I was like no I'm going to be about me and my commitment you know sort of what I said to my online community when I started this was I lost my mojo I'm going to get it back I'm going to invite you to come along with me and if you've lost your mojo like come and get yours back with me and we're going to do it by being unapologetically who we are just forget what everybody else thinks be authentic let your freak flag fly and you know and assess all these different facets of your life like what's missing from your life what's joyful in your life like where do you need to put more attention where do you need to you know what what might you need to change in your life and and so it started that way and it it it very quickly got a lot of traffic and within three months I had a you know Twitter following and Facebook following and a blog following and and all of the sudden the publishers were all interested in me I was like wow what an interesting what an interesting business it had nothing to do with whether or not it was good writer you know yeah I mean which is speaks to a whole evolution in the publishing yeah these days yeah so from there now your honor you're in a different place you're speaking to women about a wide variety of things you've got this platform there is some sort of financial viability to it and I want to find out where you go from there but well there wasn't there was no financial viability to it but you have this this asset now that's going people to come to you yeah but there's a lingering question which is that those two years where you weren't working your husband's not working hmm and you got a kid mm-hmm are you sure how did I how did I survive I liquidated my entire retirement account so you know I had been when I was working for those eight years I was putting the maximum amount of money that I could in my retirement account every year and I borrowed $50,000 from my mother bless her heart so literally we were living off of savings borrowed money and then credit cards so it was a huge financial risk and again the whole time like the recruiters were going nuts like come back we'll pay you half a million dollars to move to Indiana you know like come be a doctor in this underserved community and they would come and I finally had to just like block all the recruiters because my husband was like that sounds like a good opportunity like let's go try that you know and yet there was that that voice again was telling me you can't do it like you're not going back to the hospital there's something else there's something next and I didn't know what it was but my mantra during that time was you're on the right path even though you don't know where you're going so that's how I funded that and and then I got in the situation where I was running owning pink comm I had employees by that and I was costing me and overhead about $5,000 a month to fund this and for two years it wasn't a business I was I mistakenly thought that it was worth investing in in that platform so that I could be a writer and then I'd get make lots of money writing books oh and and that didn't happen so you know I write my books and it's like then you get this post publishing depression of like wow I just spent more money hiring publicists and going on a book tour and you know getting the word out then I actually made on my book advance and it's not a New York Times bestseller and oh no now what so I don't know what well then enter our mutual friend Chris kilvo right Chris comes up to me because we run a book tour at the same time and he's like what are you doing you've got this huge online platform and you're not making any money and then Danielle Laporte or other mutual friend was like what are you doing you know you're sitting on a goldmine you've got a got to invite your community to actually pay you something so the two of them were awesome because they both were sort of kicking my ass and and giving me some guidance on how to turn this asset I really wasn't even thinking of it as an asset but how to turn this asset into a business so I wound up launching my first online course eCourse and then that led to I started doing one-on-one sessions I started sort of hiring myself out as a you call it what pick your brain or you were doing that so I started doing essentially coaching and then that led to you know another book deal with Hay House where I started working on the book that I'm that my next book which is mind over medicine scientific proof you can heal yourself and there's a whole story about how I went from what's up down there to that one and which I think I need to know well well it was there was there came a dark point oh I missed a piece of the story which was when I was in Monterey I kept feeling like I was supposed to go back to medicine but I just couldn't figure out I knew it wasn't I knew it wasn't going back to the hospital but I kept feeling like there was this more holistic way to practice and the hot track on that was I kept hearing people talk about this integrative medicine thing and I thought okay that sounds good integrative I like that word so I started investigating integrative medicine I looked into dr. Andrew Weil has an integrative medicine fellowship at the University of Arizona and I had several m.d. friends that had done that so I looked into that thought about applying for that and then I thought well maybe I'll start an integrative medicine practice in Monterey and I'll you know I'll bring together all these different practitioners and kind of combine medicine and coaching and these sorts of things and all the doors were shutting like every Avenue I was kind of going down was shutting but then I got offered a job in Mill Valley up in the Bay Area at an integrative medicine practice and the woman who ran the practice was so generous she when she interviewed me she said I want you to imagine your dream practice and then let's see if we can help you build it here and she was offering me the opportunity to come in and have a cash pay business where basically I get an hour with my patients they pay me cash it's outside of the insurance system so by going out to outside of the insurance system you can do that when you're when you're a you know preferred provider for an insurance company you can't bill for time you you can only build for the icd-9 codes they call it so this this felt great the idea of like wow I can have an hour with my patients so I started working at this integrative medicine practice in Mill Valley which Marin County for those of you who don't know Marin County it's like the pinnacle of health right like people there really care about their health it's it's um you know almost all of my patients we're drinking their green juice they're vegans they're working out with personal trainers they're sleeping eight hours a night they're taking 20 southern words if you're not doing this totally like that's really normalized in Marin and I wasn't used to that because I was I had just moved to Marin for this job stars like wow these people are like the proverbial choir and what was so interesting to me was they were just as sick as my inner-city Chicago patients that I've been working with it wasn't like I was like what is going on here like we're missing something if these people are this sick like I thought this is how you get healthy right you eat well you exercise you take your vitamins you see your doctor for Giller checkups and and it wasn't working and many of these people by this point had seen the doctors at Stanford the doctors at UCSF they've gone to well you know the cash pay integrative medicine doctors the acupuncturist the Chinese medicine doctor the herbalist like they had done everything nothing was working so I started asking my patients it was really interesting so when I first started working there I would come home and I'd tell Matt I'm like I'm doing something wrong because every one of my patients starts to cry ok and I would ask them things like you know what's missing from your life or the big one was what does your body need in order to heal I started asking people that question I was thinking they'd give me treatment intuitions you know like oh I think I'll skip the antidepressant maybe try the 5htp you know but that's not what they were saying they'd say things like I need to leave my husband you know I need to quit my job I need to put my son in rehab I need to finally go to art school and what's amazing I mean because the first question that came to me was well so many people are so tuned out to their needs that make maybe they can't but what you're saying is actually people are insanely tuned into them but maybe just nobody's asking them or right away yeah which is interesting because it surprises me actually but I guess as soon as you said like to have somebody who creates the space to ask the question right it's almost like it's just below the surface right it was amazing to me and then of course the next thing they'd say is well but I can't do that yeah I can't leave my husband he pays the bills I can't leave my job you know that's that's my security you know I can't go to art school that's impractical right even if I'm dying so I'd say well then are you are you fine with staying sick are you cool with that you're making a trade-off here you've just told me what your body needs in order to heal and now you're telling me you're not willing to do it is that cool with you and then they get mad so it started I started getting increasingly frustrated with the integrative medicine world as well so in many ways it was so much better because we had time with our patients like the doctors I was working with were so kind like they were so nice to their patients it was a million times better than the job that I had been for but I kept feeling like it was still too small like we were we were doing a much better job of not being so reductionist when it came to body parts it wasn't just I'm going to look at your vagina or I'm going to look at your lungs it was I'm going to look at your lungs and how they interact with your thyroid and how that interacts with your adrenal glands but there was there were there was still a piece of it that I felt like we weren't addressing yeah it was still like at the metrics based yeah it was and it was still allopathic medicine in many ways like instead of giving people drugs we were giving them supplements so it was natural medicine which is you know arguably better in many ways but it was still like the message was still there isn't a solution outside of you yeah so take something you have to come to me exist and I have to diagnose what's wrong with a bunch of lab tests and then I have to prescribe which supplements you need and that I was becoming increasingly clearly they knew what they needed to do it wasn't about the labs I was ordering it wasn't about the supplements there's a piece of that like functional medicine is great you know there's a piece of that of like subclinical hypothyroidism and you're feeling tired and you know things aren't going well in your life and you give people a little thyroid and they feel like a million bucks or they have adrenal fatigue or whatever so there's definitely a piece of that but I was getting the feeling that that was maybe 20% and that there was this 80% other that nobody had taught me about and I didn't really understand what it was so I got I got really curious at this point and I wound up leaving that practice and starting my own integrative medicine practice and I was committed to like I'm going to figure this out there's something here and so my patient intake form is interesting because you know I'm running this platinum program now that's a mentoring program where I'm working with primarily health care providers that are kind of looking to get outside of the system and the intake form that I created for my integrative medicine practice is almost exactly the same just as the application for my mentoring program because it's I was asked it's like a 10 page intake form that was asking people all the stuff you usually get asked by the doctor but then I also had 10 questions about your love life about your sex life about your spiritual life your creative life your professional life your financial life the environment in which you live and whether it's in alignment with your soul so my patients would come and be like wow I thought it was just going to the gynecologist you know but I learned so much in that practice and I really learned how I thought medicine should be practiced and in doing so I started really digging deep into the medical literature trying to figure out okay if this if this medicine piece that I was taught is maybe 20% and what is this other 80% that determines whether or not we're optimally healthy and the shocking findings that I found and that became mind over medicine which is the next book the next bug yeah so share some of what you discovered well I first saw I was really curious you know at all you and I have talked about this I I write what I need to learn you know I'm the same way I'm like I have questions I'm getting paid to kill like actually what I would want to learn anyway exactly so I had a series of questions and the questions led the investigation so the first question is there's all these New Age people talking about how you can heal yourself you know you got Louise Hay you can heal your life and all these people saying that you know you can say affirmations and it's going to affect the physiology of your body you can you know you can have use your mind to heal your body and I was like is that really true nobody's ever taught me that and I've never seen any proof of that right where's the data where's the data and I was reading all these you know mind-body medicine pioneer books by incredible people like dr. Bernie Siegel and Rachel Naomi Remen and Larry Dossey and so I started reading all these books you know like I read love medicine and miracles at this point Bernie sequel's book that sold like 2 million copies back in that I think 80s or 90s I forget exactly when it was published and it was fascinating like I was fascinated reading it but I kept reading it thinking but where's the data like I get this and this is written by a doctor so I wound up becoming friends with Bernie and I was like Bernie I want to see the data and Bernie said you know it's really I'm more interested in the stories like that's where I think there's so much healing in the stories and he's right there's so much healing in the stories and Rachel Naomi Remen also her books kitchen table wisdom and my grandfather's blessings like their incredible stories of healing and I was so touched by these and so like increasingly intuitively convinced by the stories but there was that piece of me that's like show me that I went to Duke in northwestern like I want to see this in the New England Journal of Medicine like I needed I needed for myself I needed some evidence that these stories that I was hearing were true so that's that was the first thing was like is it true that we can heal ourselves and I read an article in The New York Times that was all about the placebo effect so you know we all know about the placebo effect we all hear about it and certainly as a physician you know it's part of the vernacular but you know it's funny it's it's it's like it's like we've been asking this question for a long time and the medical establishment has been proving that you can heal yourself since the 1950s and yet we perceive the placebo effect as like a thorn in our side it's like it's always the outlier well it's what gets in the way of new treatments and surgeries being approved as better than nature taking its course right so nature taking its course is like that's the lowest common denominator right so the placebo effect means if a drug or a treatment is as good as the placebo effect then evidence-based medicine the conclusion says it doesn't work even if the placebo effect is 80% and the drug or the treatment is 80% then it doesn't work and so that that also started digging at me but wait a minute if if a placebo works 80 percent of the time for this condition that's pretty good like 80 percent it's pretty good like show you're just throwing it away because they're just focused on is this is it better is the pharmaceutical viable exactly is is it going to get FDA approval is the surgery any good so I started reading all of these studies about the placebo effect like one of them this guy Bruce Mosley he's a orthopedic surgeon this was fascinating so he had this great knee surgery he was like the go-to guy for sports medicine like you blow out your knee that's you read the same study it's fascinating as med shares I was gonna say you can feel free to tell the story so he had the brilliant idea of wanting to prove that his surgery was better than other surgeries so he wound up developing a great beautifully designed study where he had people that were getting his signature knee surgery and then he had a placebo surgery arm where people were also getting the same like set up you know they're going to the Ori I think they're getting they're awake so it's conscious sedation they're looking at the video monitor of like there's their knee but it's actually somebody else's knee that's been recorded being played on the video and he's down there making noise and splashing and you know turning on the power tools and doing all the things that you would do to make it sound like you're getting surgery so the patient doesn't know whether they're getting the real surgery or the placebo surgery they've signed informed consent so they know they might get one or the other and what they found was the people that got dr. Mosley's surgery got better and the people who got the placebo surgery got better at the same exact rate in fact at one point in the early healing process the people getting the placebo surgery did better than the people who were getting dr. Mosley surgery probably because all they had was little incisions right yeah all they had was little incisions on their knee but nobody had actually gone in and done anything so there was less trauma so what I found saddest about this I read a bunch of articles in interviewing dr. Moseley and what I found saddest about this is they asked him so what are you going to do with your surgery now and he said well clearly it doesn't work I got to stop and then they were interviewing all these people several years later who had gotten the placebo surgery and their knee pain had never come back and they said what do you think about this you got a fake surgery and they're like I don't care my knee pain is gone good so I got really curious in that like what's going on there you know what why are we making the conclusion that well it doesn't work so we should stop altogether and I get that if there's a better if there's a something that's been proven to be better than the placebo surgery but in this case there wasn't so you're starting to find data for this knee like all the claims of you know self healing the ability you know sort of exploring the bigger yang has potential to actually create some really profound well this I just got fascinated with all of this I mean like there was another study I was I became really fascinated especially with the placebo surgeries because there was something so radical about that right like one of the one of the the standard treatments for angina for chest pain historically was a surgery called mammary artery ligation so in this they'd open your chest and they'd go in and they'd take this artery that runs under the rib cage and they'd like ate the artery and the theory was if the blood isn't going through the internal mammary artery which wasn't you know necessary then it would get shunted and bypassed it would go over to the coronary arteries and you'd increase blood flow to the coronary arteries so 80% of people there ang and I got better when you did this surgery so it was standard treatment for years and then somebody decided to do a placebo surgery and they compared mammary artery ligation to you know open the chest and don't like ate the artery and 80% of people got better so to me that led me down to the next question which was is this just happening in people's minds like are they just is it just positive belief is it just that they think they're going to get better and somehow they do and if so what's the physiology behind that or is there actually something physiologic happening like if you went into their knee and looked at it would it get better like if you if you looked at their coronary arteries are they opening like was there any evidence that the body was physiologically you know changing as a result of these placebo you know groups and what I found was amazing like in these placebo trials like bronchi dilate like men in the Rogaine trials bald men getting Rogaine grew hair like here's my nose because I think about two years ago when my hair started jumping out of my head I was like huh should I try it and I actually started looking at the research behind it and I and I stumbled upon the placebo yeah statistics on Rogaine I was like wait a minute a whole bunch of people who took less evos actually started to have hair we grow hate that's incredible named you I and I'm like really like you can think your hair back totally maybe not everybody but to a surgeon and that blew me away that's crazy right because that type of physical outcome and change I was like wow yeah the opposite is also true really I never took it I got some sugar pills $10 no yeah so the opposite is also true if when you look at placebo studies when people are doing chemo chemotherapy trials if people think they're getting chemotherapy they lose their hair and vomit so there's something that's real it's happening ulcers are healing like if you go in and look at colons that are getting placebos there's they're less inflamed like there's measurable things that are happening warts are disappearing you know so I was like there must be something there's something that's going on related to this positive belief that comes around thinking you're in a clinical trial and that you're getting the new wonder drug because you don't know you're getting the placebo so I thought well that was so that was the next question is it just the positive belief or is there something else that's part of this placebo effect and that's when I found the data of Ted Kaptchuk he's this incredible guy who's who I've now been in communication with because I was fascinated by his data he is a Harvard researcher and he runs the place the program for placebo studies at Harvard and he's basically studying placebos intentionally because most of the placebo data is the side effect right pharmaceutical trials are trying to prove that your surgery to try because you have to track since the 1950s when we discovered that 18 to 80 percent of people get better when they're getting a placebo basically all peer-reviewed you know randomized controlled clinical trials include a placebo arm so you can prove that that you're true it really does work better than placebo so he actually got curious about like looking at the placebo really intentionally and he's published many many studies many of them in the New England Journal of Medicine in the Journal of American Medical Association like really good high-quality medical journals so I started looking at his data and he was really interested in is it the positive belief or is there something else and when I when I actually did an NPR interview and then I asked him some questions and he essentially was saying positive belief is a piece of it but he thinks it's actually much more so the nurturing care of a health provider hmm which is really interesting right because then it means self-healing sort of a misnomer he's like no it's really the love like it's really that people are going to the doctor they're in a clinical trial they're getting tended by nurses and doctors who believe in what they're doing and believe that they're helping the patient and that by holding that container for the patient and offering that hope that that in and of itself is happening so to test this he did a study where he was looking at people with irritable bowel syndrome and he was giving them a placebo and telling them this is a placebo there is no active ingredients here and comparing it to a no treatment group and the people getting the placebo got better even when they knew it was a placebo so that was further kind of supporting his idea and there's a ton of data I had a whole chapter in mind over medicine about the data proving that what your health care how your health care provider treats you and what they believe themselves like it is profoundly affecting outcomes so if your doctor really thinks you have a five percent five-year survival but there's a 95% chance you're going to die that is bad for you your outcome will actually be better if your doctor believes you're going to out you know you're going to you're going to survive your cancer so that was interesting to me too so now we have these two pieces of this positive belief this combination of positive belief and the nurturing care of a health care provider that's doing something to the physiology of the body so the next question was how like how is this happening how are you having this belief in the mind or this thought in the mind or this feeling that's coming from being held by a healthcare provider and how is that mental thought or feeling or belief translating into the physiology of the body and so that kind of fueled the next phase of my research and what I found was that there's a lot of data suggesting that the placebo effect probably works because it turns off what Walter Canon at Harvard called the stress response and turns on what Herbert Benson at Harvard called the relaxation response so when you look at that the theory is when you're sick and and you don't know what to do the reason people are going into clinical trials because things aren't working right if if their medical care was working they wouldn't need to be in a clinical trial so they're sick and things aren't going well so they join a medical trial and and then they get the nurturing care of health care providers and they get the positive belief that maybe they're getting the new wonder drug or the new wonder surgery and that combination relaxes the nervous system so when the stress response is activated you know the amygdala has this like threat feeling and the amygdala can't tell whether the threat is like you're getting chased by a cave bear or you're lonely or you're worried about your health like basically any fear-based anxiety based thought feeling or belief triggers the amygdala to communicate with the hypothalamus which then communicates with the pituitary gland which communicates with the adrenal gland and then you start getting all the stress hormones cortisol epinephrine norepinephrine and the stress response has kicked on the sympathetic nervous system goes crazy you get that whole fight-or-flight response the thing that I found fascinating I didn't know this this was like one of the most shocking things that I found in my data is that the but we know the body has like natural self-repair mechanisms right like if a protein breaks the body knows how to go in and fix that protein like we all make cancer cells every day the immune system goes in and takes care of it you know a foreign invader comes into the body the body like gets rid of it so we know this but what I didn't know is that those mechanisms only work when the relaxation response is in effect when the parasympathetic nervous system is operating so when the stress response is in charge your the body's natural self-repair mechanisms get flipped off right because it's not the priority if you think you're chasing you're getting chased by a caveman urges not supposed to die in the short term great right it turns off your GI tract it turns off your reproductive tract you know it all the blood flow is shunted to your large muscle groups and your lungs and you know trying to get you so that you can run away from the threat fight or flee the body isn't worried about self maintenance or preventative care when it's in that stress response and the body is and that's you know the studies show that that on average we have about 50 stress responses a day in modern society and if you're stressed at work if you're lonely if you're worried about your illness so you were just chronically ramped you're it's double that you're getting about a hundred stress responses per day so your body's always in this fight-or-flight sympathetic nervous system state where the body can't ever relax so it can't ever fix itself and for some reason if you give people a sugar pill or a fake surgery it shuts that down and the the relaxation resolve is with care you wrap it with love yeah you wrap it with love and that combination of being held and and having faith and this for me is where sort of some spiritual side of things come in you know sort of reclaiming the heart of medicine to me that's what being a healer is like that's what I did with those squirrels when I was a child I just loved them back to health and sometimes it worked and sometimes it didn't but at least it gave them the best shot that they could have so that so that I by that point I was convinced I was convinced that yes the body can heal itself and it has to be in the relaxation response in order for that to happen and so what the next question for me was what do we do with this information most of us aren't in clinical trials right are we supposed to go around taking sugar pills am I supposed to check myself into the surgery into an operating room to get a fake surgery you know so that my health condition gets better so it that that was really the next phase for me was how can i how can I help people activate that relaxation response turn off those stress responses and get the benefit of the placebo effect without necessarily having to go and take a sugar pill and I did a whole bunch of research into all the data that shows that basically doctors are using placebos against patients you know without their consent and there's a whole ethical dilemma around and I decided not to go there in the book like I actually personally think it would be great if every time you go see a new doctor they have you sign a consent form that says if you ever think of placebo will benefit me I agreed to take a sugar telcos there and they can just dole out sugar pills if they think it's going to benefit you at some point you know and then you've got given consent but that's that's a whole that's a whole other conversation I mean it's an amazing sort of like full circle for ya the time you were seven it's like you're you're back to the essence well and it took me even it took me back to the essence of that healer archetype but then it also took me back to the essence of what I started blogging about because again my intention without any pink was to write about you know getting in touch with your inner pilot light and and health and relationships and professional life and creativity and spirituality and sexuality and all these facets of what makes us whole and as I started doing the research for this and I was trying to find out how do we minimize stress responses how do we increase relaxation responses I started looking at the data on all those facets of our lives and I discovered for example that lonely people have twice the risk of heart disease as people who have a strong social network and I have you heard about the Roseto Pennsylvania data this is like one of the most fascinating stories a Malcom Gladwell wire Gladwell wrote about it in outliers ok so a lot of people have heard the story from then but it was the there was a study that came out of the 1960s in this town Roseto Pennsylvania right yeah that was a group of Italian immigrants that had come over and they'd set up shop in this tiny little mountain town that was very similar to the town that they were in in Italy and long story short basically the the local doctor had discovered that wow it's so interesting these people for whatever reason are not dying of heart disease and he you know he was talking to this researcher about this they were having a beer at the local pub and the researcher decided to look at the at the death certificates and determine whether that was in fact true and it was in fact true they had half the rate of heart disease of the rest of the country so they figured like there must be something in their diet they've got some gene there's you know they're doing something and they found that this community they were eating meatball Cole's fried in lard pasta pizza they're like drinking a bottle of red wine every night they're smokers they're working in a rock quarry like 12-hour days and they couldn't figure out like why are these people not getting heart disease and they were immune to many other health conditions when they started looking at them they just lived longer they were dying of old age and what they ultimately concluded was that these people live in multi-generational homes but they've got the Kennedys if you work yeah every day when they came home they were they would have these communal dinners they'd stop by everybody else's house and they ultimately determined that the reason they weren't dying because was because nobody was lonely that was huge fascinating to me it was so funny – it's like so many people like the the aspirational track when you become successful in life and make money is to pull yourself more and more out of community paint which is which is so fast because it leads to being more and more than happy more and more physical illness and fundamentally it also starts a degree performance also right and so it is really interesting when you look at all that the work you're doing is so fast me we could go on for a second because I want to let a lot more better stuff don't – all the risk of the geeking well they're all in mind over medicine yeah so I wrote it for the Nerds I can't wait to dive into that and really like parse it I'm curious what your response is to this question which I like to ask everybody as I wrap these conversations which is the name of this project is good luck project when you think about what it means to you to live a good life what comes up well I told you I started listening to that voice back when I left my job that voice that I call my inner pilot light that's just the voice of I don't know call it your divine spark your highest self your inner guidance your inner doctor whatever you want to call it the minute I started listening to that voice everything changed in my life it was it was pervasive it wasn't just my job that changed it was like my relationships got so much stronger my creative life became so much richer my spiritual life became so much deeper and all the kind of pieces of my life started falling into place in a way that I couldn't have even imagined it before and it was such a simple thing to just start to get quieter and get less busy and start trusting that voice so to me a good life is about listening to that voice and being willing to align your life with your personal truth and to really fully self actualize – I think so often we we wear these masks and we conform to what society wants us to be and I did that for years you know it's sort of makes me sad I have to grieve sometimes how many years I lost living that way but the more I'm willing to have the courage to face my truth because my truth isn't always popular right like what's true for me may go against convention it may you know it may put me at risk of criticism but the more again the more I align with that truth and take action to make choices in my life like whether it's quitting my job or writing a book like this that I'm really kind of scared about because it's very it's lies in the face of everything that I learned as a physician so I'm a little nervous about getting burned at the stake you know but the braver I get and the more I'm willing to just kind of live my life out of the box the better my life gets and the better the lives of the people that are important to me get and so when it comes right down to it I mean really what is a good life it's having a life filled with love like living with an open heart like you know having your life have meaning and purpose and being in alignment with your what your soul is here on this earth to do but I could go on about that one I won't I'll leave it it is beautiful I love that thank you so much been incredible conversation have you learned a lot and my head is spinning with things so my guest again today has been listening I can the author of mind over medicine physician Explorer of the world and life i'm jonathan field signing off project

24 comments

  1. What an incredible woman, ad yet more people follow Kim Kardashian than they do this incredible person. How sad.

  2. I want to believe in her but when she states she's in her third marriage, I get scared and wonder about her decision-making? I like what she says, and I want to believe her, but 10 yrs later, will she be doing something totally different?

  3. She has made the journey from practicing doctor to media high earner, don't be fooled ,these videos are nothing more the advertisements

  4. I am from Kerala, a small state in India, this tiny state with a per ca pita yearly income of less than $1200/- per capita consumption, over eight litres (1.76 gallons) per person per year.
    Infant Mortality rate (SRS 2013) 12
    Maternal Mortality Rate (SRS 2010-12) 66
    Life expectancy at birth (Male) 71.40
    Life expectancy at birth (Female) 76.30
    Life expectancy at birth (Average) 74.00 and state has the lowest doctor density in India with some of its cities having just 0.2 doctors for every 1,000 people.

  5. I understand you might be nervous depending on who your guest is but I can't watch this. You keep cutting her off with questions while she's developing on her thoughts. Sry it just breaks the flow it's very painful to watch, learn to relax so you can listen the ppl you are interviewing pls.

  6. I am an Indian and I feel that modern medicine is gravitating towards ancient indian methodologies of yoga, meditation, relaxation, stress relief and self healing. I have been practising all of these myself and realised how effective they were both to handle stress and remain detached from materialistic desires. With the death of my wife and a child of 13 years to take care my parental obligations took the better of me and I took recourse to Indian methods of mental well being which paid rich dividends.
    R. Srinivasan

  7. please, hold on until 52:20 – its worth it!
    LOVE over Medicine! Hug, Lissa!.. and yes, it was not expected to last long, and indeed it took less than three years and we do make it work!

  8. I remeber the studies of witch doctors I believe in Africa in particular Who would convince people they were going to die because they had disobeyed some god. They fell down and evidently believe him and all of them ( Some of them young people) died in minutes. After in a few cases forensic doctors from the U.S. could find no real medical reason for their deaths.

  9. Mind over medicine is true in some cases, not all the time true ..we still need medicine and drugs to cure our sickness but not to abuse them …. burn out due to over work will shorten our life ….. she shown a basic burnout by quit out physician job …. she could tell us more about physician routine work on a patient (as by the book and insurance charging …)

  10. Thank you so much for this my pain was leaving my body as this interview went on and I feel so much better,,,,

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